Post-extraction Complications Research Articles

How to manage a dry socket?- review of the latest treatment methods

Introduction Alveolar osteitis is the most common postoperative complication of tooth extraction. This medical condition has been recognized for decades, however its treatment approach is diverse with varying outcome. Aim of the study The purpose of this review is to examine and discuss contemporary methods of treating dry socket. Through a synthesis of available studies, the paper aims to identify the most beneficial methods to deal with this post-extraction complication. Materials and methods An analysis of scientific articles available in Pubmed and Google Scholar databases was conducted. The study used publications from 2017 to 2024. The search process included the use of the following keywords: “dry socket”, “alveolar osteitis”, “alveolitis sicca dolorosa”, “socket pain treatment”. Results Thirty-five articles were selected and reviewed carefully and independently by all authors. The agents used in the treatment of dry socket were classified as: remedies, drugs and medications, blood products, and technologies. Each group of agents is described with a discussion of their therapeutic efficacy. Summary Dry socket is a common dental problem. Currently, non-invasive methods of treating this complication are preferred. Modern solutions can provide quick and effective therapy. The treatment should relieve discomfort and promote tissue regeneration. Despite various methods, there is still no clear opinion on the best way to treat dry socket.

Decision-making concordance in thoracic drain management: is necessary previous experience?

IntroductionProper management of thoracic drainages is essential in the recovery of patients after lung resection. This study evaluates the concordance in decision-making for drain removal depending on the type of drainage system used and the previous experience of the personnel. Material and methodsProspective, comparative, and stratified randomization study on interobserver variability between senior specialist doctors and inexperienced healthcare personnel in the removal of thoracic drains in patients undergoing lung resection connected to conventional systems (CS) or digital systems (DS) with continuous recording. The withdrawal criteria were established before the study, and decisions were recorded during three postoperative days. Results75 patients were included, 38 CS and 37 DS, with no statistically significant differences in sex distribution, age, intervention performed, presence of pleuropulmonary adhesions, drain time, or post-extraction complications between the groups. The overall concordance in drain removal decisions was moderate (kappa = 0.452), with notable variations in concordance depending on the drainage system used: CS (kappa = 0.188) with an overall agreement rate of 61.7% compared to DS (kappa = 0.716) with an overall agreement rate of 86.4%. Digital systems showed substantial concordance regardless of the operator's experience, with kappa values indicating high concordance on all postoperative days. ConclusionsThe use of digital systems for managing thoracic drains significantly improves concordance in clinical decision-making regardless of the experience level. These findings suggest that adopting digital systems not only optimizes patient safety but also reduces the dependence on highly specialized healthcare professionals.

Frequency of Dry Socket among Patients Undergoing Dental Extractions Presenting to A Teaching Hospital, Rawalpindi

A dry socket, a painful post-extraction complication, occurs when the blood clot at the extraction site is dislodged or fails to form. Understanding its prevalence is crucial for improving outcomes in dental practices. Objective: To determine the frequency of dry sockets in patients undergoing dental extraction. Methods: A cross-sectional descriptive study was carried out and two customized questionnaires were filled out over three months. One questionnaire was for patients undergoing extractions and the other was filled for patients returning with dry sockets. The study included Pakistani individuals with permanent dentition while excluding non-Pakistani individuals, children with deciduous/mixed dentition, and severely immunocompromised patients. Chi-square and Fischer's exact tests were used to compare the frequency of dry sockets between gender and age groups. p-value of less than or equal to 0.05 was considered statistically significant. Results: Out of the 188 patients, 85 (45.2%) were males and 103 (54.8%) were females. Medically compromised patients comprised 24.5% of the study population. The overall incidence of dry sockets was 9.0%, with a slightly higher occurrence in females (9.7%), though the difference was not statistically significant (p-value=0.802). Smokers demonstrated a higher incidence of dry sockets (23.1%), which was also not statistically significant (p-value=0.099). Medically compromised patients experienced dry sockets at 17.4%, compared to 6.3% in healthy patients, suggesting a trend that did not reach statistical significance (p-value=0.363). Conclusions: It was concluded that identifying high-risk groups and promoting effective prevention and management techniques can reduce the incidence of dry sockets, leading to better outcomes and overall oral health

The effect of antibiotic premedication on postoperative complications following dental extractions.

