706 results on '"dry socket"'
Search Results
2. Efficacy and Safety of Concentrated Growth Factor Fibrin on the Extraction of Mandibular Third Molars: A Prospective, Randomized, Double-Blind Controlled Clinical Study
- Author
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Feng Xiao, Chengjing Li, Dongdong Fang, Wenyu Yang, Dan Li, and Zhangbiao Long
- Subjects
Molar ,Bone density ,Visual analogue scale ,Dentistry ,Bone healing ,Trismus ,Mandibular second molar ,Humans ,Medicine ,Prospective Studies ,Bone regeneration ,Fibrin ,Pain, Postoperative ,business.industry ,Tooth, Impacted ,medicine.disease ,body regions ,Dry socket ,Otorhinolaryngology ,Tooth Extraction ,Intercellular Signaling Peptides and Proteins ,Molar, Third ,Surgery ,Oral Surgery ,medicine.symptom ,business - Abstract
To investigate the efficacy and safety of concentrated growth factor fibrin (CGF) for the extraction of mandibular third molars.This was a randomized, double-blind, and controlled clinical study. Patients who underwent mandibular impacted tooth extraction were randomly divided into 2 groups. In the CGF group, the tooth extraction fossa was utilized to place CGF gel. In the control group, the fossa was filled with serum. The visual analogue scale (VAS), reductions in swelling and trismus, incidence of postoperative dry socket, distal periodontal depth and bone regeneration of the second molar, and bone density (BMD) of the extraction fossa at 24 weeks were evaluated.One hundred eighteen patients were enrolled in this study. There was no significant difference in baseline clinical characteristics between the 2 groups. The pain score of the CGF group was significantly lower than that of the control group at 2, 24, and 48 hours after operation. There was no significant difference in the reduction in swelling or trismus between the 2 groups. There were no cases of dry socket in the CGF group and 3 cases of dry socket in the control group. The periodontal probing depth and bone regeneration of the second molar when the socket was implanted with CGF were better than those that healed naturally (P.05). The bone mineral density of each group was significantly increased at 24 weeks but was significantly different between groups (P.05).CGF can effectively reduce reactive tooth extraction pain and help avoid dry sockets. It can promote periodontal tissue and bone healing in distal and extracted sockets.
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- 2022
3. Retrieval of foreign body from maxillary sinus through extraction socket
- Author
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Harish Saluja, Seemit Shah, Anuj Dadhich, and Kumar Nilesh
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Adult ,Male ,Maxillary sinus ,Dentistry ,Dry Socket ,Case Report ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Radiography, Panoramic ,medicine ,Maxillary first molar ,Humans ,030223 otorhinolaryngology ,business.industry ,Extraction (chemistry) ,030206 dentistry ,General Medicine ,Maxillary Sinus ,medicine.disease ,Foreign Bodies ,Molar ,Dry socket ,medicine.anatomical_structure ,chemistry ,Zinc oxide eugenol ,Tooth Extraction ,Oral and maxillofacial surgery ,Foreign body ,Osteitis ,business - Abstract
Dry socket or alveolar osteitis is one of the most common complication following tooth extraction. Patients usually reports of pain, which typically starts on third or fourth postoperative day and responds to simple irrigation and placement of zinc oxide eugenol (ZOE) pack, which provides an obtundent effect. The pack should be loosely kept in the extraction socket and should be changed periodically to allow healing. This report presents a case of retrieval of foreign body, which actually was a ZOE pack from maxillary sinus, 6 months after the patient underwent extraction of upper left maxillary first molar.
- Published
- 2023
4. Antibiotics in Dentoalveolar Surgery, a Closer Look at Infection, Alveolar Osteitis and Adverse Drug Reaction
- Author
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Simra Azher and Amish Patel
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medicine.medical_specialty ,Drug-Related Side Effects and Adverse Reactions ,Osteoradionecrosis ,medicine.medical_treatment ,Dry Socket ,Context (language use) ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Dental implant ,Intensive care medicine ,Adverse effect ,business.industry ,Amoxicillin ,030206 dentistry ,Antibiotic Prophylaxis ,medicine.disease ,Anti-Bacterial Agents ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Infective endocarditis ,Surgery ,Oral Surgery ,Osteitis ,business ,Osteonecrosis of the jaw ,Adverse drug reaction - Abstract
Purpose To execute an evidence-based review answering the following questions: “What antibiotic type and mode of delivery are most effective at reducing inflammatory complications in third molar and dental implant surgery? What are the types and rates of antibiotic-related adverse reactions in the context of third molar surgery, infective endocarditis, medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN)?” Material and Methods We performed a comprehensive literature review of peer-reviewed studies using MEDLINE/PubMed, Cochrane, Scopus/Elsevier, Google Scholar, and Wiley online library databases. Results Twenty-five studies were reviewed for third molar surgery. Although there is some evidence that systemic antibiotics reduce inflammatory complications (infection and alveolar osteitis), routine use is not recommended for third molar surgery. For at-risk cases, a single preoperative dose of amoxicillin is preferred. Clindamycin, amoxicillin-clavulanic acid and erythromycin have a high adverse risk profile. Eight studies were reviewed for dental implant surgery. Antibiotics with dental implant placement showed little reduction in post surgery infection and minimal improvement in long-term success. A comprehensive search found limited data on antibiotic-related adverse effects in the context of infective endocarditis, MRONJ and ORN. Conclusions A set of clinical recommendations are presented to better guide evidence-based and standardized antibiotic usage on the basis of the literature discussed in this review. This review highlights the need for further research focusing on antibiotic type and timing of delivery with adverse drug reaction as a primary outcome measure when assessing treatment outcomes and complications in dentoalveolar surgery. This will better elucidate the risks vs benefits of antibiotic in dentoalveolar surgery.
- Published
- 2021
5. Clinical management of alveolar osteitis. A systematic review
- Author
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Eduardo Piemonte, Gerardo Gilligan, René Panico, Federico Garola, and Nicolás Leonardi
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medicine.medical_specialty ,impacted tooth ,Visual analogue scale ,Psychological intervention ,Pain relief ,MEDLINE ,Dry Socket ,Review ,Cochrane Library ,Pain control ,Platelet-Rich Fibrin ,Medicine ,Humans ,Pain Management ,third molar ,General Dentistry ,UNESCO:CIENCIAS MÉDICAS ,business.industry ,antibiotic prophylaxis ,surgical wound infection ,medicine.disease ,Clinical trial ,Otorhinolaryngology ,Tooth Extraction ,Physical therapy ,Surgery ,Osteitis ,Oral Surgery ,business - Abstract
Background Alveolar Osteitis (AO) is one of the most common complications of tooth extraction. Several therapeutic interventions have been described for the treatment of AO, however, there are no treatment standardized protocols. The aim of this study was to conduct a systematic review on the efficacy in pain control of the different treatments for AO. The feasibility of the application of these interventions is also discussed. Material and Methods A structured electronic and hand search strategy was applied to PubMed, Scopus, Cochrane Library, OpenGrey, and Google Scholar between January 2010 and July 2020 to identify studies according to PRISMA guidelines. The inclusion criteria were original English and Spanish clinical trials that analyzed pain-control parameters according to visual analog scale (VAS, 0-10 scale), or pain relief patients’ percentages. Those treatments that reach VAS ≤ 4 on day 2 or before; or ≥ 85% of patients with absence of pain symptoms at day 7 or before were considered accepTable for their recommendation. Results The final review included 17 clinical trials. Among them, there were analyzed a total of 39 different AO treatments. 53,8% of the treatments fulfill the proposed parameters for pain control. Conclusions Treatment alternatives are multiple, heterogeneous, and difficult to compare. The management of AO is summarized in basic (intra-alveolar irrigation) and specific procedures (Alveogyl®, Neocones®, SaliCept Patch®, Low-Level Laser, Platelet-Rich Fibrin) that reach pain control success. They could be selected according to their availability and advantages or disadvantages. Key words:Dry socket, alveolar osteitis, treatment, management, pain control, pain relief.
- Published
- 2021
6. Effectiveness of warm saline mouth bath in preventing alveolar osteitis: A systematic review and meta-analysis
- Author
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Wasiu Lanre Adeyemo, Olufemi Erinoso, Adegbayi Adeola Adekunle, and Uchenna P. Egbunah
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medicine.medical_treatment ,Population ,Mouthwashes ,Dry Socket ,Dentistry ,law.invention ,Postoperative Complications ,Randomized controlled trial ,law ,medicine ,Humans ,education ,Saline ,education.field_of_study ,business.industry ,medicine.disease ,Clinical trial ,Dry socket ,Otorhinolaryngology ,Dental extraction ,Meta-analysis ,Tooth Extraction ,Surgery ,Saline Solution ,Oral Surgery ,Osteitis ,business - Abstract
This systematic review and meta-analysis aimed to assess the effectiveness of a warm saline mouth bath (WSMB) in preventing dry socket after tooth extractions. A systematic search for randomized controlled trials published until August 30, 2020, in seven databases was conducted: Cochrane, PubMed, Ovid Medline, Google Scholar, and OpenGrey databases, ClinicalTrials.gov , and the World Health Organization International Clinical Trials Registry. The inclusion criteria were studies investigating the use of a warm saline mouth bath postoperatively in a population of participants who had a tooth extraction, compared to no mouth rinse at all/any other mouth rinse. The primary outcome assessed in the studies was the incidence of alveolar osteitis. Only eight randomized studies met all inclusion criteria and were selected for qualitative analysis. Six of the studies compared WSMB with antimicrobial rinses, and two studies compared WSMB with no-rinse. This review found no significant difference (P > 0.05) in the incidence of alveolar osteitis between WSMB and other antimicrobial rinses. Based on the results of this review, WSMB has potential in reducing post-operative complications such as alveolar osteitis following a routine or surgical extraction of teeth. However, more studies are needed to validate these findings, as most of the studies reviewed had a high level of bias.
- Published
- 2021
7. Risk Factors for Post-Tooth Extraction Complications in HIV-Infected Patients: a Retrospective Study
- Author
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Yasuyuki Shimada, Ritsuo Takagi, Yutaka Maruoka, Yohei Kawasaki, Y. E. Nakagawa, Takahiro Aoki, Haruhito Honda, Yusuke Takanabe, and Shinichi Oka
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Anti-HIV Agents ,030106 microbiology ,Dry Socket ,HIV Infections ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Humans ,Surgical Wound Infection ,Medicine ,Blood test ,030212 general & internal medicine ,Risk factor ,Aged ,Retrospective Studies ,Aged, 80 and over ,AIDS-Related Opportunistic Infections ,medicine.diagnostic_test ,business.industry ,Medical record ,Postoperative complication ,Retrospective cohort study ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,CD4 Lymphocyte Count ,Surgery ,Infectious Diseases ,Dental Care for Chronically Ill ,Tooth Extraction ,Female ,Osteitis ,business - Abstract
We aimed to assess the rate and risk factors of postoperative complications following tooth extraction in HIV-infected patients by CD4 count. The study participants were 231 HIV-infected patients who underwent tooth extraction at our institution between January 2007 and December 2011. Blood test results, underlying diseases, surgical site, extraction method, and postoperative complication data were obtained from medical records. Potential risk factors of postoperative complications were analyzed using multivariate logistic regression. Patients were divided into two groups: 61 (26%) patients with a CD4 count < 200/μL, and 170 (74%) with a CD4 count ≥ 200/μL. Of the 231 patients, 12 (5.2%) developed postoperative complications (alveolar osteitis, n = 10; surgical site infection, n = 2). The rate of complications did not differ between the CD4 < 200/μL group (1.6%) and the CD4 ≥200/μL group (6.5%) (adjusted odds ratio [aOR]: 9.328, 95% confidence interval [CI]: 0.470, 185.229; P = 0.1431). Surgical extraction with bone excavation, but without CD4 count, was identified as a risk factor for post-extraction complications (aOR: 22.037, 95% CI: 1.519, 319.617; P = 0.0234). A low CD4 count is not a risk factor for post-extraction complications in patients with HIV infection. We conclude that tooth extraction should be performed based on dental/oral conditions, and not delayed until CD4 count improvement.
