Incidence Of Alveolar Osteitis Research Articles

Analysis of Different Treatment Approaches to Prevent Alveolar Osteitis

Alveolar Osteitis (AO) is a complication that can arise after tooth extraction. It refers to a socket following extraction that lacks epithelium, blood clot, and has an exposed bony surface, often causing intense and radiating pain. Objectives: To determine the incidence of AO among different treatment groups undergoing tooth extraction. Methods: A prospective comparative study was conducted. Patients were enrolled and allocated into treatment groups: Control, Saline Irrigation, and chlorhexidine (CHX) Rinse. Outcome measures included the incidence of AO. Statistical analysis was performed to compare outcomes between treatment groups. Results: The overall occurrence rate of dry socket was 14.22%, with the highest incidence observed in patients who received saline irrigation. Conversely, the use of chlorhexidine rinse once postoperatively resulted in the lowest incidence rate. Conclusions: It was concluded that post-operative use of chlorhexidine rinse shows a promising and favorable outcome in preventing AO among patients. However, this study does not support the justification for irrigation with saline. Further well-designed clinical trials are necessary to validate these findings.

Use of platelet- and leukocyte-rich fibrin (L-PRF) as a healing agent in the postoperative period of third molar removal surgeries: a systematic review.

The aim of this study was to analyze the effectiveness of L-PRF as a healing agent in the postoperative period of third molar extraction surgeries, as well as to investigate secondary effects, such as the reduction of pain, edema and other discomforts after the surgical intervention. The methodology adopted consisted of carrying out a systematic review of the literature, following the model outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The inclusion criteria were previously established according to a systematic review protocol approved by the Prospective Register of Systematic Reviews (PROSPERO) under number CRD42023484679. In order to carry out a comprehensive search, a search in five databases was carried out, PubMed, Web of Science, Scopus, Cochrane Library and Embase. The search resulted in the selection of randomized controlled trials that conformed to the established criteria. Two authors independently screened the records and extracted the data. The assessment of bias was conducted according to the guidelines recommended by the Cochrane Collaboration, using version 2 of the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2). This study demonstrated that L-PRF stands out by providing direct benefits to healing, vascularization and tissue regeneration. L-PRF plays an important role in reducing postoperative pain, edema, the incidence of alveolar osteitis and infections after third molar removal surgery, compared to patients who did not undergo the use of L-PRF.

Effects of platelet‐rich fibrin on post‐extraction wound healing and wound pain: A meta‐analysis

AbstractWe conducted a meta‐analysis to assess the effect of platelet‐rich fibrin (PRF) on post‐extraction wound healing and pain, with a view to providing a reliable basis for the selection of treatment options in clinical practice. A computerised search of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for studies on the effect of PRF on post‐extraction wound healing and pain compared with natural healing (control group) was performed from the time of creation of the respective databases to July 2023. Literature screening, data extraction and quality assessment were done independently by two authors. Meta‐analysis was performed using RevMan 5.4 software. Fourteen studies with a total of 508 patients were finally included. Meta‐analysis showed that the use of PRF relieved patients' wound pain (standardised mean differences [SMDs]: −1.78, 95% confidence intervals [CIs]: −2.61 to −0.94, p < 0.001), promoted soft tissue healing of extraction wounds (SMD: 1.09, 95% CIs: 0.26–1.91, p = 0.010) and also reduced the incidence of alveolar osteitis (AO) in patients after tooth extraction (2.42% vs. 10.14%, odds ratio: 0.27, 95% CIs: 0.11–0.65, p = 0.004). Current clinical evidence suggests that the use of PRFs can reduce patients' postoperative wound pain, promote soft tissue healing of extraction wounds and reduce the incidence of postoperative AO compared with natural healing. However, due to limitations in the number and quality of studies, large‐scale randomised controlled trials are still needed to validate the results of this study in the future.

