Management Of Dry Socket Research Articles

The Use of Platelet-Rich Fibrin (PRF) in the Management of Dry Socket: A Systematic Review.

Dry socket or alveolar osteitis is a common postoperative complication following tooth extraction, characterized by severe pain due to the disintegration of the blood clot within the socket. Various factors contribute to its development, such as traumatic extraction, patient age and sex, smoking, and anesthetic use. To mitigate this condition, socket preservation techniques, including the use of bone substitute materials, have been employed. Platelet-rich fibrin (PRF) has emerged as a promising biomaterial, enhancing healing and reducing the incidence of dry socket. Materials and Methods: This systematic review, adhering to the PRISMA guidelines and registered with PROSPERO (ID: CRD 578018), examines the efficacy of PRF in managing dry socket by analyzing studies from PubMed, Scopus, and Web of Science published between January 2013 and May 2024. Boolean keywords have been used in the search strategy: ("Treatment") AND ("Dry Socket") AND ("Platelet Rich Fibrin" OR "PRF"). A total of 738 publications were found using the electronic database search. After the screening phase, 13 records were chosen for qualitative analysis. The results from multiple clinical trials and comparative studies indicate that PRF significantly reduces postoperative pain, expedites healing, and lowers the incidence of Alveolar Osteitis. Despite promising results, further large-scale, randomized studies are needed to validate PRF as a standard treatment for dry socket.

Detection of the Effect of Platelet-Rich Fibrin on the Management of Dry Socket

A dry socket is a commonly seen issue that happens throughout the process of wound healing following a tooth extraction. The etiology of this condition is still limited understood, and it frequently manifests in persons who have a state of good health. As a consequence, the management strategies for dry sockets have always depended on practical experience rather than scientific theory. This study aims to assess the efficacy of platelets-rich fibrin (PRF) in treating dry sockets and compare it with traditional therapy methods. A randomized controlled clinical trial was conducted among patients with a dry socket, who were categorized into two treatment groups. In the group I, the conventional treatment was used with performing gentle socket curettage and saline irrigation. The group II was treated with platelet-rich fibrin (PRF); the dry socket patients were examined at day 0 and achieved one of two treatment options, then scheduled follow-up appointments on days 4 and 7 after therapy. The pain score, inflammation and tenderness around the socket, and quantity of granulation tissue formation were assessed, respectively. In total, sixty patients with a dry socket were included in two treatment groups. The results show that The conventional therapy group required more than seven days to reach the same healing phase as group II with PRF-treated socket. It was observed that the PRF-treated group II patients experienced an improvement in pain, tenderness, inflammation and granulation tissue formation. The sockets treated with PRF showed statistically significant improvement in the healing process and granulation tissue formation compared with conventional treatment.

To assess knowledge and awareness regarding treatment of dry socket among interns

Objectives: A painful dental condition known as a dry socket (also known as alveolar osteitis) can occasionally develop after the extraction of a tooth. A dry socket occurs when the blood clot at the site of the tooth extraction dislodges before it has healed. The idea of treating dry sockets with medication-related combined treatment is relatively new. Many drugs have the ability to treat dry sockets. The study aimed to assess the knowledge regarding the combined treatment of dry socket among interns. Material and Methods: This cross sectional study was carried out at a dental college to evaluate the knowledge and awareness of dental students regarding treatment of dry socket. Results: The statistical analysis showed significance in knowledge about the combined treatment of dry socket. The participants had basic knowledge regarding various aspects of dry socket except recent advances.. Female interns showed more knowledge than male counterparts however, due to the unequal number of male and female participants the difference is not statistically significant. Basic knowledge regarding dry socket management was satisfactory however, awareness regarding newer advances needs to be improved. Conclusion: It is strongly recommended that the students should update their knowledge using continuing education programmes, journal articles so that they can manage this clinical condition effectively.

Update on Management of Alveolar Osteitis (Dry Socket): A Review of The Literature

An inflammation of the maxilla or mandible's alveolar process is known as alveolar osteoitis (AO). The disease is usually self-limiting, but it can occasionally persist for up to seven days after extraction. It is characterized by dull, radiating discomfort that can affect the neck, eyes, or temple. Despite the fact that dry socket has been known about for over a century, its etiology is still not well understood, and there are many different treatment options with variable results. This review's objective is to look into upgrades for dry socket management. The three types of treatment endeavors were regenerative techniques, conventional approach, and empirical methodology. While contemporary therapeutic approaches influence angiogenesis and granulation tissue production, earlier approaches focused on controlling pain, preventing infections, and resolving inflammation. These later arsenals employ laser and ultrasonic technology to induce and disseminate tissue regeneration while using blood-based consumables like platelet-rich plasma. Keywords: Dry socket, Alveolar osteitis, Low Level Laser Therapy