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- 2021
8. The efficacy of minocycline hydrochloride ointment versus iodoform gauze for alveolar osteitis: A prospective cohort study
- Author
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Yu-Qi, Sun, Rui, Sun, and Ji-Hong, Zhao
- Subjects
Ointments ,Tooth Extraction ,Tooth, Impacted ,Humans ,Dry Socket ,Pain ,Minocycline ,Molar, Third ,Prospective Studies ,General Dentistry - Abstract
Background Alveolar osteitis (AO) is one of the most commonly encountered complication following tooth extraction, however, to date there is no standard methods of prevention and treatment. The study aims to investigate the efficiency of minocycline hydrochloride ointment (MHO) for the treatment of alveolar osteitis compared with traditional treatment with iodoform gauze (IG). Methods/design STROBE checklist was followed to report this study. All patients underwent tooth extraction either in our department or other hospitals, whom presented with postoperative pain, were screened out to meet the inclusion and exclusion criteria of this study about AO. Patients who fulfilled the inclusion criteria were enrolled in our prospective cohort study, and MHO or IG was administered. The Visual analog scale scores were used to assess the pain score of patients. The healing status of the extraction sockets was followed up. Differences in responses between groups were analyzed using Mann-Whitney U tests. Chi-square test was performed to explore the differences in the teeth position of AO. Results Of 41,371 patients underwent tooth extraction with post-operative follow-up in our departments, only 20 patients (0.05%) suffered from AO. 31 patients with AO, whose teeth were extracted in other places, were also enrolled. The incidence of AO was significantly higher in third molars than other teeth (P Conclusion MHO has a safer and higher therapeutic effect in the treatment of AO compared with traditional treatment with IG. MHO may become a preferred treatment modality for AO.
- Published
- 2022
9. Alveolar osteitis associated with methicillin-resistant Staphylococcus epidermidis
- Author
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Alessio, Buonavoglia, Adriana, Trotta, Marco, Cordisco, Fausto, Zamparini, Marialaura, Corrente, and Carlo, Prati
- Subjects
Adult ,Methicillin-Resistant Staphylococcus aureus ,Staphylococcus epidermidis ,Dry Socket ,Humans ,Female ,Methicillin Resistance ,Microbial Sensitivity Tests ,Azithromycin ,Staphylococcal Infections ,Anti-Bacterial Agents - Abstract
A critical point in dentistry is the empiric prescription of broad-spectrum antibiotics that could increase the levels of antimicrobial resistance. Alveolar osteitis is one of the most common post-op- erative complications in which antibiotic use is controversial. A 35-year-old female, with pain in the right mandibular region and treated with cefixime, was diagnosed with cracked tooth syndrome and pulpitis. The tooth was extracted and a massive purulent bleeding drainage was observed. Irrigation of the socket and a new therapy with azithromycin were done. Bacteriological analysis, a specific mecA gene PCR for the methicillin resistance, and the antimicrobial susceptibility test were per- formed on the bacterial isolate. A Staphylococcus epidermidis isolate was methicillin-resistant and showed resistance to erythromycin, azithromycin, clarithromycin, and sulfamethoxazole + trimeth- oprim. After 7 days, intraoral examination showed a complete resolution. The aim of this report is to suggest that systemic antibiotics may provide insufficient efficacy during alveolar osteitis, especially when caused by a multidrug-resistant organism.
- Published
- 2022
10. Improved access to the bone marrow space by multiple perforations of the alveolar bundle bone after tooth extraction—A case report
- Author
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Kristina Bertl, Andreas Stavropoulos, Toni Dobsak, Azadeh Esfandeyari, Christian Ulm, and Georg D. Strbac
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Bundle bone ,business.industry ,Dentistry ,Osteoblast ,Alveolar Ridge Augmentation ,Odontologi ,medicine.disease ,Dry socket ,medicine.anatomical_structure ,Bone Marrow ,Lamina dura ,Bone Substitutes ,Tooth Extraction ,Alveolar Process ,Alveolar ridge ,medicine ,Humans ,Cortical bone ,Tooth Socket ,business ,Bone regeneration ,General Dentistry ,Dental alveolus - Abstract
Objectives. The dental alveolus is lined by a thin cortical layer (“bundle bone”, “alveolar bone proper”, “cribriform plate”, “lamina dura”), that can impede access to the bone marrow and its vasculature. During unassisted socket healing, the alveolar bundle bone is gradually resorbed allowing tissue resources from the bone marrow to enter into the socket space. An optimized wound healing process, either during unassisted socket healing or during ridge preservation procedures, with autogenous bone and/or any bone/collagen substitute material, depends at least partly on an adequate vascularization of the socket space. This ensures sufficient recruitment of osteoblast and osteoclast precursor cells and facilitates fast bone regeneration and/or uneventful integration of the augmentation material. Methods. The present technical note describes an easy treatment step after tooth extraction aiming to improve socket healing with or without any ridge preservation procedure, by facilitating an increased blood inflow into the dental alveolus. Specifically, after tooth extraction the alveolar bundle bone is perforated several times – mainly in a palatally/lingually – by a small round bur (diameter < 1 mm) extending into the trabecular bone. Results and conclusions. By means of this relatively simple treatment step, an increased blood inflow into the alveolus is achieved after tooth extraction, which might enhance socket healing and corticalization of the entrance, and in turn result in a lower complication rate (e.g., dry socket), in an enhanced graft incorporation, and/or in a reduced loss of alveolar ridge volume.
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- 2021
11. Effect of Photobiomodulation on the Incidence of Alveolar Osteitis and Postoperative Pain following Mandibular Third Molar Surgery: A Double‐Blind Randomized Clinical Trial
- Author
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Majid Abrishami, AmirHossein Nejat, Majid Eshghpour, Reza Fekrazad, Farshid Vahdatinia, and Nasrin Danaeifar
- Subjects
Molar ,Postoperative pain ,Dry Socket ,Dentistry ,Biochemistry ,law.invention ,Double blind ,Mandibular third molar ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,stomatognathic system ,Randomized controlled trial ,law ,Humans ,Medicine ,Physical and Theoretical Chemistry ,Pain, Postoperative ,business.industry ,Incidence ,Incidence (epidemiology) ,030206 dentistry ,General Medicine ,medicine.disease ,Clinical trial ,030220 oncology & carcinogenesis ,Tooth Extraction ,Molar, Third ,Osteitis ,business - Abstract
The current study aimed to evaluate the effectiveness of photobiomodulation therapy for the prevention of incidence of alveolar osteitis (AO) and postoperative pain following third molar surgery. In this double-blind clinical trial, the impacted teeth of patients having bilateral impacted mandibular third molars were surgically extracted; for each participant, one socket was randomly assigned to receive photobiomodulation treatment, the other received sham treatment. 660 nm 200 mW CW was applied at a distance of ~1cm to 4 points on the occlusal area of extraction socket (beam area at the tissue ~0.64 cm2 , 312.5 mW cm-2 , 1J, 1.6 J cm-2 ). Also, 810 nm 200 mW CW was applied at tissue surface at three points on the buccal and three points on the lingual gingiva, for 15 s (400 mW cm-2 , 3 J, 6 J cm-2 ). There was a statistically meaningful difference in AO frequency between the two groups, and the photobiomodulation group showed lower AO frequency compared with the sham PBM treatment (P-value = 0.035). According to the findings of this study, photobiomodulation therapy reduced the incidence of AO following surgical removal of impacted mandibular third molars. The incidence of AO typically occurs 3-7 days post-extraction, and our results suggest that PBM treatment within the 7 days could help reduce the risk of AO development.
- Published
- 2021
12. Three-Dimensional evaluation of the effect of platelet-rich fibrin on edema in lower impacted third molar surgery performed with piezosurgery
- Author
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MF Senturk and B Konuk
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Pain, Postoperative ,Platelet-Rich Fibrin ,Tooth Extraction ,Tooth, Impacted ,Dry Socket ,Edema ,Humans ,Molar, Third ,General Medicine ,Prospective Studies ,Piezosurgery - Abstract
Platelet-rich fibrin (PRF) are widely used in impacted lower third molar (IL3M) 7 surgery and its effect on postoperative edema was generally analysed with linear methods.To analyze the effectiveness of platelet-rich fibrin (PRF) applied to the socket after tooth extraction in impacted lower third molar (IL3M) surgery performed with piezosurgery in the reduction of edema observed in the postoperative period, together with conventional (linear) and three-dimensional (volumetric) measurement methods.The study was designed as a prospective randomized split-mouth study and was conducted on 30 patients with bilateral IL3M teeth. Extraction of the patients' IL3M teeth was performed in the same session with the help of piezosurgery. After the extraction, PRF was randomly applied to one socket, but it was not applied to the other socket, which formed the control group. On the first, second, and seventh days after the procedure, volume was measured using 3dMD, and the distance between the topographic guide points was measured using a flexible ruler. The results were analyzed statistically. Alveolar osteitis (AO) presence was also recorded.A significant improvement in edema was observed in both groups, but no significant difference was found between the groups (P0.05). A moderate correlation was found between the two methods of measuring edema. AO was not seen in any patient.Although PRF reduces edema after IL3M tooth extraction and 3dMD is effective in its evaluation, it has no statistical advantage over classical methods.
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- 2022
13. Microbiota of alveolar osteitis after permanent tooth extractions: A systematic review
- Author
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Eduard Valmaseda-Castellón, Jorge Toledano-Serrabona, Laura Aguilar-Duran, Adrià Jorba-García, N. Riba-Terés, and Rui Figueiredo
- Subjects
medicine.medical_treatment ,Dry Socket ,Dentistry ,Cochrane Library ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Humans ,Medicine ,030223 otorhinolaryngology ,biology ,business.industry ,Microbiota ,Postoperative complication ,030206 dentistry ,Bacteria Present ,biology.organism_classification ,medicine.disease ,Peptostreptococcus ,stomatognathic diseases ,Dry socket ,Otorhinolaryngology ,Dental extraction ,Fusobacterium ,Tooth Extraction ,Molar, Third ,Surgery ,Oral Surgery ,Osteitis ,business - Abstract
Alveolar osteitis (AO) or dry socket after dental extractions is a common postoperative complication characterized by the presence of severe pain associated with an empty socket. Although some authors consider AO to be related to an alteration of the blood clot, the underlying etiology remains unclear, and recent reports suggest that bacteria might play an important role. A systematic review was made, compiling relevant references from PubMed, the Cochrane Library, Scopus and the Web of Science databases to determine which bacteria have been identified in AO sockets after dental extractions. Papers published between 1980–2019, identifying the bacteria present in AO sockets after tooth extractions, were included. Data were displayed in tables, and a descriptive analysis was carried out. After the screening process, four papers were analyzed, comprising a total of 138 samples from 138 patients with AO. The most commonly detected bacteria were Prevotella, Fusobacterium, Parvimonas and Peptostreptococcus. Two studies also showed the microbiota of patients that developed AO after dental extractions to be apparently different from that of patients without postoperative complications. These results indicate that bacteria may play an important role in the pathogenesis of AO, though further studies are needed to confirm these findings.