EFFECT OF ELECTRONIC CIGARETTE SMOKING AFTER TOOTH EXTRACTION ON THE INCIDENCE OF ALVEOLAR OSTEITIS

Highlights Smoking is a notable and extensively debated risk factor for problems following tooth extraction, but research on electronic cigarettes remains scarce. Electronic cigarettes contain various components comparable with those in conventional cigarettes, potentially resulting in similar chemical composition and effects on alveolar osteitis. Abstract Background: Tooth extraction is one of the minor dental surgical procedures involving the hard and soft tissues of the oral cavity and has several possible complications. One potential risk is alveolar osteitis, also known as dry socket, which is an inflammation marked by intense pain and the dislodging of the blood clot. Smoking behavior is a significant risk factor for alveolar osteitis. Objective: This article aimed to analyze the effect of smoking and electronic cigarette ingredients on the incidence of alveolar osteitis after tooth extraction. Material and Methods: This research was conducted as a scoping review by performing thorough search of the PubMed, Scopus, ScienceDirect, and Google Scholar databases. Research published between 2013 and August 2023 in English language were assessed in this review. Result: A total of ten papers have been included in the analysis. Comparative studies consistently demonstrated that individuals who engage in smoking are at a significantly elevated risk of developing alveolar osteitis following tooth extraction. Discussion: Both conventional and electronic cigarettes can dislodge the blood clot that forms at the tooth socket after tooth extraction as a result of the sucking movement involved in smoking. Electronic cigarette components reduce oxygen delivery to healing tissues, hence accelerating fibrinolysis. Conclusion: Electronic cigarettes affect the occurrence of alveolar osteitis by the act of smoke inhaling and the presence of substances like carbon monoxide and nicotine.

Effect of chlorhexidine gel on the prevention of alveolar osteitis and post‐operative pain following transalveolar extraction of impacted mandibular third molars: A randomized study

AbstractObjectiveThis study aimed to compare the efficacy of 0.2% chlorhexidine gel with warm saline mouth rinse (WSMR) in the prevention of alveolar osteitis (AO) following transalveolar impacted mandibular third molar (IMTM) extraction after accounting for surgical operative confounding factors.Materials and MethodsWe conducted a parallel design randomized study. Participants were consenting adults randomly assigned to 0.9% WSMR and 0.2% chlorhexidine gel (administered twice daily post‐operatively) groups. All participants were followed up daily post‐operatively for one week. The primary outcome was an incidence of AO, assessed using Blum's criteria. Fischer's exact tests and regression models were used to investigate the effect of interventions on AO.ResultsOne hundred participants were enrolled in the study, with 50 participants in each group. A higher incidence of AO was observed in the WSMR group than the chlorhexidine group (16% vs. 2%, p = 0.01). However, after adjusting for duration of extraction (aOR: 0.18; 95% CI: 0.02, 1.71) and bone operating time (aOR: 0.16; 95% CI: 0.02, 1.47), the difference was not statistically significant.ConclusionsIn conclusion, the study demonstrates that the application of the 0.2% chlorhexidine gel was not significantly more effective in preventing AO compared with the use of WSMR following transalveolar IMTM extraction after controlling for operative factors.

Frequency and etiological denominators of alveolar osteitis at Northern Province of Kingdom of Saudi Arabia-An observational study.

Alveolar osteitis is a painful complication that often arises after tooth extraction, presenting a significant clinical challenge. It is imperative to gain a comprehensive understanding of both its occurrence and the contributing factors to enhance the quality of dental care. The aim of this study was to assess the frequency and prevalence of alveolar osteitis among patients and compare these variables based on demographic characteristics (age and sex), the number of teeth extractions, operator experience, health status, and smoking habits in the target population. This cross-sectional observational study was conducted from May 2019 to April 2020. It included all patients above 16 years of age, of both genders, who underwent permanent tooth extraction for various reasons. Patient demographics, smoking habits, health status, operating dental surgeon's clinical experience, extraction technique, and the number of teeth extracted were recorded. Statistical analysis was performed using SPSS version 25. Chi-square test and regression analysis were used to assess differences between age, sex, smoking habit, dentist category, and the number of teeth extractions in relation to alveolar osteitis. A total of 679 permanent tooth extractions were performed in 438 patients. Alveolar osteitis was observed in 107 cases (15.7%) following tooth extractions. Among these, 36 cases (33.6%) occurred in single tooth extraction cases, while 71 cases (66.4%) were present in patients with multiple extractions. Moreover, 67 cases (62.6%) of alveolar osteitis were found in cigarette smokers. In addition, 61 cases (57%) of dry sockets were reported after tooth extractions performed by dental interns, while 46 cases (43.0%) were noted in extractions performed by experienced dental surgeons and specialists. The study found a 15.7% incidence of alveolar osteitis in tooth extraction patients in the Al-Jouf region. Alveolar osteitis was more prevalent in males and the age group of 56-77 years. Multiple tooth extractions were associated with higher alveolar osteitis incidence, while operator inexperience increased post-extraction complication risks. In addition, a promising novel protocol and risk assessment scoring system have been devised which require further validation and future research.