THE EFFECTIVENESS OF CEMCEM (Spondiaspinnata (L.f) Kurz) LEAF EXTRACT IN INHIBITING THE GROWTH OF Streptococcus mutans

Introduction: Dry socket is post-tooth extraction pain characterized by partial or complete loss of blood clots in the alveolar socket. One of the management of dry socket is by using antibiotic therapy. Inappropriate use of antibiotics in addition to being economically wasteful can also cause bacterial resistance to antibiotics. The use of herbal ingredients such as Cemcem (Spondiaspinnata (L.f) Kurz) is one solution. Cemcem leaves are thought to have antibacterial effects because they contain flavonoids, tannins and saponins. This study aims to determine the inhibition of cemcem leaf extract (Spondias pinnata (L.f) Kurz) against the growth of Streptococcus mutans. Materials and methods: The research method used is the Kirby Bauer method which is a sensitivity test with the agar diffusion method using the disc diffusion technique. In the Kirby Bauer sensitivity test using selective media, namely Muller Hinton Blood Agar media, the inhibition zone created is characterized by a clear zone around the disc. The data obtained were analyzed using the Kruskall Wallis test to determine whether or not there was a significant difference then continued with the Mann Whitney U - Test. Results: Cemcem leaf extract (Spondias pinnata (L.f) Kurz) with a concentration of 60% and 70% can inhibit the growth of Streptococcus mutans better than positive control and 80% concentration. Conclusion: 60% concentration of cemcem leaf extract is more effective in inhibiting the growth of Streptococcus mutans than 70% and 80% concentrations.

Literature review of dry socket: etiology, pathogenesis, prevention, and management

Dry socket/alveolar osteitis is a detrimental and excruciatingly painful post-extraction condition of the socket caused by the breakdown of a clot leading to the denudation of the socket that exposes underlying bone that is not protected by a blood clot or healing tissue and persists within or around the alveolus for days after the surgical tooth extraction with or without halitosis and suppuration. It is inevitable that dry socket will develop during routine oral surgery or dental procedures. The common factors that cause dry socket are smoking, poor oral hygiene, traumatic extractions caused by inexperienced dentists, previous bacterial infection, inflammation, fibrinolysis, and systemic disorders, in conjunction with oral contraceptives, menstrual cycle, and rapid irrigation of the socket after extraction with normal saline. The management of dry socket is directed towards palliative care. A substantial amount of research is required to provide a definitive treatment choice for dry socket. This literature review focuses on the pathogenesis, prevention, and management of dry socket.

Zinc-Oxide Eugenol Paste, Antimicrobial Gel, and Ayurvedic Medicament in the Management of Alveolar Osteitis: A Prospective and Comparative Study

Objectives: The objective of this study was to compare the three treatment strategies of zinc oxide eugenol (ZOE), metronidazole gel, and Aloe vera gel in the management of dry socket with respect to pain relief and mucosal healing. Methods: This was a comparative study in which 90 patients were recruited and randomly divided into three groups of 30. ZOE dressings were applied in Group A, Metronidazole gel in Group B, and Aloe vera gel was applied in Group C patients on the day of reporting. Patients were followed up for seven consecutive days. Day-wise pain and mucosal healing were assessed in each patient using the visual analog scale and mucosal healing index, respectively. Results: The mean age for the 90 patients recruited in the study was 44.02 (9.9). Male: Female ratio was 37:53. Higher values of pain were reported in Group A from day 1 to 6 (P < 0.01). However, the difference was not significant among the three groups (P > 0.05) on the 7th day. Significant differences were seen among groups (P < 0.01) for mucosal healing on days 2–6 with higher mean values in Group A. On day 1 and day 7, a non-significant difference was seen for the values across all three groups (P > 0.05). Conclusion: Metronidazole and Aloe vera gels were found effective in early pain relief while producing a similar amount of mucosal healing. These gels offer the potential to be used as alternative home remedies, thus reducing the number of dental appointments required in the case of ZOE dressings. However, further randomized and clinical studies are required to evaluate the three strategies for their potential adverse effects.

