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    Alveolar Ostitis

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    Aamir Bidiwala
    Alveolar osteitis, commonly known as dry socket, is a painful condition that can occur after a tooth extraction where the blood clot in the extraction socket becomes dislodged prematurely. It typically develops 1-3 days after the extraction and causes increasing pain in and around the extraction site. Risk factors include difficult extractions, smoking, oral contraceptives, and inadequate clot formation after the procedure. Treatment focuses on pain management and prevention through careful extraction technique, minimizing trauma, and ensuring proper clot formation after tooth removal.

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    Alveolar Ostitis

    Uploaded by

    Aamir Bidiwala
    65 views8 pages
    Alveolar osteitis, commonly known as dry socket, is a painful condition that can occur after a tooth extraction where the blood clot in the extraction socket becomes dislodged prematurely. It typically develops 1-3 days after the extraction and causes increasing pain in and around the extraction site. Risk factors include difficult extractions, smoking, oral contraceptives, and inadequate clot formation after the procedure. Treatment focuses on pain management and prevention through careful extraction technique, minimizing trauma, and ensuring proper clot formation after tooth removal.

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    Alveolar osteitis, commonly known as dry socket, is a painful condition that can occur after a tooth extraction where the blood clot in the extraction socket becomes dislodged prematurely. It typically develops 1-3 days after the extraction and causes increasing pain in and around the extraction site. Risk factors include difficult extractions, smoking, oral contraceptives, and inadequate clot formation after the procedure. Treatment focuses on pain management and prevention through careful extraction technique, minimizing trauma, and ensuring proper clot formation after tooth removal.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    65 views8 pages

    Alveolar Ostitis

    Uploaded by

    Aamir Bidiwala
    Alveolar osteitis, commonly known as dry socket, is a painful condition that can occur after a tooth extraction where the blood clot in the extraction socket becomes dislodged prematurely. It typically develops 1-3 days after the extraction and causes increasing pain in and around the extraction site. Risk factors include difficult extractions, smoking, oral contraceptives, and inadequate clot formation after the procedure. Treatment focuses on pain management and prevention through careful extraction technique, minimizing trauma, and ensuring proper clot formation after tooth removal.

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    © All Rights Reserved
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    ALVEOLAR OSTITIS

    DR. AAMIR BIDIWALA


    INTRODUCTION

    • One of the most common postoperative complications following the extraction of


    permanent teeth is a condition known as dry socket.
    • This term has been used in the literature since 1896, when it was first described by
    CRAWFORD.
    • Since then, several other terms have been used in referring to this condition, such as
    alveolar osteitis (AO), localized osteitis, postoperative alveolitis, alveolalgia, alveolitis sicca
    dolorosa, septic socket, necrotic socket, localized osteomyelitis, and fibrinolytic alveolitis.
    DEFINITION

    • Postoperative pain in and around the extraction site, which increases in severity at any time
    between 1 and 3 days after the extraction accompanied by a partially or totally disintegrated
    blood clot within the alveolar socket with or without halitosis.(I.R. Blum 2002)
    • The incidence of AO has been reported as 3–4% following routine dental extractions and ranges from 1% to 45% after the
    removal of mandibular third molars.

    • Early and recent studies have reported that AO onsets 1–3 days after tooth extraction and within a week between 95% and
    100% of all cases of AO have been registered.
    AETIOLOGY

    • Actinomyces viscosus and Streptococcus mutans in AO was highlighted by Rozanis et al.


    • Plasmin-like fibrinolytic activities from cultures of the anaerobe Treponema denticola.
    • Difficulty and trauma during surgery and AO.
    • Roots or bone fragments remaining in the wound and AO.
    • Excessive irrigation or curettage of the alveolus after extraction and AO.
    • Physical dislodgement of the clot and AO.
    • Local blood perfusion, anaesthesia and AO.
    • Oral contraceptives and AO.
    • Smoking and AO Sweet
    PATHOGENESIS

    Tissue injury

    Release of kinase from the tissue

    Activation of Plasminogen in Fibrin

    Conversion of plasminogen into


    plasmin.

    Lysis of Blood Clot


    PROPHYLACTIC MANAGMENT

    • A summary of non-pharmacological measures to prevent AO.


    • Use of good quality current preoperative radiographs.
    • Careful planning of the surgery. Use of good surgical principles. Extractions should be performed with minimum
    amount of trauma and maximum amount of care
    • Confirm presence of blood clot subsequent to extraction (if absent, scrape alveolar walls gently).
    • Wherever possible preoperative oral hygiene measures to reduce plaque levels to a minimum should be
    instituted.
    • Encourage the patient (again) to stop or limit smoking in the immediate postoperative period.
    • Advise patient to avoid vigorous mouth rinsing for the first 24 h post extraction and to use gentle
    toothbrushing in the immediate postoperative period.
    • For patients taking oral contraceptives extractions should ideally be performed during days 23 through 28 of
    the menstrual cycle.
    • Comprehensive pre- and postoperative verbal instructions should be supplemented with written advice to
    ensure maximum compliance.
    • Antibacterial agents – penicillins, clindamycin, Erythromycin and metronidazole.
    • Antiseptic agents and lavage- Chlorhexidine (CHX) is a bisdiguanide antiseptic with
    antimicrobial properties.
    • Antifibrinolytic agents- alveolar cone with a formulation of 32 mg acetylsalicylic acid, 3 mg
    propyl ester of PHBA and Tranexamic acid
    • Steroid anti-inflammatory agents: - The topical application of a hydrocortisone and
    oxytetracycline mixture however, has been shown to significantly decrease the incidence of
    AO after the removal of impacted mandibular third molars.
    • Obtundent dressings: - eugenol containing dressing.
    • Clot support agents: - a biodegradeable ester polymer, polylactic acid (PLA) was widely
    promoted as the ultimate solution for preventing AO

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