The effectiveness of intra‐alveolar Aloe vera extract powder on reducing the incidence of dry socket after tooth extraction: A randomized controlled clinical trial

AbstractObjectiveThe purpose of the study was to determine if the intra‐alveolar Aloe vera extract powder could reduce the incidence of alveolar osteitis (Dry socket) following extraction in the premolar site.Materials and methodsThis trial was a double‐blinded randomized controlled clinical study with a split‐mouth design which included 40 premolars sockets in 20 adult patients, aged 25–49 years. Each patient had two symmetrical extraction sites. The study sample was randomly allocated into two groups (A) the Aloe vera group, and group (B) the control group, extractions were performed for both sides in the same appointment. The occurrence of dry sockets was recorded on the third and seventh days after the extraction. Also, post‐extraction pain scores and the healing of the extraction socket were assessed.ResultsThe Aloe vera group showed a lower post‐extraction alveolar osteitis (dry socket) occurrence compared with the control group with a statistically significant difference (p < 0.05). The results also showed a decrease in pain scores in the experimental group compared to the control group with statistically significant differences on the first, third and seventh day after extraction (p < 0.05). Also, there were statistically significant differences in the degrees of healing of the extraction socket between the two groups on the seventh day after extraction (p < 0.05).ConclusionIt was concluded that the topical application of Aloe vera extract powder intra‐alveolar after extraction may decrease the incidence of alveolar osteitis (dry socket), improve socket healing and reduce post‐extraction pain.

Oral Contraceptive Use and Alveolar Osteitis Following Third Molar Extraction: A Systematic Review and Meta-Analysis.

Alveolar osteitis (AO) is a common postoperative complication of third molar extractions that is thought to be associated with the intake of oral contraceptives (OCPs). This meta-analysis sought to evaluate the risk of AO associated with OCP use and sex independently and whether this risk was affected by the use of postoperative analgesics or antibiotics. PubMed/Medline, EMBASE, and Cochrane databases were searched for articles pertaining to OCP use and the incidence of AO using MESH terms. The measured outcome was the development of AO following a third molar extraction. Additional variables such as sex, analgesic, and antibiotic use were documented and included in the analysis. The data were analyzed in R using the Mantel-Haenszel method. Fifteen studies with a total of 1366 female participants who were OCP users and 2919 nonuser female participants were included in this meta-analysis. OCP users were approximately twice (pooled-RR: 1.98, 95% CI: 1.42-2.76) as likely to develop AO following a third molar extraction when compared to nonuser females. The increased incidence of AO in the OCP group was statistically significant (p < 0.01). The pooled-RR of AO in females not taking OCPs was not significantly different from males (p=0.45). OCP use significantly elevated the risk of AO in females. Females who did not take OCPs had a similar risk of developing AO compared to males, suggesting that OCP use is a potential effect modifier. Neither postoperative antibiotics use nor the type of postoperative analgesic significantly affected AO incidence in those taking OCPs.

Efficacy of type-1 collagen cones in extraction sockets following surgical removal of semi-impacted mandibular third molars: a randomized controlled trial.

Third molar extractions may affect the periodontal health of the adjacent second molars as well as the patient's comfort. The objective of this study was to evaluate the efficacy of type-1 collagen cone (CC) on periodontal health and postoperative sequelae following extraction of third molars with secondary healing. This was a randomized, controlled, split-mouth clinical trial. Sixty mandibular third molars (30 patients) were subdivided according to side. A collagen cone was randomly inserted into one side and the other side was the control. Pain was evaluated using a visual analog scale. Trismus and facial swelling were determined on postoperative days 2, 7, and 30. The alveolar osteitis (AO) incidence was recorded on days 2 and 7. The Plaque Index, Gingival Index, clinical attachment level, and pocket probing depth of the second molars were evaluated at postoperative months 1, 3, and 6. No significant differences were found between groups regarding postoperative pain, trismus, facial swelling, or the incidence of AO. However, AO developed in 10% of control side cases, while no sign of AO was observed on the experimental side. Plaque Index, Gingival Index, and clinical attachment level were comparable in both groups. Pocket probing depths for the distobuccal surface of the second molar was significantly higher on the control side at 6 months (P = .017). Insertion of a type-1 collagen cone into an extraction socket did not show a significant clinical improvement in extraction socket healing and postoperative sequelae after the third molar extraction.