We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System. We conducted a retrospective cohort study of patients undergoing dental extractions in 2015-2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome. Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (p = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13-1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92-1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83-1.30). In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use.

The Effect of Bismuth as A Local Hemostatic Material Post Extraction of Permanent Mandibular First Molars Teeth

Background: Bleeding is a post-extraction complication that is often found in dentistry. Normally post-extraction bleeding stops 12-24 hours after surgery, but it is often found for more than 24 hours. The post-extraction bleeding usually stops by pressing the area with sterile gauze but there is an obstacle due of the large volume of blood. Objective: to evaluate the bismuth subgallate as an effective local hemostatic agent. Methods: This study conducted on patients who came to the Oral Surgery Clinic, Nala Husada Hospital Surabaya, population aged 18-60 years, with permanent mandibular first molars diagnosed with chronic apical periodontitis et causa pulp gangrene or radix gangrene without systemic disorder and planned for extraction teeth with close method. It was divided into 2 groups by simple random sampling group design; the control group and the treatment group. After tooth extraction with the close method, a local hemostatic agent will be applied at the socket. The control group used a paste containing vaseline, while the treatment group used a paste containing bismuth subgallate. This paste contains 2.25% bismuth subgallate mixed with Peruvian balsam. After the application of local hemostatic agents, both the control group and the treatment group will be calculated the bleeding time, bleeding volume, and whether or not the secondary bleeding occurs. Conclusion: of this study is that bismuth subgallate has an effect as a local hemostatic agent after extraction of the mandibular first permanent molars.

Risk factors for oral infection and dry socket post-tooth extraction in medically complex patients in the absence of antibiotic prophylaxis: A case-control study.

Dry socket and infection are complications of tooth extractions. The objective was to determine risk factors for post-extraction complications in patients without antibiotic prophylaxis stratified by early- and late-complications and complication type (oral infection and dry socket). Retrospective, case (with complications)-control (without complications) study of patients (n=708) who had≥1 extraction performed at any Veterans Health Administration facility between 2015-2019 and were not prescribed an antibiotic 30 days pre-extraction. Early complication cases (n=109) were more likely to be female [odds ratio (OR)=2.06; 95% confidence interval (CI):1.05-4.01], younger (OR=0.29; 95% CI:0.09-0.94 patients ≥ 80 years old, reference:18-44 years), Native American/Alaska Native (OR=21.11; 95% CI:2.33-191.41) and have fewer teeth extracted (OR=0.53 3+ teeth extracted; 95% CI:0.31-0.88, reference:1 tooth extracted). Late complication cases (n=67) were more likely to have a bipolar diagnosis (OR=2.98; 95% CI:1.04-8.57), history of implant placement (OR=8.27; 95% CI:1.63-41.82), and history of past smoking (OR=2.23; 95% CI:1.28-3.88). Predictors for post-extraction complications among patients who did not receive antibiotic prophylaxis were similar to prior work in cohorts who received prophylaxis. Unique factors identified in a medically complex population included being younger, Native American/Alaska Native, having mental health conditions, history of a dental implant, and fewer teeth extracted.

Asociación entre hiperglucemia y complicaciones post-exodoncia en pacientes con Diabetes Mellitus tipo II: Scoping Review

Introduction: Diabetes mellitus (DM) is a prevalent chronic metabolic disorder worldwide, with Type II DM (T2DM) emerging as the most widespread variant. In Chile, approximately 11% of adults aged 20 to 79 suffer from this condition. Given its high prevalence, dental surgeons should be trained to evaluate risk factors, particularly the potential complications linked to tooth extraction in individuals with T2DM. Objetive: To describe the available scientific evidence on post-exodontia complications associated with hyperglycemia in patients with Type II diabetes mellitus. Materials and Methods: An exploratory systematic review was conducted following the PRISMA-ScR extension protocols using the databases PubMed, EBSCO, Scopus and the Cochrane Library. The search employed the following algorithms: ((“Diabetic patient complications” AND “Dental extractions”)), ((“Diabetes” AND “tooth extraction”)), ((“Glycemia” AND “Tooth extraction complications”), ((“Blood glucose” AND “Tooth extractions”), ((“Dental extraction sockets” AND “Diabetics”). Results: Out of a total of 973 articles, 25 were included for this review. Six relevance criteria were considered, revealing safety parameters for conducting extractions in patients with T2DM, with capillary blood glucose levels not exceeding 200 mg/dL for elective extractions and 240 mg/dL for emergency extractions. Conclusions: There is limited evidence correlating threshold values of hyperglycemia with post-extraction complications in patients with T2DM. Most authors agree that the primary concern is not T2DM itself, but hyperglycemia. Furthermore, there is minimal consistency in the recommended care protocols for these patients.