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- 2021
14. Effect of platelet-rich fibrin on the control of alveolar osteitis, pain, trismus, soft tissue healing, and swelling following mandibular third molar surgery: an updated systematic review and meta-analysis
- Author
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J. Wang, X. Yuan, Sheng Zhang, J. Zhu, B. Xu, T. He, and H. Liu
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medicine.medical_specialty ,Dry Socket ,Cochrane Library ,Trismus ,03 medical and health sciences ,0302 clinical medicine ,Platelet-Rich Fibrin ,medicine ,Humans ,Pain, Postoperative ,business.industry ,Tooth, Impacted ,Soft tissue ,030206 dentistry ,medicine.disease ,Platelet-rich fibrin ,Confidence interval ,Surgery ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Meta-analysis ,Relative risk ,Tooth Extraction ,Molar, Third ,Oral Surgery ,medicine.symptom ,Osteitis ,business - Abstract
The purpose of this study was to estimate the effect of platelet-rich fibrin (PRF) on the control of alveolar osteitis (AO), pain, trismus, soft tissue healing, and swelling following mandibular third molar surgery. A comprehensive search of the literature was conducted through PubMed, Embase, Web of Science, and Cochrane Library up to May 2019. Randomized controlled studies conforming to the inclusion criteria were included. The record screening and data extraction were conducted by two authors independently. The risk of bias assessment was performed according to the guidelines recommended by the Cochrane Collaboration. The quantitative analysis was performed using RevMan version 5.3. Nineteen studies were included in the systematic review and 17 studies were eligible for the meta-analysis. The use of PRF significantly reduced the incidence of AO and postoperative pain when compared to the controls (AO: relative risk 0.43, 95% confidence interval (CI) 0.28 to 0.65, Z = 3.90, P
- Published
- 2021
15. Prevention of dry socket in mandibular 3rd molars by means of single preoperative oral dose of metronidazole and amoxicillin compared to conventional therapy
- Author
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null Tahseen shabbir Khooharo, null Sayed Umer Hassan, null Abdul Hafeez Shaikh, and null Admin
- Subjects
Male ,Molar ,Dry Socket ,Dentistry ,law.invention ,Randomized controlled trial ,law ,Metronidazole ,medicine ,Humans ,business.industry ,Incidence (epidemiology) ,Tooth, Impacted ,Amoxicillin ,General Medicine ,medicine.disease ,Clinical trial ,Dry socket ,Tooth Extraction ,Oral and maxillofacial surgery ,Female ,Molar, Third ,business ,medicine.drug - Abstract
Objective: To compare the efficacy of metronidazole and amoxicillin as preoperative single dose treatment with conventional therapy in prevention of dry socket. Methods: A double blind randomized control trial; patients attending the oral and maxillofacial surgery OPD at DUHS Karachi requiring surgical extraction of madibular 3rd molar during October 2018 till April 2019 were randomly divided into 3 groups. Ethical approval was taken from Institutional Review Board of DUHS Karachi. Consent from patients was also taken. First group was given single preoperative oral dose of 400mg metronidazole one hour before extraction, second group was treated with single oral dose of 500mg amoxicillin an hour before tooth extraction, and both of the groups were given painkillers postoperatively. Third group was given 500mg of Amoxicillin BD, 400mg of metronidazole and painkillers postoperatively. Every group had a follow-up on fifth postoperative day. Results: Dry socket was reported among 19 patients (8.4 %) amongst them 4 were males and 15 were females. Chi-square test was used to calculate the p-value (0.066). Results of the present trial were statistically insignificant. Incidence of dry socket in amoxicillin group was 3 (5.5%), in metronidazole was 4 (7.5) and in conventional therapy group was 12(16%). Conclusion: Present trial was not effective in preventing the occurrence of dry socket by means of single preoperative oral dose of metronidazole and amoxicillin compared to conventional therapy. However, clinically percentage of occurrence of dry socket was higher in conventional group compared to amoxicillin and metronidazole group. Clinical Trial Number: NCT03992144. Continuous...
- Published
- 2021
16. Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial
- Author
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Nicolás Yanine, Valentina Vergara-Gárate, Julio Villanueva, Nicole Sabelle, Alonso Carrasco-Labra, Josefina Salazar, Ignacio Araya-Cabello, and Conchita Martin
- Subjects
Molar ,medicine.medical_specialty ,Dry Socket ,size of periapical radiolucency ,Placebo ,law.invention ,Mandibular third molar ,Double-Blind Method ,Randomized controlled trial ,periapical radiography ,law ,Humans ,Medicine ,cbct ,Antibiotic prophylaxis ,General Dentistry ,UNESCO:CIENCIAS MÉDICAS ,volume ,Pain, Postoperative ,business.industry ,Research ,Tooth, Impacted ,area ,Antibiotic Prophylaxis ,Amoxicillin ,sensitivity ,medicine.disease ,Surgery ,Otorhinolaryngology ,panoramic radiography ,Tooth Extraction ,treatment outcome ,Molar, Third ,Oral Surgery ,Osteitis ,business ,Surgical site infection ,medicine.drug - Abstract
Background The objective of this study was to determine the effect of antibiotic prophylaxis in preventing postoperative infections after extraction of impacted mandibular third molars. Material and Methods A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patients were randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery and control (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was the need for rescue analgesia. Results 4.5% of patients developed postoperative infections, five patients of the control group (4 alveolar osteitis, 1 surgical site infection) and two of the experimental group (1 alveolar osteitis, 1 surgical site infection). Difference between groups was not statistically significant, RR=0.4 (95%CI 0.08-1.99, 𝘱=0.41) NNTB=26. Rescue analgesia intake was significantly higher in the control group (41 vs 18 patients of experimental group) RR=0.49 (95%CI 0.32-0.75, 𝘱
- Published
- 2021
17. Evaluation of the effects of intra-alveolar irrigation with clindamycin, rifampicin and sterile saline in alveolar osteitis treatment
- Author
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Ahmet Taylan Çebi
- Subjects
medicine.drug_class ,medicine.medical_treatment ,Antibiotics ,Dry Socket ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030223 otorhinolaryngology ,Saline ,Alveolar mucosa ,business.industry ,Clindamycin ,030206 dentistry ,respiratory system ,medicine.disease ,Curettage ,Dry socket ,Otorhinolaryngology ,Anesthesia ,Tooth Extraction ,Female ,Molar, Third ,Surgery ,Rifampin ,Oral Surgery ,Osteitis ,business ,Rifampicin ,medicine.drug - Abstract
Background To evaluate the efficacy of intra-alveolar irrigation made with clindamycin, rifampicin and sterile saline on pain and alveolar mucosa healing in the treatment of alveolar osteitis (dry socket). Methods Fifty-four patients diagnosed with alveolar osteitis were divided into three groups for the treatment protocol. Sterile saline was used in Group A, rifampicin was used in Group B and clindamycin was used in Group C for intra-alveolar irrigation. In the groups, the patients were evaluated for their pain levels and alveolar mucosa healing. Results The incidence of alveolar osteitis was significantly higher in females and mandibles at a statistically significant. In the group that used clindamycin for intra-alveolar irrigation, the pain level was found lower than the two other groups. Clindamycin and rifampicin groups were superior to the sterile saline group in clinical alveolar mucosa healing. Conclusion Irrigation with clindamycin appears to reduce the pain associated with alveolar osteitis when compared to rifampicin and sterile saline. In the treatment of alveolar osteitis, irrigation with antibiotics following curettage was found effective for pain relief and alveolar mucosa healing.
- Published
- 2020
18. Molecular events in the clinicopathological diagnosis of alveolar osteitis
- Author
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Talaya Zahid and Sarah Ghafoor
- Subjects
Wound Healing ,Necrosis ,biology ,business.industry ,medicine.medical_treatment ,Dry Socket ,General Medicine ,medicine.disease ,Bioinformatics ,Pathophysiology ,Risk Factors ,Tooth Extraction ,Fibrinolysis ,medicine ,Osteocalcin ,biology.protein ,Humans ,Poor oral hygiene ,Osteitis ,medicine.symptom ,business ,Tooth ,Pathological - Abstract
Alveolar osteitis (AO) is an extremely distressing outcome following extraction of tooth. Its pathophysiology is poorly understood due to varied nature of presentation of the condition. However, a delay in the healing process of bone due to fibrinolysis is believed to be the underlying pathophysiology. This review highlights three major risk factors – trauma, bacterial accumulation due to poor oral hygiene, and smoking – in causing alveolar osteitis, and describes underlying related molecular events. Fibrinolysis results due to traumatic tooth extraction as well as due to accumulation of certain microorganisms which leads to the development of alveolar osteitis. Tumour necrosis factor-alpha (TNF-?), Runt-related transcription factor 2 (Runx 2) and osteocalcin (OCN) can be used as molecular markers for evaluating alveolar osteitis. Assessment assays of such biomarkers can lead to a better understanding of the pathological process in providing a clearer picture to researchers and clinicians. Continuous...
- Published
- 2020
19. Does Chlorhexidine Prevent Complications in Extractive, Periodontal, and Implant Surgery? A Systematic Review and Meta-analysis with Trial Sequential Analysis
- Author
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Giuseppe Troiano, Ilaria D'Onofrio, Luigi Canullo, Pierfrancesco Filetici, Francesca Longo, and Luigi Laino
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Dental Implants ,business.industry ,Chlorhexidine ,Dry Socket ,Dentistry ,General Medicine ,Periodontology ,030204 cardiovascular system & hematology ,medicine.disease ,Placebo ,03 medical and health sciences ,Dry socket ,0302 clinical medicine ,Meta-analysis ,Bacteremia ,Inclusion and exclusion criteria ,medicine ,Humans ,030212 general & internal medicine ,Oral Surgery ,Osteitis ,business ,medicine.drug - Abstract
Purpose: This systematic review aimed to assess the effect of chlorhexidine (CHX) in preventing complications after extractive, implant, and periodontal surgery. Materials and Methods: The PICO question set for this systematic review was: “Is the use of chlorhexidine formulations able to prevent complications (safety) in patients undergoing procedures of either oral surgery, dental implantology, or periodontology compared to treatment procedures in patients without a chlorhexidine prescription?” Once inclusion and exclusion criteria were established, a search was carried out independently by two researchers on PubMed/MEDLINE, Scopus, and Web of Science. The primary outcomes investigated were the rate of alveolar osteitis and bacteremia after surgical procedures in oral surgery. Meta-analysis and trial sequential analysis (TSA) were performed in order to evaluate the findings. Results: After the selection, the 32 studies that fully met the eligibility criteria were considered in this systematic review. A meta-analysis was only possible for data obtained from studies related to extractive surgery. Meta-analysis and TSA showed a statistically significant decrease in the rate of alveolar osteitis after tooth extraction when CHX was employed compared with placebo treatments or treatments not using CHX (RR = 0.49; 95% CI: [0.40, 0.60], P < .001; I2 = 8%). Focusing on the rate of bacteremia, meta-analysis and TSA showed how the employment of CHX (RR = 0.87; 95% CI: [0.79, 0.96], P = .004; I2 = 4%) decreases the rate of bacteremia after extractive surgery. Data from the literature seem to lack in the evaluation of CHX use for the reduction of complications in periodontology and implant dentistry. Conclusion: This systematic review showed with a good power of evidence that CHX employment reduces alveolar osteitis and bacteremia rates after dental extractions.
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- 2020
20. A systematic review of the complications of high-risk third molar removal and coronectomy: development of a decision tree model and preliminary health economic analysis to assist in treatment planning
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N. O’Connor, P. Pitros, Victor Lopes, and Andrea Tryfonos
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Molar ,Mandibular Nerve ,Dentistry ,Mandible ,Inferior alveolar nerve ,03 medical and health sciences ,0302 clinical medicine ,Surgical extraction ,medicine ,Humans ,Economic analysis ,Radiation treatment planning ,Tooth Crown ,business.industry ,Incidence (epidemiology) ,Decision Trees ,Tooth, Impacted ,030206 dentistry ,Odds ratio ,medicine.disease ,Dry socket ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Tooth Extraction ,Molar, Third ,Trigeminal Nerve Injuries ,Surgery ,Oral Surgery ,business - Abstract
Coronectomy is an alternative surgical technique for the management of high-risk third molars. It involves the removal of the crown of a tooth and the deliberate retention of the roots, thereby avoiding injury to the inferior alveolar nerve (IAN). Previous studies have suggested that it reduces the risk of nerve injury when compared with surgical extraction. The purpose of this study was to systematically review the incidence of complications following coronectomy such as IAN injury, pain, dry socket, infection, root migration, and need for re-operation. A comparative cost analysis of coronectomy and surgical extraction was done based on the results of the review. This provides an insight into the economic implications of the two procedures. A search through the MEDLINE database via Ovid, PubMed, Scopus, EMBASE via Ovid, and Web of Science, was carried out to extract randomised and non-randomised controlled trials. Four studies fulfilled the inclusion criteria. A meta-analysis was conducted to measure the overall effect of each outcome. The pooled odds ratio (OR) for IAN injury was 0.16 (95% CI 0.01 to 0.39). Coronectomy reduced this risk by 84%. Dry socket may occur less frequently following coronectomy whereas infection did not show a higher incidence with either intervention. Root migration was found to occur in 13%-85% of cases and the average incidence of re-operation was 2.2%. The ratio of the average costs was 1.12 favouring coronectomy if cone-beam computed tomography (CBCT) was not done prior to the procedure. If a scan was taken routinely for coronectomy, the cost ratio marginally favoured extraction. Coronectomy reduced the risk of nerve injury in high-risk third molars. Definitive conclusions, however, cannot be made for outcomes such as the need for re-operation, which may alter the cost ratio of coronectomy:extraction, as higher quality studies with longer follow-up are needed.