Analysis of Role of Turmeric in Management of Alveolar Osteitis

Background and objective: Alveolar osteitis created disruption in healing process after clot foration but before wound organization. The main objective of the study is to analyse the role of turmeric in management of alveolar osteitis. Material and methods: This descriptive cross sectional study was conducted in DHQ Sargodha during Nov 2019 to Jan 2020. This study was done with the permission of ethical committee of hospital. There were 180 participants in this study. Data was collected from two study groups, one was treated with turmeric and group B was treated with Zinc oxide eugenol (Alveogel). Results: The data was collected from 180 patients, 90 patients in each group. Group A shows symtopms of pain, swelling and halitosis from second day while Group B shows all these symptoms around day 5th. According to t-test there was a significant difference between two treatments. The significant value of p < 0.05. There was no side effect of turmeric observed in our study, so it can be used as an alternative for the management of dry socket. Conclusion: It is concluded that there are no side-effects of turmeric. Excess use of euginol, can lead to necrosis of bone. The turmeric can be used as a medicament for the management of dry socket. Excess use of eugenol can lead to necrosis of bone.

EFFICACY OF LASER THERAPY FOR ALVEOLAR OSTEITIS: A SYSTEMATIC REVIEW OF THE AVAILABLE EVIDENCE.

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. 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. 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. 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. Laser therapy can be applied for the management of dry socket.

Management of Dry Socket: New regenerative techniques emerge while old treatment prevails

Although dry socket has been recognized for more than a century, its etiology is still poorly understood, and treatment approach is diverse with varying outcome. The aim of this review is to investigate, classify, summarize, and discuss the treatment of dry socket. Four databases (PubMed, Science Direct, Scopus and Medline) were searched from April 2000 till April 2020 for articles featuring the key words: ‘dry socket’, OR ‘alveolar osteitis’, OR ‘post-extraction complication’, OR ‘treatment of dry socket’, OR ‘treatment of alveolar osteitis’, OR ‘treatment of pain following tooth extraction’. The Standard Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were adopted for data gathering. A total of 3,857 results were found and 17 articles were finally selected and reviewed thoroughly. Treatment initiatives were categorized into empirical approach, conventional approach and regenerative strategies. 19 treatment products were identified. Earlier therapeutic approaches focus on pain control, infection prevention and resolving inflammation while current strategies modulate angiogenesis and granulation tissue formation. These latter armamentariums use blood-based products such as Platelet-Rich Plasma; employing laser and ultrasound technology that initiate and propagate tissue regeneration. While evidence support a regenerative approach for dry socket healing, the old treatment modality controlling infection, inflammation and pain prevails.

Efficacy of Aloe Vera Gel in Dry Socket After Removal of Mandibuler Third Molar

Objective: To evaluate the effectiveness of Aloe Vera gel in management of dry socket after surgical removal of 3rd molar. Study Design & Setting: From December 2020 to November 2021, a descriptive research was conducted in the Section of Oral & Maxillofacial Surgery, Liaquat University of Medical & Health Sciences, Jamshoro, Hyderabad, Sindh. Methodology: Total 70 patients were included and divided equally in two groups i.e. Group-A (Alveora dressing) and Group-B (Controls). Dry socket, pre-operative assessment was carried out on the basis of pain Visual analog scale (VAS) and healing index. Socket was irrigated with sterile saline 0.9% in experimental group. In control group, patient were given tablet Panadol 1gm SOS. Patients were evaluated post operatively at 1st, 2nd, and 3rd day on the basis of pain (VAS) and healing index. Results: In group-A mean postoperative VAS at day-1, day-2 and day-3 was 6.69±2.59, 3.17±2.39 and 1.14±1.03 respectively. In group-B it was 7.77±2.03, 6.97±2.14 and 4.57±2.57. In group-A, mean postoperative healing scale at day-1, day-2 and day-3 was 2.83±0.56, 3.49±0.61 and 4.37±0.73 respectively and in group-B it was 2.31±0.58, 2.63±0.69 and 3.26±0.65 respectively. Significant association of pain intensity at day-2 and day-3 and healing index (at day-1, day-2 and day-3) was observed. Conclusion: Aloe Vera gel significantly reduced postoperative pain and improve healing index. Keywords: Effectiveness, Aloe Vera Gel, Dry Socket, Surgical Removal, Third Molar

Comparison of Iodoform and Paraminobenzoate for The Managment of Dry Socket

Objective: The aim of present study is to compare effectiveness of two different modalities Iodoform and Para-Aminobenzoate for the management of Dry socket. Material And Methods: Patients reported with dry socket at the OPD of Oral and Maxillofacial Surgery, Institute of Dentistry, Liaquat University of Medical and Health Sciences, after mandibular molar tooth extraction were included After thorough irrigation with sterile saline and followed up for three alternative days by replacing dressing and then findings were recorded in the designated proforma of the patients. Pain was measured by Visual Analogue Scale (VAS). Results: The mean age of group A was 26.18+4.41 years and mean age in group B was observed 26.0+3.92 years. Males were predominantly reported in both groups. In this study 3rd molar extraction was commonest as 81.1% in group A. Similarly 3rd molar extraction was 85.5% in group B. Most of the cases of both groups underwent surgical extraction. In our study mostly onset symptoms were seen at 72 hours in both study groups. On day 3 and 4 pain was markedly decrease in patients of group B as compared to group A, p-values were quite insignificant (p=0.001). Conclusion: Para-Aminobenzoate showed better effectiveness in decreasing the pain from day 2nd. Keywords: Dry socket, Iodoform, Para-Aminobenzoate, Pain