Efficacy of a novel combination of aloe vera gel and pineapple extracts in improving post-extraction pain and healing: A Randomized Controlled Trial.

Absorbable gelatin sponges are able to reduce the incidence of post-extraction complications when soaked with antimicrobial agents. However, the drawbacks associated with the injudicious use of antibiotics warrant the need to explore alternatives to the existing drugs. Aim: The present study aimed to evaluate the efficacy of an absorbable gelatin sponge soaked in a combination of aloe vera and pineapple extracts in reducing post-operative pain and improving the healing rate following dental extractions. Patients aged 18 to 60 years undergoing a single dental extraction of a posterior tooth were provided with either plain absorbable gelatin sponge (control group) or absorbable gelatin sponge soaked in freshly prepared solution of aloe vera gel and pineapple extracts. The pain levels were measured after one, three, seven, and fourteen days post-extraction. The socket healing status was evaluated by Landry Turnbull and Howley Index after one and two weeks post-extraction respectively. The mean pain was significantly less (p<0.05) for patients in the experimental group on the 1st, 3rd, and 7th postoperative days as compared to the patients in the control group. No significant differences (p>0.05) were observed in the healing status between the two groups at any time interval. The present study found the combination of aloe vera gel and pineapple extracts to be effective in reducing post-operative pain following dental extractions. While the improvement in the healing rate failed to reach statistical significance in the present study, generally less inflammation was observed in sockets treated with absorbable gelatin sponge soaked in the a combination of aloe vera and pineapple extracts. Key words:Post-extraction pain, Socket healing, Aloe Vera, Bromelain.

Post-extraction Clinical Evaluation Using Local Anesthesia Techniques for State SMKPP Students in the Ikur Koto Health Center Area, Padang, West Sumatra

Abstract. The high prevalence of dental and oral health problems in Indonesia shows that many people have problems with dental and oral health. The problem that often arises is cavities and there tends to be major damage to the tooth structure. This condition shows the high need for dental and oral care in the community. The need to perform dental and oral care for individuals is very important to estimate costs, time, and medical personnel. The purpose of community service activities is in the form of social services for free dental and oral treatment to be able to provide services in the form of curative actions which are expected to be able to address related dental and oral problems in a simple manner in the community. The series of treatment programs consists of registration, screening, treatment measures, administering medication if needed, and filling out treatment questionnaires. Based on the results of the evaluation process, it can be concluded that the extraction action given to residents showed no post-extraction complications and treatment showed good results.

Decamethoxin and chlorhexidine bigluconate effect on the adhesive and biofilm-forming properties of Streptococcus mitis.

Was to investigate the effect of antiseptics on the adhesive and biofilm-forming properties of clinical S.mitis isolates isolated from the oral cavity of patients with an infectious and inflammatory post-extraction complication. Twenty four clinical isolates of S.mitis isolated from patients were studied. The studied antiseptics included 0.02% aqueous solution of decamethoxin and 0.05% solution of chlorhexidine bigluconate. Adhesion of clinical isolates under the action of decamethoxin and chlorhexidine bigluconate was determined by the method of V.I. Brillis. The biofilm-forming properties of clinical isolates were studied using the "microtiter plate test" according to G.D. Christensen. The studied clinical isolates of S.mitis are classified as highly adherent microorganisms. Action of decamethoxin on clinical isolates decreases the adhesion index of the studied isolates in comparison with the adhesion index of the control culture. Action of chlorhexidine bigluconate on S.mitis isolates increases of adhession of the studied clinical isolates in comparison with the control. After the effect of decamethoxin, the optical density of clinical isolates decreased considering the optical density results of the control. The clinical isolates left an average film-forming capacity even after chlorhexidine bigluconate action. Clinical isolates of S.mitis are highly adherent microorganisms. The antiseptic decamethoxin decreases the adhesion index of these bacteria, while chlorhexidine bigluconate increases the adhesion index of clinical S.mitis isolates. Clinical S. mitis isolates have an average biofilm formation capacity index. The antiseptic decamethoxin inhibits the biofilm formation capacity of S.mitis from medium to low.