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- 2020
21. Effectiveness of different socket dressing materials on the postoperative pain following tooth extraction: a randomized control trial
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Ahmad Salem, Assari, Hamad Saud, Alrafie, Abdullah Homoud, Al Ghashim, Faisal Nabeel, Talic, Ahmed Mushabbab, Alahmari, Meshal Yousef, Al Manea, and Rakan Yousef, Alrashdan
- Subjects
Pain, Postoperative ,Wound Healing ,Tooth Extraction ,Dry Socket ,Humans ,Bandages - Abstract
We aimed to prospectively evaluate and compare the effectiveness of Alvogyl and Cutanplast as intra-alveolar dressings for managing pain associated with extraction and incidence of dry socket. All patients who underwent maxillary and mandibular teeth extraction and fulfilled our inclusion and exclusion criteria from Feb 2021 to Oct 2021 were included in our study. Patients who were diagnosed with postoperative pain after tooth extraction were randomly allocated to three groups: Group A (Alvogyl), Group B (Cutanplast), and Group C (placebo). Pain relief and healing of the socket were compared between these groups. The collected data were analyzed using the Chi-square test and Z test of proportionality. Alvogyl was superior to the other medication for providing initial pain relief, and the incidence of dry socket was significantly lower than in the Cutanplast and placebo groups (p0.05). However, wound healing was statistically non-significant among groups A, B, and C (p0.05). Alvogyl is still the material of choice in terms of pain relief, wound healing, and low incidence of dry socket. Furthermore, no statistically significant difference was detected between the groups in the biographic information, location, and condition of the extracted tooth, presence of a radiologic pathology, or type of extraction procedure. Moreover, whether it is the first extraction or not, Alvogyl and Cutanpast are comparable in postoperative pain management as intra-alveolar dressing materials.
- Published
- 2022
22. Efficacy of Laser therapy for alveolar osteitis: A systematic review of the available evidence
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Hashem Mothair Al-Shamiri, Sadeq Ali Al-Maweri, Ahmed Wallan AlAhmary, Muhannad Saleh Aljunayh, Abdulrahman Omar Aldosari, Nasser Mushabab Alqahtani, Jaber Ibrahim Alabdulaziz, and Hesham Mohammed Al-Sharani
- Subjects
China ,Wound Healing ,Alveolar osteitis ,laser therapy ,dry socket ,systematic review ,Tooth Extraction ,Dry Socket ,Humans ,Low-Level Light Therapy ,General Dentistry - Abstract
Objective: Alveolar osteitis (commonly known as dry socket) is a very common painful complication of dental extraction with no definitive cure. This systematic review assessed the efficacy of laser therapy in the management of alveolar osteitis. Methods: PubMed, Scopus, Web of Science, Embase, Cochrane Central, and China National Knowledge Infrastructure (CNKI) were searched for all studies published till July, 2021 using relevant keywords. All clinical trials that assessed the efficacy of laser in the management of alveolar osteitis were included. Due to missing some numerical data and the substantial heterogeneity across the studies, no meta-analysis was performed. Results: Out of the 296 identified articles, 14 clinical trials comprising 981 patients were included. The laser wavelengths, power output, and energy fluence showed a great variability across the included studies: 632.8 – 2940 nm, 16 mW – 10 W, and 0.2 – 85.7 J/cm2, respectively. All included studies found laser to be efficacious in alleviating pain and accelerating healing in patients with alveolar osteitis. Of the 14 included studies, 13 studies reported superior outcomes in favor of laser therapy as compared to conventional therapies. Conclusion: The available evidence suggests a good efficacy of laser therapy in reducing signs and symptoms of alveolar osteitis. However, owing to the marked methodological heterogeneity and the substantial variations in laser parameters among the included studies, more well-designed clinical trials with adequate sample sizes and standardized laser parameters are highly recommended. Clinical significance: Laser therapy can be applied for the management of dry socket.
- Published
- 2022
23. Comparison of two different flap designs for bilateral impacted mandibular third molar surgery
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F. Basturk, Arif Yigit Guler, Dilek Menziletoglu, Bozkurt Kubilay Işik, and E.A. Erdur
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Adult ,Molar ,medicine.medical_specialty ,Adolescent ,Dry Socket ,Mandible ,Trismus ,Mandibular third molar ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Third molar surgery ,stomatognathic system ,medicine ,Humans ,030223 otorhinolaryngology ,Wound dehiscence ,business.industry ,Tooth, Impacted ,Mean age ,030206 dentistry ,medicine.disease ,Surgery ,stomatognathic diseases ,Otorhinolaryngology ,Tooth Extraction ,Molar, Third ,Oral Surgery ,medicine.symptom ,Osteitis ,business ,Triangular flap - Abstract
We compared the effect of lingual-based triangular flap with buccal-based triangular flap on postoperative complications in impacted third molar surgery.Thirty patients aged between 18 and 36 (mean age 19.65±2.14) were included. They all had bilateral impacted third molars. We used buccal-based triangular flap on a randomly selected side (Group 1) and lingual-based triangular flap on the other side (Group 2). We evaluated pain during 7 days after the surgery; swelling and trismus on postoperative 2., 7. and 14. days; wound dehiscence and alveolar osteitis incidence on postoperative 7. and 14. days.Pain was significantly higher in Group 2 during 7 days postoperatively (P.05). Trismus and swelling were also more prominent in Group 2 on postoperative days 2 and 7. In Group 2, the duration of the surgery in was longer than Group 1 (P.05). In Group 1, 17 patients (56.7%) had wound dehiscence and 6 patients (20%) in Group 2 (P.05). No alveolar osteitis developed in either groups.The buccal-based triangular flap seems better with regard to postoperative pain, swelling and trismus. On the other hand, the lingual-based triangular flap had a lesser incidence for wound dehiscence.
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- 2020
24. Comparison of Postoperative Outcomes Between Envelope and Triangular Flaps After Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis
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Junfei Zhu, Guang Mengkai, Xuguang Yuan, Tianzhu Li, LiE Yan, and Ye Zhang
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Molar ,medicine.medical_specialty ,Dry Socket ,Mandible ,Cochrane Library ,Trismus ,Surgical Flaps ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Pain, Postoperative ,Wound dehiscence ,business.industry ,Tooth, Impacted ,030206 dentistry ,medicine.disease ,Surgery ,Dry socket ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Meta-analysis ,Tooth Extraction ,Inclusion and exclusion criteria ,Molar, Third ,Oral Surgery ,medicine.symptom ,business - Abstract
Purpose The objective of the present systematic review was to compare the postoperative outcomes between envelope and triangular flaps after mandibular third molar surgery. Materials and Methods The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched from the inception date to November 2018. Randomized and nonrandomized controlled trials were included if they had met certain inclusion and exclusion criteria. The predictor variable was the flap design, envelope or triangular. The outcome variables were operation time, pain, trismus, alveolar osteitis (AO) incidence, wound dehiscence, and swelling. The methodologic quality assessment was performed in accordance with the Cochrane Collaboration guidelines. The meta-analysis was performed using Review Manager, version 5.2. Results A total of 21 studies were included for qualitative synthesis, 18 of which were included in the meta-analysis. The use of envelope flaps required less operation time than triangular flaps (P Conclusions Envelope flaps required a shorter operation time than triangular flaps and were associated with less postoperative pain and trismus when applied to impacted mandibular third molars of Pell and Gregory Class A or B. In contrast, triangular flaps were associated with a decreased incidence of AO compared with envelope flaps.
- Published
- 2020
25. A novel dual action monolithic thermosetting hydrogel loaded with lidocaine and metronidazole as a potential treatment for alveolar osteitis
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Jonathan Cowpe, Charles Martin Heard, Marika Zuanon, Hannah M. Boostrom, Lena Bender, Carmine Varricchio, Alastair James Sloan, and Vildan Celiksoy
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Lidocaine ,Gingiva ,Dry Socket ,Pharmaceutical Science ,Poloxamer ,02 engineering and technology ,Lidocaine Hydrochloride ,030226 pharmacology & pharmacy ,Phase Transition ,03 medical and health sciences ,Drug Delivery Systems ,0302 clinical medicine ,Anti-Infective Agents ,In vivo ,Metronidazole ,medicine ,Humans ,Anesthetics, Local ,Cells, Cultured ,Dental alveolus ,Chromatography ,Chemistry ,Temperature ,Hydrogels ,General Medicine ,Fibroblasts ,021001 nanoscience & nanotechnology ,medicine.disease ,Drug Liberation ,Dry socket ,Acrylates ,Self-healing hydrogels ,Drug delivery ,0210 nano-technology ,Biotechnology ,medicine.drug - Abstract
Alveolar osteitis is a complication that can occur after tooth extraction, whereby exposed bone results in severe throbbing pain for the patient and can be prone to infection. The current treatment options are widely regarded as sub-optimal. The aim of this project was to investigate in vitro the plausibility of a dual-action monolithic drug-loaded thermosensitive hydrogel that undergoes thermal gelation within the tooth socket and releases both anaesthetic and antimicrobial agents. Hydrogels containing different levels of lidocaine HCl and metronidazole were prepared based upon Carbopol 934P NF and Pluronic F-127 blends. Membrane-less drug release was determined from the set hydrogels into phosphate buffered saline (PBS) at 37 °C as a function of time, following analysis by HPLC. Gelation characteristics and hydrogel dissolution characteristics were also determined. At 23.38% Pluronic F-127, sol-gel transition commenced at 23 °C and gelation was completely at 37 °C (physiological temperature). Setting times varied with Pluronic content and there was an inverse relationship between drug release and Pluronic content. Sustained and dose dependent release of both drugs was observed at therapeutically relevant levels over 24 h, via a combination of diffusion, dissolution and surface erosion processes. Based on the amounts of drugs released, it was determined that hydrogels containing up to 0.5% lidocaine and 0.1% metronidazole exhibited low risk of cytotoxicity to primary human gingival fibroblasts. In an in vivo scenario, the sol-phase formulation would make contact with all inner surfaces of a tooth socket prior to transitioning to monolithic gel-phase and provide sustained release of lidocaine and metronidazole at sub-toxic levels, thereby providing simultaneous pain relief, protection from ingress of debris and potentially pathological bacteria.
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- 2020
26. A Comparative Study on Alvogyl and a Mixture of Black Seed Oil and Powder for Alveolar Osteitis: A Randomized Double-Blind Controlled Clinical Trial
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Zafar Ali Khan, Namdeo Prabhu, Naseer Ahmed, Abhishek Lal, Rakhi Issrani, Afsheen Maqsood, Fahim Vohra, and Mohammad Khursheed Alam
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Male ,Article Subject ,Dry Socket ,Pain ,General Medicine ,Drug Combinations ,Eugenol ,Oils, Volatile ,para-Aminobenzoates ,Humans ,Plant Oils ,Female ,Hydrocarbons, Iodinated ,Powders ,Aged - Abstract
Introduction. Alveolar osteitis (AO) is the most common complication faced by exodontia patients and is usually seen 24–74 hours after tooth extraction, heralded by severe throbbing pain. Nigella sativa is commonly known as black seed known to have anti-inflammatory and antibacterial properties along with other reparative properties that enhance bone formation. This study aimed to evaluate and compare the effects of Alvogyl and a mixture of Nigella sativa powder and oil in the treatment of dry sockets. Materials and Methods. Sixty patients above the age of 18 and below 70 years, from both genders, who underwent extraction of teeth and were clinically diagnosed with a dry socket at the clinic of the College of Dentistry, Jouf University, Saudi Arabia, were included in this study. Pain scores were assessed after placement of the dressing at the following intervals: 5 minutes, 30 minutes, 60 minutes, 2nd day, 4th day, and 7th day. Patients were randomly allocated to three groups, namely, Group 1 (Alvogyl), Group 2 (mixture of Nigella sativa’s powder and oil), and Group 3 (control). Pain relief and healing of the socket were compared between the three groups. The collected data were subjected to statistical analysis through Spearman’s correlation test, independent t-test, ANOVA, and post hoc test. Results. A mixture of Nigella sativa powder and oil showed a statistically significant difference in relieving pain compared to the Alvogyl group. A mixture of Nigella sativa’s powder and oil required fewer dressings when compared to the Alvogyl group. Conclusion. A mixture of Nigella sativa powder and oil is the more efficacious dressing material for the management of dry sockets compared to Alvogyl. It provides immediate and complete pain relief and fewer numbers of repeated visits.