Effectiveness of Platelet-Rich Fibrin (PRF) Following Mandibular Third Molar Extraction: A Systematic Review

(1) Purpose: The employment of platelet-rich fibrin (PRF) in the extracted teeth socket has been shown to aid tissue healing. It also minimizes detrimental consequences. The rationale of this systematic review is to observe the possible association between PRF employment and postoperative consequences following mandibular third molar surgery. (2) Materials and Methods: The following databases were explored electronically (till 28 February 2021): PubMed, Cochrane library, Embase, International Clinical Trials Registry Platform (ICTRP), and ClinicalTrials.gov. A manual explore was accomplished on various journals regarding the subject of oral and maxillofacial surgery. The online explore applied the keywords “platelet-rich fibrin or PRF,” and “mandibular third molar.” To review the efficiency of PRF, the accompanying post-operative consequences were collected: pain, swelling, trismus, inter-incisal distance, analgesic consumption, soft tissue healing, bone healing, socket complications, and periodontal parameters. (3) Results: Just 9 full-text studies out of 26 were comprised of review for qualitative analysis. All of the studies were randomized clinical trials (RCTs), with eight split-mouth designs and one parallel design study. Significant outcomes were usually observed for pain, postoperative swelling, mouth opening, periodontal pocket depth, soft tissue healing, and the incidence of alveolar osteitis or dry sockets, but not constantly. The qualitative scrutiny disclosed that the PRF had no considerable outcome in bone healing. (4) Conclusions: Local administration of PRF is a practical way of alleviating pain, trismus, oedema, and enhancing soft tissue healing following mandibular third molar extraction. PRF tends to have no function in bone healing following extraction. More controlled clinical trials and RCTs are necessitating exploring the end results of PRF following mandibular third molar extraction.

A randomized comparative study of warm saline mouth rinse protocols for prevention of Alveolar Osteitis following dental extractions

Background: Warm saline mouth rinse (WSMR) for the prevention of alveolar osteitis (AO) following tooth extraction has been proven to be beneficial. The current practice of patients performing WSMR for 6-8 times a day for one week is cumbersome especially for patients in the working class.Objective: This study was conducted to determine the effect of different WSMR regimes (frequency and duration) on incidence of AO in patients who had intra-alveolar extraction. Methods: There were 253 participants with mean age of 29.3±8.4 years. They were randomly divided into four groups. Group1 had WSMR six times daily for 7 days; group 2, twice daily for 7 days; group 3, six times daily for 3 days, and group 4, twice daily for 3 days. Subjects were reviewed on the 3rd and 7th day post extraction.Results: The overall incidence of AO was 4.3%. Incidence of AO among group 1,2,3, and 4 were 4.8%, 3.2%, 4.8%, and 4.6% respectively. Occurrence of AO was not statistically significantly affected by either frequency or duration of WSMR (p &gt; 0.05).Conclusions: We recommend WSMR twice daily as prophylactic measure for AO to allow for patient convenience and increase compliance.

Effect of Photobiomodulation on the Incidence of Alveolar Osteitis and Postoperative Pain following Mandibular Third Molar Surgery: A Double-Blind Randomized Clinical Trial.

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. 660nm 200mW CW was applied at a distance of ~1cm to 4 points onthe occlusal area of extraction socket (beam area at the tissue ~0.64 cm2 , 312.5mWcm-2 , 1J, 1.6Jcm-2 ). Also, 810nm 200mW CW was applied at tissue surface at three points on the buccal and three points on the lingual gingiva, for 15s (400mWcm-2 , 3J, 6Jcm-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 3-7days post-extraction, and our results suggest that PBM treatment within the 7days could help reduce the risk of AO development.

