Volume 17 Issue 2 - 2018
Re-visiting Alveolar Osteitis: The “Post-Extraction Socket Lavage” Dilemma!
Ziyad S Haidar1-4*
1BioMAT’X, Facultad de Odontología, Universidad de Los Andes, Santiago, Chile
2Plan de Mejoramiento Institucional (PMI) en Innovación I+D+i, Universidad de Los Andes, Santiago, Chile
3Programa de Doctorado en BioMedicina, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile
4Centro de Investigación Biomédica, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile
*Corresponding Author: Ziyad S Haidar, Professor and Scientific Director, Faculty of Dentistry, Universidad de Los Andes, Santiago de Chile. Founder and Head of BioMAT’X, Biomedical Research Center (CIB), PMI I+D+i, Department for Research, Development and Innovation, Universidad de Los Andes, Mons, Álvaro del Portillo, Las Condes, Santiago, Chile.
Received: December 29, 2017; Published: January 08, 2018
Citation: Ziyad S Haidar. “Re-visiting Alveolar Osteitis: The “Post-Extraction Socket Lavage” Dilemma!”. EC Dental Science 17.2 (2018): 27-29.
Keywords: Alveolar Osteitis; Drug Delivery Systems; Dry Socket; Inflammation; Irrigation; Regeneration; Osteogenesis; Saline; Grafts
Exodontia is one of the most common dental procedures, practiced daily in clinics and hospitals around the World. Generally, the resulting extraction socket (following the removal of a tooth or teeth from the dental alveolus within the alveolar bone of the maxillary and mandibular jaws) heals uneventfully; where a properly formed fibrin clot undergoes organisation, vascularisation and gradual replacement with bone through an osteoproliferation process, post-extraction. However, alveolar defects will still only become partially restored. This is due to the fact that most extractions are traumatic and are done with no regard for maintaining the integrity of the alveolar ridge; especially common, in under-developed and developing countries. Whether due to caries, trauma or advanced periodontal disease, which are often present in all oral cavities, exodontia and subsequent healing of the socket will result in osseous deformities of the alveolar ridge. There is well-documented, resorption of the alveolar bone ridges and loss of vertical ridge height and width, which is known to result in a narrower and shorter ridge, and consequently, deformation of facial aesthetics. As aesthetics have received more emphasis with treatment planning, within the past decade, resorption of the alveolar ridge following tooth extraction, especially in the anterior region has become a significant problem. For example, after tooth removal, the dental team faces the challenge of creating a prosthetic estoration (conventional bridge or an implant-supported crown) that blends with the adjacent natural dentition. Such clinically-significant challenges often result in requiring time-consuming secondary surgeries and the use of costly barrier membranes, bone grafts and/or bone grafting substitutes, prior to finalizing the prosthetic restoration. Furthermore, alveolar osteitis or fibrinolytic alveolitis, referred to as “dry socket” (a term first used by Crawford in 1896), remains amongst the most commonly encountered complications following routine extraction or even the surgical removal of teeth by general dentists as well as specialists. The most recent definition of dry socket describes the condition as post-operative pain inside and around the extraction site, which increases in severity at any time between the first and third day post-extraction, accompanied by a partial or total disintegration of the blood clot within the alveolar socket (due to an increased fibrinolytic activity or fibrinolysis that destroys the blood clot early). The development of this condition leads to excruciating pain, foul breath or halitosis, unpleasant taste, empty socket, gingival inflammation and lymphadenopathy. While the exact pathogenesis of dry socket is not well understood rendering no possible treatment, incidence is mainly attributed to difficulty of extraction procedure (i.e. trauma), lack of dentist’s experience, association with systemic diseases, smoking, bacterial infection due to poor oral hygiene, among other factors. Hence, the frequency of the condition continues to increase; for routine dental extractions (around 5% - 25%), after extraction of mandibular third molars (around 40% - 55%) and surgical extractions resulting in about 10 times higher incidence.
Copyright: © 2018 Ziyad S Haidar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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