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- 2022
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27. Comparison of primary and secondary closure with a buccal mucosal-advancement flap on postoperative course after mandibular impacted third molar surgery
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R Balamurugan and Thomas Zachariah
- Subjects
Molar ,medicine.medical_specialty ,Visual analogue scale ,Dry Socket ,Mandible ,Dehiscence ,Trismus ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,stomatognathic system ,medicine ,Edema ,Humans ,Local anesthesia ,030223 otorhinolaryngology ,Pain, Postoperative ,business.industry ,Wound dehiscence ,Tooth, Impacted ,030206 dentistry ,Buccal administration ,medicine.disease ,Surgery ,Otorhinolaryngology ,Tooth Extraction ,Oral and maxillofacial surgery ,Molar, Third ,Oral Surgery ,medicine.symptom ,business - Abstract
The purpose of this study was to compare primary and secondary wound closure with a buccal mucosal-advancement flap technique on the postoperative course after mandibular impacted third molar surgery. The study was conducted on 150 patients who required surgical removal of impacted mandibular third molars under local anesthesia. The study subjects were divided into three groups of 50 patients each, based on the type of closure over the third molar socket. Patients in group I underwent primary closure of the socket with hermetic suturing of the flap, including the vertical release. In group II, a secondary closure was performed, leaving the socket communicating with the oral cavity. In group III, a buccal mucosal-advancement flap technique was employed to achieve primary closure of the flap over the socket while leaving the anterior vertical release, generously patent. All the patients were assessed for pain using the visual analogue scale (VAS), swelling, and mouth opening at postoperative intervals of 2, 4, and 7 days. The wound healing was assessed on day 7. Patients in the buccal mucosal-advancement flap group had significantly less pain and swelling and increased mouth opening compared with primary and secondary closure. Wound dehiscence was seen in 18 patients and alveolar osteitis in 4 patients in primary closure. Delayed wound healing with food accumulation was seen in 6 patients in secondary closure. No complications of flap dehiscence or breakdown were observed in the buccal mucosal-advancement flap group. This study concludes that the buccal mucosal-advancement flap technique was a superior closure technique with less pain, swelling, trismus, and satisfactory wound healing compared with both primary and secondary closure after mandibular third molar surgery.
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- 2019
28. Aetiology, Prevention and Management of Alveolar Osteitis-A Scoping Review
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Richard Moore, Vishal R Aggarwal, and Anna Ghosh
- Subjects
medicine.medical_specialty ,medicine.drug_class ,business.industry ,Antibiotics ,Chlorhexidine ,Smoking ,MEDLINE ,Dry Socket ,medicine.disease ,Dry socket ,Tooth Extraction ,medicine ,Humans ,Observational study ,Molar, Third ,Osteitis ,Medical prescription ,business ,Adverse effect ,Intensive care medicine ,General Dentistry ,medicine.drug - Abstract
BACKGROUND Alveolar osteitis (AO) is a poorly understood, common, painful complication following exodontia. It is sometimes managed by inappropriate prescription of antibiotics which contributes to the global threat of antimicrobial resistance. Use of intra-alveolar chlorhexidine also presents a serious risk of anaphylaxis to the patient. OBJECTIVE This scoping review aims to investigate the aetiology, prevention and management of AO and highlight the extent of inappropriate prescribing and intra-alveolar chlorhexidine use. DESIGN A scoping review was undertaken using the PRISMA guidelines. Medline, Ovid and Pubmed were searched between 2010 and 2020, from which 63 studies were selected for review that related to the aetiology, prevention or management of AO. Data were analysed for frequency of studies reporting information on risk factors for aetiology, prevention strategies and management including inappropriate management using antibiotic prescribing and intra-alveolar chlorhexidine. RESULTS Impaired immune response, surgical technique and age were identified as significant factors in the development of AO, while there is conflicting evidence regarding the effects of smoking and gender. With regard to prevention, the use of prophylactic antibiotics is not supported within the literature. Saline irrigation and eugenol pastes used preventively have been shown to be cheap and effective alternatives to chlorhexidine with no adverse effects. Hyaluronic acid and low-level laser therapies showed a significant reduction in pain and soft-tissue inflammation in the management of AO compared to Alveogyl. CONCLUSIONS Further understanding of the pathophysiology of AO is needed, in addition to large high-quality RCTs or long-term observational studies into the aetiology, prevention, and management of AO to produce up-to-date evidence-based clinical guidelines. Clinicians should also be mindful of their contribution to growing antimicrobial resistance and avoid inappropriate prescribing of antibiotics. Saline should replace chlorhexidine as the intra-alveolar irrigant of choice.
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- 2021
29. Extensive subcutaneous emphysema, pneumomediastinum, and pneumorrhachis following third molar surgery
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Y.B.E. Tay and W.S. Loh
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Male ,Molar ,medicine.medical_specialty ,Adolescent ,Pneumorrhachis ,Trismus ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,medicine ,Humans ,030212 general & internal medicine ,Pneumomediastinum ,Mediastinal Emphysema ,business.industry ,Tooth, Impacted ,030206 dentistry ,medicine.disease ,Subcutaneous Emphysema ,Surgery ,Dry socket ,Otorhinolaryngology ,Dental surgery ,Tooth Extraction ,Molar, Third ,Oral Surgery ,medicine.symptom ,Complication ,business ,Subcutaneous emphysema - Abstract
Third molar extraction is a common procedure in dental surgery. Common complications that may occur post procedure include pain, trismus, bleeding, dry socket, and nerve injuries. Subcutaneous emphysema is an uncommon complication. A rare case of extensive cervicofacial subcutaneous emphysema, pneumomediastinum, and pneumorrhachis following third molar extraction is reported here. Issues relating to the diagnosis, aetiology, and management of these complications are discussed.
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- 2018
30. Common risk factors of dry socket (alveolitis osteitis) following dental extraction: A brief narrative review
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Vahid Rakhshan
- Subjects
medicine.medical_treatment ,Dry Socket ,Dentistry ,Oral hygiene ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Osteitis ,business.industry ,030206 dentistry ,medicine.disease ,Dry socket ,Otorhinolaryngology ,Dental extraction ,030220 oncology & carcinogenesis ,Tooth Extraction ,Contraceptive Effect ,Female ,Molar, Third ,Surgery ,Narrative review ,Oral Surgery ,Complication ,business ,Oral contraception - Abstract
Dry socket is a common complication of dental extraction, especially extraction of third molars. Knowledge of the frequent risk factors of alveolitis osteitis is useful in determining high-risk patients, treatment planning, and preparing the patients mentally. The aim of this narrative review was to summarize the common risk factors of dry socket. Unlike surgery difficulty, surgeon's experience, oral contraception use, and oral hygiene which showed stronger evidence, the influences of age, gender, and smoking were rather inconclusive. The case of female or oral contraceptive effect might relate mainly to estrogen levels (when it comes to dry socket) which can differ considerably from case to case. Many risk factors might be actually a combination of various independent variables, which should be targeted instead, in more comprehensive designs.
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- 2018
31. Novel Application of Platelet-Rich Fibrin as a Wound Healing Enhancement in Extraction Sockets of Patients Who Smoke
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Huda Moutaz Asmael, Firas A. Jamil, and Ali Mohammed Hasan
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Adult ,Male ,Adolescent ,Visual analogue scale ,Dry Socket ,Dentistry ,Fibrin ,Cigarette Smoking ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Platelet-Rich Fibrin ,medicine ,Humans ,Tooth Socket ,Aged ,Pain, Postoperative ,Wound Healing ,biology ,business.industry ,Extraction (chemistry) ,Soft tissue ,030206 dentistry ,General Medicine ,Middle Aged ,medicine.disease ,Platelet-rich fibrin ,Dry socket ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Tooth Extraction ,biology.protein ,Surgery ,Wound healing ,business - Abstract
The objectives of this study were to assess the potential of platelet-rich fibrin (PRF) on acceleration of soft tissue healing after tooth extraction and to evaluate its effectiveness in reducing the prevalence of dry socket among smoker patients. Twenty smoker male patients aged (18-72) years with multiple teeth extraction were participated in this clinical research. They underwent trans-alveolar extraction of 40 teeth. The extraction sockets were divided in each patient into 2 groups: the study group in which extraction sockets were treated with PRF and the control group: in which extraction sockets left to heal naturally without PRF. Platelet-rich fibrin enhanced soft tissue healing and reduced inflammatory process within the study group compared with control group as the 2-tailed P value equaled 0.0035 which was very statistically significant. Pain level according to visual analog scale in control group had average of (1.8), while in the study group had average of (0.65) and the P value equaled 0.1511 which was not statistically significant. Degree of epithelization was recorded by dental caliper for both groups and the 2-tailed P value equaled 0.7134 which was insignificant. The results from this study showed that PRF enhanced the quality of soft tissue healing of extraction socket among smoker patients but it did not show significant difference regarding pain reduction, dry socket prevention, and socket closure. Future clinical trials are required to clearly identify the effectiveness of PRF regarding this subject.
- Published
- 2018
32. Is it worth applying self-irrigation after third molar extraction? A randomised controlled trial
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Hyo-Jin Jang, Eun Young Kwon, Jae-Min Song, Won-Hyuk Choi, and Youn-Kyung Choi
- Subjects
Molar ,Irrigation ,Dentistry ,Dry Socket ,Mandible ,law.invention ,Mandibular third molar ,Randomized controlled trial ,Tap water ,law ,Medicine ,Humans ,Syringe ,Gingival indices ,business.industry ,Extraction (chemistry) ,Tooth, Impacted ,Water ,Halitosis ,Otorhinolaryngology ,Tooth Extraction ,Quality of Life ,Surgery ,Molar, Third ,Oral Surgery ,business - Abstract
In this study, we aimed to examine the effectiveness of self-irrigation following the extraction of mandibular third molars. A randomised controlled clinical trial was conducted with 155 patients who had undergone extraction of a mandibular third molar. The irrigation group was instructed to self-irrigate the extraction socket with tap water using a syringe three times a day, starting seven days after the tooth extraction. The incidence of complications and mouth opening, halitosis, plaque/gingival index, and oral health-related quality of life (OHRQoL) were measured. The irrigation group showed a lower incidence of complications than the non-irrigation group. The halitosis, plaque, and gingival scores were lower by mean (SD) 19.66 (5.19), 0.58 (0.06), and 0.62 (0.08), respectively, in the irrigation group than in the non-irrigation group (p = 0.0001). A greater amount of food packing was associated with higher halitosis, plaque, and gingival scores and poorer OHRQoL (p 0.05). Further, more frequent irrigation was associated with lower halitosis, plaque, and gingival scores and better OHRQoL (p ≤ 0.016). Self-irrigation of the extraction socket using a syringe containing tap water is a very effective method for keeping the extraction socket clean. This technique reduced halitosis, improved plaque and gingival indices, and increased OHRQoL.
- Published
- 2021
33. Oxytetracycline-hydrocortisone ointment reduces the occurrence of both dry socket and post-extraction pain after third molar extraction: An observational study
- Author
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Yoko Sato, Kohta Fukuta, Akihiko Ogino, Moriyasu Adachi, Hiroki Otake, Hideaki Asai, Eiji Nakatani, Philip Hawke, Atsushi Abe, and Shingo Takei
- Subjects
Molar ,Male ,Teeth ,Hydrocortisone ,Dental and Oral Procedures ,Dentistry ,Oxytetracycline ,Mandible ,Ointments ,0302 clinical medicine ,Suture (anatomy) ,Japan ,Medicine and Health Sciences ,030212 general & internal medicine ,Dental Care ,Immune Response ,Topical Medications ,Pain, Postoperative ,Analgesics ,Multidisciplinary ,Tooth, Impacted ,Drugs ,Anti-Bacterial Agents ,Dry socket ,Drug Combinations ,Medicine ,Female ,Anatomy ,medicine.drug ,Research Article ,Adult ,Visual analogue scale ,Science ,Analgesic ,Immunology ,Dry Socket ,Pain ,Surgical and Invasive Medical Procedures ,Molars ,03 medical and health sciences ,Signs and Symptoms ,medicine ,Humans ,Pain Management ,Retrospective Studies ,Pharmacology ,Inflammation ,business.industry ,Extraction (chemistry) ,Biology and Life Sciences ,030206 dentistry ,Loxoprofen ,medicine.disease ,body regions ,Jaw ,Tooth Extraction ,Molar, Third ,Clinical Medicine ,business ,Digestive System ,Head - Abstract
Objectives Dry socket and post-extraction pain are typical discomforts experienced by patients after tooth extraction. In this study, we inserted gauze coated with oxytetracycline-hydrocortisone ointment into the extraction socket immediately after lower third molar extraction and then evaluated the occurrence of dry socket and post-extraction pain compared with gauze non-insertion. Methods This retrospective study was carried out on patients undergoing lower third molar extraction in the Department of Oral Surgery at Shizuoka Prefectural General Hospital in Shizuoka, Japan from November 2018 to October 2019. A comparison was carried out between a gauze-insertion group and a non-insertion group. The occurrence versus non-occurrence of dry socket was determined, and degree of pain was assessed based on a visual analogue scale (VAS) and on patients reporting the number of loxoprofen sodium oral analgesic tablets (60mg/tablet) that they had taken. Dry socket was defined as patient-reported spontaneous pain that did not subside 1 to 3 days postoperatively. Spontaneous post-extraction pain was recorded four times: on the operative day, on the first postoperative day (POD1), on POD3, and during suture removal (POD7). Results The occurrence of dry socket was lower in the gauze-insertion group than in the non-insertion group (0.9%, 2/215 vs. 19.6%, 9/46, p Conclusions and clinical relevance Inserting gauze coated with oxytetracycline-hydrocortisone ointment into the extraction socket immediately after third molar extraction reduces the occurrence of both dry socket and post-extraction pain.