Influence of Surgical Technique on Post-Operative Complications in the Extraction of the Lower Third Molar: A Retrospective Study.

The surgical extraction of the impacted third molar is frequently associated with several complications. The purpose of this study is to assess how two different surgical protocols affect post-operative complications during the extraction of the lower impacted third molars. In order to compare and evaluate two different techniques (triangular flap vs. envelope flap), and the relative post-extraction complications, two groups of 150 patients each underwent to surgical impacted third molar extraction and 60 days of follow-up. The complication rate in the two groups was 14.00% in group A and 17.33% in group B. There was a strong association between smoking (OR: 2.8) and the use of oral contraceptives (OR: 1.75) with complications. The age- and sex-related incidence of complications in hard tissue healing has great variability in the literature; the analysis performed on our data did not show a statistically significant association between them. Even though related to a higher incidence of transient changes in sensitivity, it was found that the envelope flap saw a lower percentage of complications. There is still no clarity on which is the best protocol for the extraction of the lower impacted third molar, and the choice often depends on the surgeon's experience.

Further evidence confirms the association between smoking and dry socket: a motivational opportunity for tobacco cessation.

A systematic review and meta-analysis of observational studies. Electronic search included PubMed, Scopus, and Web of Science databases up to March 2022 using appropriate keywords. The review included all observational studies (case-control, cohort and cross-sectional studies) published in English after 2000, comparing the prevalence of dry socket between smokers and non-smokers after simple or surgical tooth extraction. Exclusion criteria included patients with other post-extraction complications, prevalence of different risk factors, and unrelated study designs (literature reviews, case reports, expert opinion, and conference reports). Two independent investigators screened the records (by title, abstract, and full text), and selected the eligible studies according to the predefined criteria. Collected data from each study included author name and country, year of publication, gender and age of patients, smoking status, inclusion and exclusion criteria, medical history and oral hygiene, prevalence of dry socket, type of tooth and extraction technique, symptoms and treatment. Risk of bias was assessed according to the (NHLBI, NIH) Quality Assessment Tool For Observational Cohort and Cross-Sectional Studies, while the level of evidence was assessed using the classification of the Oxford Centre for Evidence-Based Medicine levels for diagnosis. Two independent reviewers conducted the assessments, and any disagreements were addressed through discussion. Eleven studies from ten different countries representing a total of 10,195 patients (3007 smokers and 7188 non-smokers) were included in the final analysis. Nine studies were classified as having "good" quality and two as "intermediate," while all of the studies have the third or fourth level of evidence (through 5-graded scale). The prevalence of dry socket in smokers was about 13.2% (95% CI: 5.8-23.1%) and in non-smokers about 3.8% (95% CI: 2.1-6.0%). Meta-analysis showed that regular tobacco smoking was associated a more than 3-fold increase in the odds of dry socket after tooth extraction. Despite heterogeneity among the included studies (different age groups and types of teeth extracted), there was a consistent association between cigarette smoking and an elevated risk of developing dry socket post tooth extraction.

Assessment of Post-extraction Complications- An Institution Based Prospective Study

Exodontia is the painless removal of a tooth or tooth root with minimal trauma to the investing tissues with uneventful wound healing. The complication rate is influenced by different factors such as age and health condition of the patient, gender, tooth impact level, surgeon's experience, smoking, intake of contraceptive medicine, quality of oral hygiene, and surgical technique used.

Alveolar Bone Preservation Using a Combination of Nanocrystalline Hydroxyapatite and Injectable Platelet-Rich Fibrin: A Study in Rats.