TREATMENT OUTCOME OF DRY SOCKET FOLLOWING IMMEDIATE IMPLANT PLACEMENT USING PLATELET RICH FIBRIN: A PROSPECTIVE MULTI-CENTRE CLINICAL STUDY

Abstract: Objectives: Dry socket is a common post-extraction complication. It is possible to occur following immediate implant placement. This study was designed to assess the efficacy of PRF for the management of established dry socket following immediate implant placement. Materials and Methods: Twenty patients with established dry sockets following immediate implant placement were included. Patients were divided randomly, patients of group I were treated by socket curettage and irrigation, while in group II PRF was inserted in the space around the implant and filled the socket. Pain and granulation tissue formation score has been used to assess both groups. Results: The pain score was 6 to 10 on the day zero, 3 to 6 on the day four and 1 to 3 on the day seven in group I, while in group II the pain score was 6 to 10 on the day zero, 0 to 3 on the day four and 0 to 1 on the day seven (p 0.001). On group II the formations of granulation tissue appeared earlier than group I. Four implants failed, three implants in group I and one implant in group II. Conclusion: This study suggests that the use of PRF for the management of dry socket following immediate implant placement relieves pain, accelerates the process of wound healing and increases implant success rate.

A Comparative Clinical Study between Concentrated Growth Factor and Low-Level Laser Therapy in the Management of Dry Socket.

Objective A dry socket is a well-recognized complication of wound healing following tooth extraction. Its etiology is poorly understood and commonly occur among healthy patients. As such, management strategies for dry socket has always been empirical rather than scientific with varying outcome. The aim of this study is to investigate the efficacy of concentrated growth factor (CGF) and low-level laser therapy (LLLT) and compared them to the conventional treatment in the management of dry socket. Materials and Methods Sixty patients with one dry socket each, at University Dental Hospital Sharjah, were divided into three treatment groups based on their choice. In group I ( n = 30), conventional treatment comprising of gentle socket curettage and saline irrigation was done. Group II ( n = 15) dry sockets were treated with CGF and group III ( n = 15) sockets were lased with LLLT. All dry socket patients were seen at day 0 for treatment and subsequently followed-up at 4, 7, 14, and 21 days. Pain score, perisocket inflammation, perisocket tenderness, and amount of granulation tissue formation were noted. Statistical Analysis Data were analyzed as mean values for each treatment group. Comparisons were made for statistical analysis within the group and among the three groups to rank the efficacy of treatment using one-way analysis of variance (ANOVA). Statistically significant difference is kept at p < 0.05. Results Conventional treatment group I took more than 7 days to match the healing phase of group II CGF treated socket and group III LLLT irradiated socket ( p = 0.001). When healing rate between CGF and LLLT are compared, LLLT group III showed a delay of 4 days compared with CGF in granulation tissue formation and pain control. Conclusion CGF treated socket was superior to LLLT in its ability to generate 75% granulation tissue and eliminate pain symptom by day 7 ( p = 0.001).

Management of dry socket with low-level laser therapy.

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 30s from a delivery distance of 1cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7days 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 7days 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.

Assessment of Healing Using Alvogyl and Platelet Rich Fibrin in Patients with Dry Socket - An Evaluative Study.

Introduction:Dry socket is one of the most common postoperative complications following the extraction of permanent teeth, which is characterized by pain and exposed bone. The usual protocol followed for its management is irrigation of the socket and packing of the socket with medicated gel or paste to provide relatively faster pain relief and allow normal wound healing. In this study, we evaluated the outcome of management of dry socket with platelet-rich fibrin (PRF) and intraalveolar alvogyl dressing, in terms of improvement in pain and socket epithelialization after the treatment.Methodology:Thirty participants with established dry socket were randomly divided into two groups: Group A and Group B. The participants in Group A were treated with alvogyl and those in Group B were treated with PRF. Clinical parameters were assessed for both groups on the 1st day of the procedure and on the 3rd and 10th-day postoperatively for the reduction in pain and wound healing.Results:There was a significant decrease in pain and the number of socket wall exposure in both the groups by the 3rd postoperative day. In both the groups, the pain had completely resolved and socket fully epithelialized by the 10th postoperative day.Discussion:The use of PRF in the present study yielded promising results in terms of both pain reduction and improved wound healing which was comparable to the conventional alvogyl dressing. It may be concluded that PRF is an effective modality for the management of dry socket.