- Published
- 2021
34. Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study
- Author
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Gonzalo Hernández, Juan López-Quiles, Jesús Torres, Roberto Cecilia-Murga, Rosa María López-Pintor, and José González-Serrano
- Subjects
Molar ,Adult ,Adolescent ,Visual analogue scale ,salivary glands ,Analgesic ,Dentistry ,Dry Socket ,Pilot Projects ,Mandible ,Placebo ,Trismus ,Propolis ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,head and neck neoplasms ,Double-Blind Method ,medicine ,Edema ,Humans ,vascular endothelial growth factors ,General Dentistry ,UNESCO:CIENCIAS MÉDICAS ,Pain, Postoperative ,business.industry ,Plant Extracts ,Research ,Tooth, Impacted ,Surgical wound ,030206 dentistry ,Ascorbic acid ,medicine.disease ,salivary gland neoplasms ,Otorhinolaryngology ,Tooth Extraction ,Surgery ,Molar, Third ,prognosis ,Osteitis ,medicine.symptom ,Oral Surgery ,business - Abstract
Background Propolis has anti-inflammatory, analgesic and healing properties. The purpose of this study was to determine whether a gel containing 2% of propolis extract, 0.2% of ascorbic acid and 0.2% of tocopherol acetate is effective in preventing surgical complications related to impacted lower third molar extractions. Material and Methods A randomized, double-blind, split-mouth study was performed. Fifteen patients were recruited who needed bilateral impacted lower third molar extractions with a similar surgical difficulty. A test or placebo gel was administered randomly inside post-extraction sockets. Each patient was instructed to apply the gel 3 times/day in the surgical wound for a week. After a month, the contralateral third molar was extracted, and the opposite gel applied. The following parameters were diagnosed/evaluated and then recorded: alveolar osteitis following Blum’s criteria, swelling and trismus at day one, two, three and seven post-intervention, wound healing at day 7 post-intervention, and postoperative pain using a visual analog scale, as well as, the number of analgesic pill intake. Results A total of twenty-six surgical procedures were performed in 13 patients (mean age 20.67±2 years). Alveolar osteitis was reported in 3 patients from the placebo group (23.1%) and none in the test group (0%) (p=0.25). No statistically significant differences were reported in swelling, trismus, wound healing or analgesic pill consumption between two groups. But statistically lower postoperative pain during the 7 days after surgical extractions was found according to visual analog scale in test group compared to the placebo group (p=0.007). No side effects were reported. Conclusions The application of this gel may be effective in preventing alveolitis and thus reducing postoperative pain after impacted third molar extractions. More randomized clinical trials with larger sample are needed to confirm these results. Key words:Propolis, nanovitamin, third molar surgery, oral surgery, alveolar osteitis.
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- 2021
35. Antibiotics to prevent complications following tooth extractions
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Giovanni Lodi, Lorenzo Azzi, Elena Maria Varoni, Monica Pentenero, Massimo Del Fabbro, Antonio Carrassi, Andrea Sardella, and Maddalena Manfredi
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medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Population ,Dentistry ,Dry Socket ,Pain ,Placebo ,Postoperative Complications ,stomatognathic system ,Bias ,medicine ,Humans ,Pharmacology (medical) ,Antibiotic prophylaxis ,Postoperative ,Impacted wisdom teeth ,education ,Impacted ,Dental alveolus ,Third ,Pain, Postoperative ,education.field_of_study ,business.industry ,Risk of infection ,Tooth, Impacted ,Bacterial Infections ,Antibiotic Prophylaxis ,medicine.disease ,Molar ,Surgery ,Anti-Bacterial Agents ,Controlled Clinical Trials as Topic ,Molar, Third ,Tooth Extraction ,stomatognathic diseases ,Dry socket ,business ,Tooth - Abstract
BACKGROUND: The most frequent indications for tooth extractions, generally performed by general dental practitioners, are dental caries and periodontal infections. Systemic antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. This is an update of a review first published in 2012. OBJECTIVES: To determine the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions. SEARCH METHODS: Cochrane Oral Health’s Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 16 April 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 3), MEDLINE Ovid (1946 to 16 April 2020), Embase Ovid (1980 to 16 April 2020), and LILACS (1982 to 16 April 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomised, double‐blind, placebo‐controlled trials of systemic antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication. DATA COLLECTION AND ANALYSIS: At least two review authors independently performed data extraction and 'Risk of bias' assessment for the included studies. We contacted trial authors for further details where these were unclear. For dichotomous outcomes, we calculated risk ratios (RR) and 95% confidence intervals (CI) using random‐effects models. For continuous outcomes, we used mean differences (MD) with 95% CI using random‐effects models. We examined potential sources of heterogeneity. We assessed the certainty of the body of evidence for key outcomes as high, moderate, low, or very low, using the GRADE approach. MAIN RESULTS: We included 23 trials that randomised approximately 3206 participants (2583 analysed) to prophylactic antibiotics or placebo. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, only one of the trials evaluated the role of antibiotic prophylaxis in groups of patients affected by those clinical conditions. We assessed 16 trials as being at high risk of bias, three at low risk, and four as unclear. Compared to placebo, antibiotics may reduce the risk of postsurgical infectious complications in patients undergoing third molar extractions by approximately 66% (RR 0.34, 95% CI 0.19 to 0.64; 1728 participants; 12 studies; low‐certainty evidence), which means that 19 people (95% CI 15 to 34) need to be treated with antibiotics to prevent one infection following extraction of impacted wisdom teeth. Antibiotics may also reduce the risk of dry socket by 34% (RR 0.66, 95% CI 0.45 to 0.97; 1882 participants; 13 studies; low‐certainty evidence), which means that 46 people (95% CI 29 to 62) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. The evidence for our other outcomes is uncertain: pain, whether measured dichotomously as presence or absence (RR 0.59, 95% CI 0.31 to 1.12; 675 participants; 3 studies) or continuously using a visual analogue scale (0‐to‐10‐centimetre scale, where 0 is no pain) (MD −0.26, 95% CI −0.59 to 0.07; 422 participants; 4 studies); fever (RR 0.66, 95% CI 0.24 to 1.79; 475 participants; 4 studies); and adverse effects, which were mild and transient (RR 1.46, 95% CI 0.81 to 2.64; 1277 participants; 8 studies) (very low‐certainty evidence). We found no clear evidence that the timing of antibiotic administration (preoperative, postoperative, or both) was important. The included studies enrolled a subset of patients undergoing dental extractions, that is healthy people who had surgical extraction of third molars. Consequently, the results of this review may not be generalisable to all people undergoing tooth extractions. AUTHORS' CONCLUSIONS: The vast majority (21 out of 23) of the trials included in this review included only healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. None of the studies evaluated tooth extraction in immunocompromised patients. We found low‐certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction when compared to placebo, and very low‐certainty evidence of no increase in the risk of adverse effects. On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. It is unclear whether the evidence in this review is generalisable to patients with concomitant illnesses or patients at a higher risk of infection. Due to the increasing prevalence of bacteria that are resistant to antibiotic treatment, clinicians should evaluate if and when to prescribe prophylactic antibiotic therapy before a dental extraction for each patient on the basis of the patient's clinical conditions (healthy or affected by systemic pathology) and level of risk from infective complications. Immunocompromised patients, in particular, need an individualised approach in consultation with their treating medical specialist.
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- 2021
36. COVID-19 patients could be at high risk for dry socket
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A. Thirumal Raj, Trivina Domah, Shruti Nahar, and Lakshmi Shetty
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,Dry Socket ,General Medicine ,medicine.disease ,Severe Acute Respiratory Syndrome ,Virology ,Dry socket ,Tooth Extraction ,medicine ,Hong Kong ,Humans ,business - Published
- 2020
37. Does smoking increase the incidence of postoperative complications in simple exodontia?
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Tharzon Barbieri, Sabrina Marchetti, Marcelo Carlos Bortoluzzi, Diogo Lenzi Capella, Camila P. Dresch, and Claiton Tirello
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Dentistry ,Dry Socket ,Logistic regression ,Young Adult ,Postoperative Complications ,Internal medicine ,Epidemiology ,medicine ,Alveolar Process ,Humans ,Surgical Wound Infection ,Prospective Studies ,Prospective cohort study ,Adverse effect ,Child ,General Dentistry ,Aged ,Aged, 80 and over ,business.industry ,Incidence (epidemiology) ,Smoking ,Odds ratio ,Middle Aged ,Confidence interval ,Tooth Extraction ,Original Article ,Female ,business ,Complication - Abstract
Objective: To investigate whether smoking has adverse effects in simple exodontia. Methods: A single-centre, prospective study of postoperative inflammatory complications in simple exodontia was performed. All procedures were conducted under similar and sterile conditions. Postoperative complications (PCs) in exodontia were classified as alveolar osteitis (AO) or alveolar infection (AI) and their incidences then added. Results: A logistic regression model for PCs revealed tooth sectioning [odds ratio (OR) = 4.3, 95% confidence interval (CI) 1.0–18.8; P = 0.050], smoking (OR = 4.5, 95% CI 1.0–18.9; P = 0.03) and amount of smoking (> 20 cigarettes/day: OR = 12.3, 95% CI 1.0–149.8; P = 0.04) to be associated with the occurrence of PCs. Conclusions: Tooth sectioning, smoking and degree of smoking are all associated with the development of PCs such as AO and AI after simple exodontia. Dentists must be alert to these factors when performing simple exodontia in smokers in view of the increased risk for PCs.
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- 2020
38. A Comparison of Pre-Emptive Co-Amoxiclav, Postoperative Amoxicillin, and Metronidazole for Prevention of Postoperative Complications in Dentoalveolar Surgery: A Randomized Controlled Trial
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Giath, Gazal, Khalid H, Al-Samadani, Hamdi Mohammed, Alsaidalani, Ghofran Ali, Karbouji, and Abdullah Mohammed, Alharbi
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Adult ,Pain, Postoperative ,Postoperative Complications ,Metronidazole ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Amoxicillin ,Dry Socket ,Humans ,Molar, Third ,surgical dental extraction ,dry socket ,oral antibiotics ,Amoxicillin-Potassium Clavulanate Combination ,Anti-Bacterial Agents - Abstract
Objective: To compare the effectiveness of different oral antibiotics for prevention of dry socket and infection in adults following the surgical extraction of teeth under LA. Methods: This randomized controlled study was conducted from 10 September 2020 until 10 May 2021. Forty-six patients were randomly allocated to three groups. Sixteen patients were in the postoperative co-amoxiclav (625 mg) group, fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative metronidazole (500 mg) group and fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative amoxicillin (500 mg) group. Evaluation of the postoperative signs of alveolar osteitis and infection was made by a dental surgeon five days postoperatively. Evaluation of the post-surgical extraction pain was made by patients immediately and five days postoperatively on standard 100 mm visual analogue scales (VAS). Furthermore, difficulty of surgery was recorded for all patients immediately postoperatively using (VAS). Results: all antibiotics used in this study were effective. Only 15% of patients had painful alveolar osteitis and 2% had oral infections. There was no significant decrease in the number of patients with severe alveolar osteitis or infection for co-amoxiclav plus metronidazole and co-amoxiclav plus amoxicillin groups compared to co-amoxiclav group at 5 days post-operation (p-values: 0.715, 0.819 & 0.309). Clinically, metronidazole was more effective in protecting the extracted tooth socket from alveolar osteitis compared to co-amoxiclav and amoxicillin. Moreover, there were significant decreases in mean pain scores at 5 days post-operation compared with the levels of pain immediately after surgery (p-value: 0.001). Conclusions: Administration of a single preoperative dose of co-amoxiclav with a full postoperative dose of amoxicillin or metronidazole was more effective than conventional treatment with postoperative co-amoxilcalv in reducing the incidence of both alveolar osteitis and infection after surgical extractions. However, these differences were not statistically significant. Interestingly, patients in metronidazole group had the lowest incidence of dry socket.