Alveolar bone resorption is a post-extraction complication wherein there is a reduction in the dimensions and quality of the alveolar bone. This study aimed to examine the effects of implantation of a combination of nanocrystalline hydroxyapatite (nHA) and injectable platelet-rich fibrin (IPRF) on the expression of tartrate-resistant acid phosphatase (TRAP), alkaline phosphatase (ALP), osteocalcin (OCN), and new bone formation. A total of 32 male rats had their upper right incisors extracted under general anesthesia and were then divided into a control group, nHA group, IPRF group, and nHA-IPRF group. Decapitation was carried out on day 14 and day 28 in each group and the jaws of each rat were subjected to immunohistochemical and histological analysis. The results showed a decrease in TRAP expression in the nHA-IPRF group compared with the control group on day 14 (p = 0.074) and day 28 (p = 0.017). The study also showed an increase in ALP and OCN in the HA-IPRF group on day 14 and day 28 compared with the control group. New bone formation suggested a significant increase in the nHA-IPRF group compared with the control group on day 14 (p = 0.001) and day 28 (p = 0.001). nHA-IPRF implantation can suppress alveolar bone resorption, which is indicated by decreased TRAP expression, and it can increase bone growth, as indicated by increased expression of ALP, OCN, and new bone formation.

Evaluating the Efficacy of Green Tea and Chlorhexidine Mouthwashes in Relieving Post-extraction Complications like Pain and Hemorrhage

This cross-sectional observational study aimed to evaluate the effectiveness of green tea and chlorhexidine mouthwashes in reducing post-extraction complications such as pain and bleeding. The studied sample consisted of 80 people with an average age of 43.67 (±4.78) years. Tooth extraction is shown to all participants. After the tooth extraction, the green tea group was advised to bite the pictures of the gauge into the green tea, take a bite, and rinse their mouths with green tea mouthwash the next day. Subjects with another group bite soaked in chlorhexidine saline solution after tooth extraction and chlorhexidine mouthwash. Operation time, hemostasis time, VAS pain after tooth extraction and total number of analgesics were recorded. Descriptive statistics were calculated and chi-square t-tests and independent samples were performed using SPSS 22. The results showed that there was no significant difference in age, sex, and time of surgery between the two groups. The mean VAS was significantly lower in the green tea group compared to the chlorhexidine group. In addition, the green tea group also showed a shorter time for complete hemostasis and less analgesic consumption than the chlorhexidine group. It can be concluded that green tea is significantly effective in reducing the time of complete hemostasis and pain after tooth extraction. Thus, by conducting additional studies, green tea can be found to be therapeutically useful for the treatment of post-extraction bleeding and pain.

ASSESSMENT OF ANTIBACTERIAL AND ANTIADHESIVE PROPERTIES OF ANTISEPTICS AGAINST CLINICAL ISOLATES OF KOCURIA SPP

According to the literature, microorganisms of the genus Kocuria are becoming widespread, but not as avirulent representatives of the normal microbiota of the human body, but as pathogens.&#x0D; Recently, after the identification of the causative agents of infectious and inflammatory processes, various types of Kocuria have been included in the list of etiological agents isolated from patients with cholecystitis, endocarditis, peritonitis, and meningitis as well as from carious tooth cavities and post-extraction tooth sockets. Bacteria of the genus Kocuria possess pathogenicity that enables them to play an important role in the occurrence of infectious and inflammatory processes in various organs and systems of the human body. Given that antibiotics are the most commonly used drugs of choice in medical and dental practice for the treatment of infections and inflammations, antibiotic resistance is considered as a global health and development threat.&#x0D; In order to overcome the challenge of antibiotic resistance, antiseptics, a group of medicines with a pronounced antimicrobial effect, are being increasingly used for the treatment of infectious and inflammatory processes. The purpose of this study is to investigate the antibacterial and antiadhesive activity of dekasan, and drugs of comparison, chlorhexidine and iodoform, against clinical isolates of Kocuria spp. isolated from the oral cavity of patients with infectious inflammatory post-extraction complications. Materials and methods: five clinical isolates of Kocuria spp. were studied as microorganisms isolated from patients, who received the treatment for infectious and inflammatory post-extraction complications at the medical and surgical departments of Poltava Regional Center of Stomatology – Dental Polyclinic. We determined the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBcC) of antiseptics against clinical isolates of Kocuria spp. taking into account ISO recommendations. The adhesive properties of clinical isolates of Kocuria spp. were assessed by exposing them to subbacteriostatic concentrations of antiseptics, namely dekasan, chlorhexidine, and iodoform. The evaluation was conducted using erythrocytes of blood group 1(0) Rh+ and considering the index of microorganism adhesion (IAM) following the method developed by V. I. Brillis. The results obtained have demonstrated variations in the antimicrobial and anti-adhesive activities among the tested antiseptics, dekasan, chlorhexidine, and iodoform.