“Importance of Plasma Rich Growth Factors In Tooth Socket-In Concern of DRY SOCKET” (A Comperative Study)

Introduction: The high prevalence of dry socket or alveolar osteitis (AO) is of concern in surgical removal of third molars. The aim of the present study was to assess the preventive effect of plasma rich in growth factors (PRGF) on AO and also its effect on pain management and healing acceleration in third molar extraction sockets of high-risk patients.&#x0D; Materials and Methods: This split-mouth, double-blind clinical trial included 40 bilateral third molar extractions (80 sockets) with at least one identified risk factor for AO. PRGF was obtained from patient’s own blood, based on manufacturer’s instruction, and blindly placed in one of the two bilateral sockets (PRGF group; n = 20) of each patient. The contralateral socket was treated with a placebo (control group; n = 20). Samples were evaluated for AO and pain incidence on days 2, 3 and 4 and healing and infection on days 3 and 7. Data were analyzed in SPSS v16 using Wilcoxon test.&#x0D; Results: There was a significant difference in dry socket and pain incidence and healing rate between the two groups. Intensity of pain and occurrence of dry socket in the study group was lower than the controls. Also the healing rate was higher (P &lt; 0.05) for the PRGF group. No sign of infection was seen in either group.&#x0D; Conclusion: The application of PRGF may significantly reduce the incidence of AO or its associated pain and may accelerate healing. The prophylactic use of PRGF following third molar extraction may be suggested especially in the patients at risk of AO.

Incidence of alveolar osteitis after mandibular third molar surgery. Can inflammatory cytokines be identified locally?

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.

Surgical techniques for the removal of mandibular wisdom teeth.

Surgical techniques for the removal of mandibular wisdom teeth.

Intrasocket interventions to prevent alveolar osteitis after mandibular third molar surgery: A systematic review and network meta-analysis

A systematic review and network meta-analysis was carried out to assess the efficacy of different intrasocket interventions immediately after mandibular third molar surgery to prevent alveolar osteitis (AO). An electronic search was undertaken using EMBASE, Cochrane Library, MEDLINE/PubMed, Web of Science, Scopus, LILACS, and grey literature. We reviewed studies published up to September 2019 and included 37 randomized controlled trials (6175 mandibular third molar surgeries in 4716 patients). The pairwise meta-analysis showed that the incidence of AO decreased significantly when an intrasocket intervention was performed (risk ratio 0.39 [0.30, 0.52]; p < 0.0001). Platelet-rich fibrin (odds ratio 0.28; 95% CI [0.10, 0.71]), chlorhexidine gel 0.2% (0.52 [0.32, 0.95]), eugenol paste (0.06 [0.00, 0.77]), recombinant bovine growth factor (0.07 [0.00, 0.97]), colloidal silver gelatin sponge (0.05 [0.00, 0.74]), and acellular dermal matrix (0.04 [0.00, 0.74]) were significantly more effective than the placebo. Platelet-rich fibrin and chlorhexidine 0.2% gel had a large number of included studies and patients per comparison. Overall, there was moderate evidence to support the use of platelet-rich fibrin or chlorhexidine 0.2% gel in the socket for the prevention of AO after mandibular third molar surgery.

Dentoalveolar Surgery Articles

Resnick CM, Calabrese CE, Afshar S, Padwa BL: Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars? J Oral Maxillofac Surg 77:1332, 2019 Nicolatou-Galitis O, Schiødt M, Mendes RA, et al: Medication-related osteonecrosis of the jaw: Definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 127:117, 2019 Otto S, Pautke C, Van den Wyngaert T, et al: Medication-related osteonecrosis of the jaw: Prevention, diagnosis and management in patients with cancer and bone metastases. Cancer Treat Rev 69:177, 2018 Schmitt CM, Buchbender M, Musazada S, et al: Evaluation of staff satisfaction after implementation of a surgical safety checklist in the ambulatory of an oral and maxillofacial surgery department and its impact on patient safety. J Oral Maxillofac Surg 76:1616, 2018 Pippi R, Spota A, Santoro M: Medicolegal considerations involving iatrogenic lingual nerve damage. J Oral Maxillofac Surg 76:1651.e1, 2018 Geisler BP, Ji YD, Peacock ZS: Value in oral and maxillofacial surgery: A systematic review of economic analyses. J Oral Maxillofac Surg 75:2287, 2017 Ferneini EM, Goldberg MH: Management of oral and maxillofacial infections. J Oral Maxillofac Surg 76:469, 2017 Cheng KL, Dodson TB, Egbert MA, Susarla SM: Which factors affect citation rates in the oral and maxillofacial surgery literature? J Oral Maxillofac Surg 75:1313, 2017 Dennis MJ, Bennett JD, DeLuke DM, et al: Improving the medical curriculum in predoctoral dental education: Recommendations from the American Association of Oral and Maxillofacial Surgeons committee on predoctoral education and training. J Oral Maxillofac Surg 75:240, 2017 Reiland MD, Ettinger KS, Lohse CM, Viozzi CF: Does administration of oral versus intravenous antibiotics for third molar removal have an effect on the incidence of alveolar osteitis or postoperative surgical site infections? J Oral Maxillofac Surg 75:1801, 2017 Bouloux GF, Busaidy KF, Beirne OR, et al: What is the risk of future extraction of asymptomatic third molars? A systematic review. J Oral Maxillofac Surg 73:806, 2015