Management of Dry Socket―A Review

Dry socket is one of the common complications which may befall following the extraction. It is characterized by intense painful episodes, loss of taste sensation and halitosis. However, the pathogenesis is unbeknown but occurs more likely due to blood clot disintegration which has multiplex etiological factors. There are many methods emphasized for the prevention and management of this condition that is empirical and not the standard one. This review article aims to lists possible methods for management of dry socket.

Evaluation of Efficacy of Platelet-Rich Fibrin (PRF) versus Alvogyl and Zinc Oxide and Eugenol (ZOE) packing in the Management of Alveolar Osteitis: A prospective randomized clinical study

Purpose: The purpose of this research was to compare the effectiveness of platelet rich fibrin (PRF), alvogyl and zinc oxide/ eugenol (ZOE) intra-alveolar dressings for pain relief and socket healing (Epithelialization) in dry socket management and to study relevant epidemiological features.Patients and methods: A total of 45 patients with alveolar osteitis were randomly divided into three groups; Group (A) patients received PRF, Group (B) patients received Alvogyl and Group (C) patients received ZOE dressing. All the patients were evaluated for Pain (VAS), degree of inflammation, healthy granulation tissue formation and number of exposed socket walls (socket epithelialization) at 1st, 3rd, 7th, and 14th post-operative day. Results: Group A (PRF) showed better and faster socket healing than Group B and C. However, symptomatic pain relief was faster in Group B (Alvogyl) than in Group A and C.Conclusion: PRF in this study illustrates the promising results to be used effectively as the suitable dressing material in the management of alveolar osteitis. PRF treated cases showed a shorter time required for complete and fast clinical healing.

A Study to Evaluate the Efficacy of Honey in the Management of Dry Socket.

Background:Natural products have been used for several years in folk medicine. Honey was used to treat infected wounds as long ago as 2000 years before bacteria was discovered to be the cause of infection. It has been reported from various clinical studies on the usage of honey as a dressing for infected wounds that the wound become sterile in 3–6 days.Aim:This study aimed to find out the efficiency of naturally occurring honey in alveolar osteitis.Methodology:Fifty patients of dry socket were selected from the outpatient department of oral and maxillofacial surgery. A diagnosis of dry socket was made clinically. Honey was used as a dry socket dressing in all these patients. Parameters such as mucosal edges, pain, and formation of granulation tissue were assessed in the postoperative period for a week.Statistical Analysis Used:Analysis was done by paired t-test method using SPSS software version 17.Results:In this study, there was a significant reduction in inflammation, hyperemia, and mucosal edges that resulted in the reduction of pain and discomfort to the patient. There was no side effect of honey observed in our study, so it can be used as an alternative for the management of dry socket. Change in distance between mucosal edges when compared from the day of clinical presentation to 5th day postplacement was statistically significant (P < 0.001).Conclusions:There are no side effects of honey. Excess use of eugenol can lead to necrosis of bone. Thus, honey can be used as a medicament for the management of dry socket.

Efficacy of plasma rich in growth factor used for dry socket management: a systematic review.

Background The main aim of this systematic review was to assess the dry socket management using plasma rich in growth factor (PRGF) in terms of pain relief, alveolar fossa healing, inflammation, the incidence of dry socket. Material and Methods PubMed, Cochrane Library, Elsevier Science Direct, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI) and VIP database were searched for the related articles without language limitation. Two reviewers independently searched and evaluated relevant studies. This review has been registered in the website PROSPERO (CRD42018087252). Results 28 articles were retrieved on PubMed and 98 on other electronic databases in the initial search. In the end, 4 randomized controlled trials (RCTs) were included, with a total of 139 patients enrolled. The descriptive results indicated that the use of PRGF may help reduce pain and inflammation after tooth extraction. To some extent, it is beneficial to the management of dry socket after extraction. Conclusions Quality assessment indicated all the included studies were judged to be at high risk of bias with low quality. Hence, it was impossible to make a recommendation for clinical use of PRGF based on the current evidence. Clearly, a multicenter clinical randomized controlled trial is needed urgent to evaluate the safety and efficacy of PRGF for dry socket management. Key words:plasma rich in growth factor, PRGF, dry socket, systematic review.