Prevalence and Management of Post-Extraction Complications

Introduction: Simple tooth extraction is one of the most common procedures performed by general dentists and Oral and Maxillofacial surgeons throughout daily practice. However, although it is a simple procedure, tooth-related complications could occur at any time. These complications are categorized into immediate and delayed complications. Immediate complications are due to either tooth-related or dentist-related factors and require prompt actions and immediate management. Tooth-related factors depend on tooth morphology and tooth structure conditions. Dentist-related factors depend on the proper selection and application of the instruments. On the other hand, delayed complications might occur after two days or more following the extraction. Objective: To evaluate the prevalence, prediction of risk factors complications, prevention and management of possible immediate and delayed post-extraction complications occurring in our Oral Surgery clinics at King Abdulaziz University Dental Hospital. Method: An observation and assessment of the extraction procedure, data collected via validated survey were used to gather the following: Demographic data, medical history, cause of extraction, number of tooth/teeth extracted, complications if any, and who did the procedure. For each patient who underwent dental extraction, a survey was filled out, by a doctor other than the operator and the procedure was assessed under observation to record any complications that occurred during the procedure and assess the undertaken management in such a case without intervention. Data was analyzed using Chi-square test through SPSS. Result: We observed 172 extraction procedures with 160 different patients, 12 had extraction more than once. A total 350 teeth were extracted from 160 patients, we observed 92 complications (53.4%) between immediate and delayed, 7 patients had both, the most common immediate complication was soft tissue injury with (81.7%) 67/82, and for the delayed complications the most common was dry socket (64.7%) 11/17 patients. Conclusion: In conclusion, we found a significant association between the number of post-operative complications, their management, and the experience of the operator

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.

Complications in exodontia

All surgical procedures pose risk of complications. Exodontia, essentially being one, comes with the need to judiciously practise all precautions and carry out proper aseptic measures to reduce the risk of complications. The aetiology of postextraction complications can be vastly correlated to patient’s medical history, habits, type of intervention and surgical site. This article aims to study few of the common complications of exodontia and the possible treatment and prevention of the same.Literature was selected through search of literature reviews, case reports and standard books for oral and maxillofacial surgery. No restrictions were posed regarding year of publication.

Permanent First Mandibular Molar: Loss Prevalence and Pattern among Saudis in Al-Ahsa.

The permanent first mandibular molar (PFMM) is the first tooth to erupt, usually at the age of 6 years. It is the most effective oral masticatory unit due to its wide occlusal surface and its role in favorable occlusion. This study describes the prevalence of PFMM loss and the reasons for extraction in a group of King Faisal Dental Complex Clinics (KFUDC) Saudi attendees. In addition, to report postextraction complications, consider the gender, age, and the time elapsed from the moment of the extraction. A cross-sectional study was performed in January to April 2020, focusing on the loss of PFMM among a group of Saudis attending KFUDC in Al Hofuf, Saudi Arabia. A total of 417 participants were recruited. The inclusion criteria were adults aged ≥ 18 years. The principal investigator performed all the necessary measures for calibration in the forms of training on clinical examination and interviews. Data were analyzed using the Statistical Package for the Social Science, version 25 (SPSS Inc., Illinois, United States). Four hundred seventeen attendees participated in the present study. Majority were males 73.9% (308), and 26.1% (109) females. A third, 30% (125), reported missing PFMM; the overwhelming majority reported the reason for extraction as caries 93.6% (117).On clinical examination, 80.8% (101) had complications; drifting of adjacent teeth was the most common complication, 57.6% (72), followed by supraeruption in 23.2% (29).More males than females reported missing PFMM (22.8 and 7.2%, respectively), and those ≥ 25 years reported more missing PFMM than younger (17.5 and 12.5%, p ≤ 0.000). Those confirmed with systemic diseases reported more missing PFMM than their counterpart (23.3 and 6.7%, p ≤ 0.01).Those with good oral hygiene reported less missing PFMM than their poor oral hygiene counterparts (27.8 and 34%). Those who had good knowledge about the complications of early extraction of PFMM stated less missing PFMM than their counterparts (15.6 and 14.4%, p ≤ 0.01). This study indicated that PFMM were the most common extracted tooth. Caries is the principal reason for tooth extraction among the studied population, followed by periodontal diseases. Emphasis on preventing dental caries is essential to maintain a socially and economically productive life and reduce the burden of oral disease.