Evaluation of the effects of intra-alveolar irrigation with clindamycin, rifampicin and sterile saline in alveolar osteitis treatment

BackgroundTo 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). MethodsFifty-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. ResultsThe 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. ConclusionIrrigation 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.

Comparison of efficacy of ozonated water, normal saline, and povidone-iodine after surgical removal of impacted mandibular third molars: A cross-sectional study.

Background:Surgical extraction of mandibular third molars is an important and one of the most frequently performed operative procedures in dentistry. There are a variety of postoperative complications that may follow this procedure. These include pain, trismus, infection, dry socket, or alveolar osteitis. Numerous techniques have been used for reducing these morbid conditions. These range from flap designs, suture placement, use of various irrigating solutions, etc.,Aim:The present study aimed to compare the effectiveness of three irrigating solutions: Ozonated water, normal saline, and povidone-iodine in reducing postoperative complications following surgical removal of impacted mandibular third molars.Materials and Methods:A total of 100 study participants formed the sample size of this study. Study subjects were categorized into three groups: Group I (third molar surgeries using ozonated water), Group II (third molar surgeries with normal saline irrigation), and Group III (third molar surgeries using povidone-iodine irrigation). Parameters studied postoperatively were alveolar osteitis (dry socket), pain, trismus, and infection after a week interval. All data obtained were entered in Microsoft Excel 2007 worksheets and Analysis of Variance (ANOVA) as a statistical tool was employed. A P value of < 0.01 was considered statistically significant.Results:It was found that ozonated water provided the best statistically proven results with comparison to normal saline and povidone-iodine in reducing the incidence of alveolar osteitis or dry socket and pain. No statistically significant difference was observed in the incidence of trismus and infection rate among three studied groups.Conclusion:Ozonated water is the best irrigating solution when compared to normal saline and povidone-iodine in terms of reduction in pain and dry socket after a 1-week duration.

Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study

Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compare it with the control group. Materials and methods: This clinical prospective study was conducted from October 2016 to October 2017 at the Department of Oral &amp; Maxillofacial Surgery, College of dentistry/University of Baghdad; and Al-Sadr Specialized Health Center. A total number of 50 IMTMs were surgically removed from 45 patients who met the inclusion criteria (21 males and 24 females) with age ranged from 16-41 years. The cases were divided into two groups: a study group (25 cases) where PRF were placed inside the extraction socket and control group (25 cases) where traditional surgery were performed. AO, trismus and swelling were assessed at the 2nd and 7th postoperative day. Pain scored by numeric rating scale daily by the patients. Results: The study showed that age, gender, side of impaction, oral hygiene condition, impacted tooth classification, surgical difficulty, and the time of procedure in both control and study groups had nearly similar distribution with non- significant difference. At the 1st follow up period: Trismus (P-value = 0.834) and Swelling (P-value = 0.592) were non- significant between the two groups. AO had overall incidence of 4% occurred only in the control group, while the PRF group had no occurrence (0%), but the difference was statistically non significant. Postoperative pain had no significance difference in both groups. At the 2nd follow up period there was no significant difference regarding trismus, swelling, and incidence of AO between both groups. Conclusion: Local application of PRF can reduce the incidence of AO but not to a significant level. PRF had no effect concerning postoperative pain, swelling, and trismus.