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- 2022
39. Current uses of chlorhexidine for management of oral disease: a narrative review
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Zoë L. S. Brookes, Anthony Roberts, Raul Bescos, Kamran Ali, and Louise A. Belfield
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medicine.medical_specialty ,Dentists ,MEDLINE ,Mouthwashes ,Context (language use) ,Review Article ,virus ,Dental Caries ,Dental plaque ,03 medical and health sciences ,Gingivitis ,0302 clinical medicine ,Professional Role ,Caries ,medicine ,Humans ,030212 general & internal medicine ,Mouthwash ,Intensive care medicine ,Periodontitis ,bacteria ,General Dentistry ,periodontitis ,caries ,Bacteria ,business.industry ,Chlorhexidine ,mouthwash ,030206 dentistry ,medicine.disease ,Virus ,Dry socket ,stomatognathic diseases ,Systematic review ,Anti-Infective Agents, Local ,medicine.symptom ,business ,medicine.drug - Abstract
Objectives Chlorhexidine (CHX) is a commonly used antiseptic mouthwash, used by dental practitioners and the public, due to its antimicrobial effects. The aim of this article was to provide a narrative review of current antimicrobial uses of CHX relevant to dentistry in the context of oral diseases, highlighting need for further studies to support its safe and appropriate use. Study selection, data and sources Randomised controlled trials, systematic reviews and national (UK and US) guidelines were consulted where available, with search terms for each subject category entered into MEDLINE, PubMed, Google Scholar and the Cochrane database. Results Some evidence existed to support adjunctive short-term use of CHX to manage dental plaque, and reduce clinical symptoms of gingivitis, dry socket, as well as reduce aerosolisation of bacteria. However, use must be weighed alongside the less desirable effects of CHX, including extrinsic staining of teeth, antimicrobial resistance to antiseptic agents and the rare, but fatal, allergic reactions to CHX. Conversely, evidence for the effectiveness of chlorhexidine to manage or prevent periodontitis, dental caries, necrotising periodontal diseases, peri-implantitis, and infections associated with extraction and aerosolised viruses remains less certain. Conclusions The use of CHX in dentistry and oral healthcare continues to be widespread and thus it is important that dental practitioners understand that, based on its differential mechanisms of action on different microbes, appropriate clinical and dental use of CHX should be oral disease specific. However, further scientific and clinical research is required before full recommendations can be made.
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- 2020
40. Incidence of alveolar osteitis after mandibular third molar surgery. Can inflammatory cytokines be identified locally?
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Olga Hrønn Jonsdottir, Tore Bjørnland, Janicke Liaaen Jensen, Pål Barkvoll, Janne E. Reseland, and Hauk Furnes Øyri
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medicine.medical_specialty ,Relative incidence ,Dry Socket ,Mandible ,Proinflammatory cytokine ,Mandibular third molar ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,medicine ,Humans ,General Dentistry ,business.industry ,Incidence (epidemiology) ,Incidence ,Bone markers ,Tooth, Impacted ,030206 dentistry ,General Medicine ,medicine.disease ,Surgery ,Dry socket ,Tooth Extraction ,Cytokines ,Female ,Molar, Third ,Osteitis ,business ,030217 neurology & neurosurgery - Abstract
Objectives The aims of the present study were to evaluate the relative incidence of alveolar osteitis (AO) after mandibular third molar surgery, post-operative findings and local expression of bone markers and cytokines. Study design In 445 patients, unilateral surgical third molars extractions were undertaken (584 teeth). Bone markers and cytokines were explored at the AO side and on the un-operated contralateral side and compared with the levels in samples from a control group of 18 persons without AO. Results The relative incidence of AO was 4.6%. Patients (n = 27) with AO were invited to participate in the study and 21 (77.8%) did so. Patients with AO had 1–4 extra visits for treatment of AO, the mean follow-up time was 2.6 days for all patients. There were significantly higher levels of bone markers and cytokines in the AO site compared with the un-operated contralateral site, except for Epidermal growth factor (EGF). No significant difference in expression of bone markers and cytokines between the AO and control groups was found. Lower maximum inter-incisor opening (MIO) was correlated with increased Macrophage inflammatory protein 1 alpha. A negative correlation between patients’ complaint of trismus and MIO was seen. Conclusions The relative incidence of AO was low in our patient group treated with surgical removal of third molars. AO was more frequently seen in female patients. Treatment of AO required up to four extra visits. The study provides some information on the role of cytokines in AO; but further studies are required.
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- 2020
41. The effects of photobiomodulation therapy for treatment of alveolar osteitis (Dry Socket): Systematic review and meta-analysis
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Erfan Bardideh, Reza Asadi, Bahareh Shahidi, Abdolrasoul Rangrazi, Mohammad Nazari, and Hooman Shafaee
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Visual analogue scale ,medicine.medical_treatment ,030303 biophysics ,Biophysics ,MEDLINE ,Dentistry ,Dry Socket ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Pain perception ,Humans ,Pharmacology (medical) ,Low-Level Light Therapy ,Low level laser therapy ,Permanent teeth ,0303 health sciences ,Photosensitizing Agents ,business.industry ,medicine.disease ,Dry socket ,Oncology ,Photochemotherapy ,Meta-analysis ,Tooth Extraction ,Osteitis ,business - Abstract
Introduction Dry socket (alveolar osteitis) is one of the most common complications that occur after the extraction of permanent teeth. The aim of this review was to evaluate and compare the effectiveness of photobiomodulation (PBT) with other treatment methods on alveolar osteitis. Methods and materials MEDLINE, Web of Science, EMBASE, Scopus and Cochrane’s CENTRAL online databases were searched based on the search strategy. Also, the prominent laser journals and the references of relevant studies were hand searched for eligible studies and then the data were extracted from the retrieved studies were extracted using piloted custom forms. The data were combined and analyzed using inverse-variance random-effect meta-analysis. Results For the treatment of dry socket, pain perception based on the VAS score, PBT on average has a 3.41 higher pain level reduction compared to alveogyl which seems to be both statistically and clinically significant. In addition, based on the GRADE score, the evidence seems to be of moderate quality. Also, in the individual studies which were included in this systematic review, PBT seems to be more effective than other methods (Salicept, zinc-oxide eugenol, ozone, and photodynamic therapy) in pain reduction of patients with alveolar osteitis. Conclusions PBT, in general, has a higher ability in decreasing pain levels for patients with alveolar osteitis (dry socket) compared to alveogyl. Therefore, PBT could be used as an appropriate method for treatment and controlling the signs of dry socket.
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- 2020
42. Medication related osteonecrosis of the jaws (MRONJ): Factors related to recurrence after treatment with surgery and platelet rich plasma (PRP) placement
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J-L Cebrián Carretero, J-L Del Castillo Pardo de Vera, C Sánchez-Gallego Albertos, and A. Viejo Llorente
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medicine.medical_specialty ,Osteoporosis ,pain control ,pain relief ,Breast cancer ,medicine ,Humans ,General Dentistry ,Multiple myeloma ,alveolar osteitis ,UNESCO:CIENCIAS MÉDICAS ,Aged ,Retrospective Studies ,treatment ,Bone Density Conservation Agents ,Diphosphonates ,business.industry ,Platelet-Rich Plasma ,Research ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,Zoledronic acid ,Denosumab ,Otorhinolaryngology ,dry socket ,Jaw ,Oral and maxillofacial surgery ,Bisphosphonate-Associated Osteonecrosis of the Jaw ,Female ,Oral Surgery ,Complication ,business ,Multiple Myeloma ,management ,medicine.drug - Abstract
Background Medication-related osteonecrosis of the jaws (MRONJ) is a well-known complication associated with antiresorptive and antiangiogenic therapies. The purpose of this study was to analyse if there is any predictive factor of recurrence after local debridement plus platelet rich plasma (PRP) placement in MRONJ patients. Material and Methods Seventy MRONJ patients treated at the department of Oral and Maxillofacial Surgery in La Paz Hospital (Madrid, Spain) were included in this retrospective study. All of them were treated surgically by local debridement and PRP placement. The observation period was between January 2012 and January 2019. Information regarding use, type, administration, and duration of therapy with BP/denosumab was recorded. The follow-up period ranged from 2-52 months. A descriptive analysis, a bivariate and a multivariate study were performed. Results Most of the patients were women (82.9%) between 50-70 years old (64.3%), with a stage II disease (74.3%). The therapy lasted more than 12 months in 54.8% of them. Zoledronic acid was the main antiresorptive used (44.3%), followed by oral administered BPs (29 patients, 41.4%) and denosumab (10 patients, 14.3%). Osteoporosis (48.6%), breast cancer (30%) and multiple myeloma (11.4%) were the main diseases because the patients were taking antirresorptives. 13 patients (18.6%) experienced recurrence. We found that breast cancer patients (p>0.0001), smokers (p>0.016), and administration of zoledronic acid (p>0.0001) were related to recurrence. After performing the multivariate model, we found that the only factor related to recurrence was smoking habit (Wald 3.837, p=0.05, OR 6.12). Conclusions recurrence after local debridement plus PRP placement in our MRONJ series affected to 18.6% of patients. It seems to be more frequent in breast cancer patients, smokers, and after zoledronic acid administration. Smoking habit was the only independent factor related to recurrence in our series. Key words:Osteonecrosis of the jaw, recurrence, risk factor, bisphosphonates, zoledronic acid, denosumab, platelet rich plasma.
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- 2020
43. Management of dry socket with low-level laser therapy
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Aqsa, Kamal, Basheer, Salman, Noor Hayatie, Ar, and A R, Samsudin
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Europe ,Wound Healing ,Dry Socket ,Humans ,Low-Level Light Therapy ,Tooth Socket - Abstract
The aim of this study is to investigate the efficacy of delivering low-level laser therapy (LLLT) in the management of dry socket at University Dental Hospital Sharjah.Forty-five patients with dry socket were divided into two treatment groups. Group I dry socket patients (n = 30) received conventional treatment while group II patients (n = 15) were irradiated with LLLT at a setting of 200-mW, 6-J, continuous-wave mode using an R02 tipless handpiece (Fotona Er:YAG, Europe), on the buccal, lingual, and middle surfaces of the socket for 30 s from a delivery distance of 1 cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7 days post-dry socket treatment.Results showed that the LLLT-irradiated group II sockets showed a much lower VAS pain score of 1-2 as early as day 4, and a richer amount of granulation tissue compared to the conventional treated group I socket. The amount and rate of granulation tissue formation in the dry socket are inversely proportional to the pain score showing significant clinical effectiveness of LLLT on promoting the healing of the dry socket, with improvement in symptoms (P = .001). Conventionally treated dry sockets take at least 7 days to match the effective healing of an LLLT-irradiated dry socket.LLLT irradiation influences biomodulation of dry socket healing by dampening inflammation, promoting vascularization, stimulating granulation, and controlling pain symptoms.LLLT may be an additional effective tool for managing dry sockets in general dental practice.
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- 2020
44. Choice of the treatment method of the inflammatory process in the alveolar tooth socket
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Vira M, Helei, Natalia I, Zhero, Nazariy I, Helei, and Vladimir V, Kryvanich
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Adult ,Male ,Young Adult ,Adolescent ,Tooth Extraction ,Dry Socket ,Edema ,Humans ,Female ,Mandible ,Middle Aged ,Tooth Socket - Abstract
Alveolitis – is one of the most common complications in surgical dentistry after tooth extraction and their roots, accompanied by symptoms, the leading of which are pain in the alveoli with irradiation and partial or complete decay of the blood clot. The aim of our research is to study the clinical efficacy of antihomotoxic drugs and colloidal silver in patients with inflammatory processes in the alveolar tooth socket.58 patients with inflammatory process in the alveoli after extraction of teeth or their roots (38 - female, 20 - male), aged 18-60 years, were examined with the help of clinical and microbiological, cytological study. The main group consisted of 38 patients who were prescribed complex drug therapy after diagnosis of alveolitis. 20 patients were referred to the control group where allopathic treatments were used.The main observation group in 93% ± 0.07% of patients with serous form alveolitis already on the 2nd day disappear pain, redness, swelling of the soft tissues. Gradually, the function of the mandible and the temperature response were restored. In purulent alveolitis, the function of the jaw was restored on days 3 and 4. Patients in the control group experienced a slow course of the inflammatory process in the wound, a late decrease in local pain response, swelling and hyperemia of the wound edges. Jaw function recovery averaged 3.4 ± 0.1 days longer.The complex effect of drug and surgical treatment of alveolitis was studied. The combined use of colloidal silver, Traumeel® S, Polymic®, makes it possible to eliminate the inflammatory process in the alveoli faster and to reduce the period of active disease up to 2 - 3 days.
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- 2020
45. Efficacy of a topical gel containing chitosan, chlorhexidine, allantoin and dexpanthenol for pain and inflammation control after third molar surgery : a randomized and placebo-controlled clinical trial
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M-M Bornstein, José González-Serrano, Pedro Molinero-Mourelle, Juan López-Quiles, L-M Sáez-Alcaide, and L Rubio-Alonso
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Molar ,allantoin ,Trismus ,Pantothenic Acid ,surgery ,chemistry.chemical_compound ,0302 clinical medicine ,Edema ,Medicine ,pain ,Prospective Studies ,BIOADHESIVE GEL ,Allantoin ,Pain, Postoperative ,Chlorhexidine ,chlorhexidine ,Tooth, Impacted ,postoperative wound healing ,CIENCIAS MÉDICAS [UNESCO] ,Dry socket ,IThird molar ,Anesthesia ,UNESCO::CIENCIAS MÉDICAS ,Oral Surgery ,medicine.symptom ,Dexpanthenol ,Life Sciences & Biomedicine ,medicine.drug ,gel ,dexpanthenol ,EXTRACTION ,Placebo ,03 medical and health sciences ,Double-Blind Method ,Dentistry, Oral Surgery & Medicine ,Humans ,General Dentistry ,Inflammation ,Chitosan ,Science & Technology ,business.industry ,Research ,INTRAALVEOLAR PLACEMENT ,030206 dentistry ,medicine.disease ,ALVEOLAR OSTEITIS ,PREVENTION ,Clinical trial ,Otorhinolaryngology ,chemistry ,Tooth Extraction ,Molar, Third ,Surgery ,chitosan ,business - Abstract
BACKGROUND: The aim of this study was to evaluate and compare the postoperative effect of a topic gel containing chlorhexidine, chitosan, allantoine and dexpanthenol versus a placebo for pain and inflammation control after third molar surgery. MATERIAL AND METHODS: A gel combining 0.2% chlorhexdine, 0.5% chitosan, 5% dexpanthenol, 0.15% allantoin and 0.01% sodium saccharin was selected for this split mouth randomized controlled and double-blind trial including 36 patients with bilaterally and symmetrically impacted lower third molars. The teeth (n=72) were randomly divided into two groups before surgical removal: control group (CG; in which a placebo was given) and experimental group (EG). Swelling, trismus, postoperative pain, wound healing and complications were measured and recorded in order to evaluate differences between the placebo and experimental product. RESULTS: Five patients suffered from an alveolitis in the CG (13.9%), and none in the study group (0%), but no statistically significant difference was found (p=0.063). From day 0 to day 7, trismus and swelling were significantly less pronounced in the EG, and wound healing was considered 'good' in 22.2% for the CG and 97.2% for the EG (p
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- 2020
46. Effect of concentrated growth factors on frequency of alveolar Osteitis following partially-erupted mandibular third molar surgery: a randomized controlled clinical study
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Meltem Özden Yüce, Gözde Işık, Sevtap Günbay, Tayfun Günbay, Banu Özveri Koyuncu, and Ege Üniversitesi
- Subjects
Molar ,Adult ,Male ,medicine.medical_specialty ,Dry Socket ,Mandibular third molar ,Clinical study ,Concentrated growth factors ,Statistical significance ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,General Dentistry ,business.industry ,Tooth, Impacted ,Mean age ,Third molar surgery ,medicine.disease ,Surgery ,lcsh:RK1-715 ,Alveolar osteitis ,lcsh:Dentistry ,Platelet concentrates ,Tooth Extraction ,Oral and maxillofacial surgery ,Female ,Molar, Third ,Osteitis ,business ,Research Article - Abstract
Background The aim of this prospective study was to assess the effectiveness of concentrated growth factors (CGF) in preventing the development of alveolar osteitis (AO) after the extraction of partially-erupted mandibular third molars. Methods Seventy patients (26 men and 44 women) 18 years or older (mean age 25.86; range 18–35) underwent 140 third molar extractions. All the patients presented with bilateral, partially-erupted mandibular third molars and underwent surgical extractions. In each case, one socket received CGF and the other served as a control. The predictor variable was the CGF application and the sides were categorized as ‘CGF’ and ‘non-CGF’. The outcome variable was the development of AO during the first postoperative week. Other study variables included age and gender. Data were analyzed using Cochran’s Q test with the significance level set at a P value less than 0.05. Results The overall frequency of AO was 11.4% for the control group. The frequency of AO in the CGF group was significantly lower than in the non-CGF group (p Conclusions Based on the results of this study, application of CGF fibrin gel may decrease the risk of AO development after mandibular third molar surgery. Trial registration This study was registered in ClinicalTrials.gov database on November 1, 2019 (ID: NCT04151147, retrospectively registered).
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- 2020
47. Evaluation and comparison of anti-inflammatory properties of ibuprofen using two drug delivery systems after third molar surgery: using chitosan microspheres as a carrier for local drug delivery in to the third molar socket and through the oral route
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Karthik Kp and Balamurugan R
- Subjects
Molar ,Analgesic ,Anti-Inflammatory Agents ,Dentistry ,Ibuprofen ,02 engineering and technology ,Mandible ,Trismus ,03 medical and health sciences ,0302 clinical medicine ,Drug Delivery Systems ,stomatognathic system ,medicine ,Edema ,Humans ,Chitosan ,Pain, Postoperative ,business.industry ,Tooth, Impacted ,030206 dentistry ,021001 nanoscience & nanotechnology ,medicine.disease ,Microspheres ,Dry socket ,Otorhinolaryngology ,Pharmaceutical Preparations ,Drug delivery ,Tooth Extraction ,Surgery ,Molar, Third ,Oral Surgery ,Swelling ,medicine.symptom ,0210 nano-technology ,business ,Wound healing ,medicine.drug - Abstract
We undertook this study to assess the analgesic and anti-inflammatory properties of ibuprofen when administered through two drug delivery systems after mandibular third molar surgery. The study was conducted on 100 patients who required the surgical removal of impacted mandibular third molars under local anaesthesia. The study subjects were divided into two groups of 50 patients each. Patients in the study group were given ibuprofen-incorporated chitosan-based microspheres, which were packed into the third molar sockets after removal of impacted teeth. Patients in the control group were prescribed with ibuprofen 400mg tablets that were to be administered orally after the removal of impacted mandibular third molars. All patients were assessed for pain, swelling, and trismus on the second, fourth, and seventh postoperative days, and wound healing was assessed on the seventh postoperative day. Patients in the study group had significantly less pain and comparatively better mouth opening on the second, fourth, and seventh postoperative days, which showed clinically and statistically significant results of p
- Published
- 2019
48. Incidence and treatment of complications in patients who had third molars or other teeth extracted
- Author
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Isabel Miclotte, Constantinus Politis, J. O. Agbaje, Yannick Spaey, and Paul Legrand
- Subjects
Adult ,Molar ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Dry Socket ,Postoperative Hemorrhage ,Hypesthesia ,Young Adult ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Fibrinolytic Agents ,Antithrombotic ,medicine ,Humans ,Surgical Wound Infection ,In patient ,Child ,Aged ,Retrospective Studies ,Aged, 80 and over ,Pain, Postoperative ,business.industry ,Incidence ,Incidence (epidemiology) ,Retrospective cohort study ,030206 dentistry ,Odds ratio ,Middle Aged ,Anti-Bacterial Agents ,Surgery ,Otorhinolaryngology ,Dental extraction ,030220 oncology & carcinogenesis ,Tooth Extraction ,Molar, Third ,Oral Surgery ,business ,Complication ,Oral Fistula - Abstract
The aim of this study was to compare the incidence of complications after extraction of third molars (M3) or other teeth, and to describe their management. We made a retrospective cohort study of patients having M3 or other teeth extracted, and recorded complications up to two years' follow-up. A total of 142 complications developed after 2355 procedures (6%) - 7% after extraction of M3 compared with 5% after extractions of other teeth (p=0.024). The three most common complications were wound infection (2%), pain without apparent cause (
- Published
- 2018
49. The Efficacy of Plasma Rich in Growth Factors for the Treatment of Alveolar Osteitis: A Randomized Controlled Trial
- Author
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Elizabeth M. King, Matthew Locke, Maria Davies, Nicholas C A Claydon, Nicola X West, and Tanya L Cerajewska
- Subjects
Adult ,Male ,Dry Socket ,Dentistry ,Bone healing ,Dysgeusia ,law.invention ,Plasma ,03 medical and health sciences ,0302 clinical medicine ,plasma rich in growth factors ,Quality of life ,Randomized controlled trial ,law ,Eugenol ,Oils, Volatile ,para-Aminobenzoates ,medicine ,Humans ,Single-Blind Method ,Hydrocarbons, Iodinated ,PRGF ,alveolar osteitis ,Pain Measurement ,Wound Healing ,alvogyl ,business.industry ,Standard treatment ,Significant difference ,Halitosis ,030206 dentistry ,Middle Aged ,medicine.disease ,Alternative treatment ,Drug Combinations ,Treatment Outcome ,Otorhinolaryngology ,Tooth Extraction ,Quality of Life ,Intercellular Signaling Peptides and Proteins ,Female ,Surgery ,bone healing ,Oral Surgery ,medicine.symptom ,Osteitis ,business ,030217 neurology & neurosurgery - Abstract
Purpose: To investigate the efficacy of plasma rich in growth factors (PRGF)® for the treatment of alveolar osteitis compared to a positive control Alvogyl®. Methods: This single centre, single blind, randomised, two treatment, parallel study was conducted in a UK dental hospital. All healthy adults who presented with alveolar osteitis following tooth extraction over a 3 month period were invited to participate. Each socket was randomised and treated with one of two treatment modalities, a test treatment PRGF® or a positive control Alvogyl®. Following treatment, patients were reviewed at 3 and 7 days by a second clinician blinded to the treatment given. Outcome measures included pain, exposed bone, inflammation, halitosis, dysgeusia and quality of life assessment. Results: 38 patients with data from 44 sockets, 22 in the PRGF® group and 22 in the Alvogyl® group, were analysed. The PRGF® group demonstrated significantly faster bone coverage as well as significantly reduced inflammation and halitosis (p Conclusion: PRGF® predictably treated alveolar osteitis following tooth extraction compared to the conventional standard treatment of Alvogyl® which has been used for many years. PRGF could be considered as an alternative treatment for alveolar osteitis, and indeed appears to have significant advantages over Alvogel®.
- Published
- 2018
50. An unusual microscopic pattern of foreign body reaction as a complication of dry socket management
- Author
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Christos Droukas, Afroditi Nonni, Jason Tasoulas, Argyrios Daskalopoulos, and Nikolaos G. Nikitakis
- Subjects
medicine.medical_specialty ,Dry Socket ,Mandible ,Pathology and Forensic Medicine ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Radiography, Panoramic ,medicine ,Humans ,Bicuspid ,Radiology, Nuclear Medicine and imaging ,Dentistry (miscellaneous) ,business.industry ,Foreign-Body Reaction ,Postoperative complication ,030206 dentistry ,Middle Aged ,medicine.disease ,Bandages ,Surgery ,Dry socket ,030220 oncology & carcinogenesis ,Tooth Extraction ,Female ,Oral Surgery ,Differential diagnosis ,Foreign body ,Osteitis ,MEDICATED DRESSINGS ,Complication ,business - Abstract
Foreign body reactions in the oral cavity are relatively common, frequently resulting from iatrogenic causes. Depending on the nature of the foreign material, various microscopic patterns may be observed, causing diagnostic difficulties. Recognition of the ensuing unusual microscopic pattern, especially for cases in which the possibility of a foreign body reaction is not entertained in the clinical differential diagnosis, necessitates sufficient degree of suspicion, familiarization with the spectrum of microscopic appearances, and careful clinicopathologic correlation. Medicated dressings of various compositions are commonly placed for prevention or management of dry socket (or alveolar osteitis, a common postoperative complication of tooth extraction) and may be a cause of foreign body reaction. Here, we report a foreign body reaction to a medical dressing material in a postextraction socket, with an unusual microscopic pattern bearing resemblance to parasitic infestation.
- Published
- 2018
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