Alveolar osteitis: a comprehensive review of concepts and controversies

Antonia Kolokythas, Eliza Olech, Michael Miloro, Antonia Kolokythas, Eliza Olech, Michael Miloro

Abstract

Alveolar osteitis, "dry socket", remains amongst the most commonly encountered complications following extraction of teeth by general dentists and specialists. A great body of literature is devoted to alveolar osteitis addressing the etiology and pathophysiology of this condition. In addition numerous studies are available discussing methods and techniques to prevent this condition. To this date though great controversy still exists regarding the appropriate terminology used for this condition as well as the actual etiology, pathophysiology, and best methods of prevention and treatment. This article is a comprehensive critical review of the available literature addressing the concepts and controversies surrounding alveolar osteitis. We aim to assist the dental health care professional with patient preparation and management of this commonly encountered postoperative condition should be encountered.

References

    1. Osborn TP, Frederickson G, Jr., Small IA, Torgerson TS. A prospective study of complications related to mandibular third molar surgery. Journal of Oral and Maxillofacial Surgery. 1985;43(10):767–769.
    1. Larsen PE. Alveolar osteitis after surgical removal of impacted mandibular third molars: identification of the patient at risk. Oral Surgery Oral Medicine and Oral Pathology. 1992;73(4):393–397.
    1. Crawford JY. Dry socket. Dental Cosmos. 1896;38:929–931.
    1. Blum IR. Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, aetiopathogenesis and management: a critical review. International Journal of Oral and Maxillofacial Surgery. 2002;31(3):309–317.
    1. Torres-Lagares D, Serrera-Figallo MA, Romero-Ruíz MM, Infante-Cossío P, García-Calderón M, Gutiérrez-Pérez JL. Update on dry socket: a review of the literature. Medicina Oral, Patologia Oral y Cirugia Bucal. 2005;10(1):77–85.
    1. Alexander RE. Dental extraction wound management: a case against medicating postextraction sockets. Journal of Oral and Maxillofacial Surgery. 2000;58(5):538–551.
    1. Birn H. Etiology and pathogenesis of fibrinolytic alveolitis (’dry socket’) International Journal of Oral Surgery. 1973;2(5):211–263.
    1. Birn H. Fibrinolytic activity of alveolar bone in "dry socket". Acta Odontologica Scandinavica. 1972;30(1):23–32.
    1. Birn H. Bacteria and fibrinolytic activity in "dry socket". Acta Odontologica Scandinavica. 1970;28(6):773–783.
    1. Lilly GE, Osbon DB, Rael EM, Samuels HS, Jones JC. Alveolar osteitis associated with mandibular third molar extractions. Journal of the American Dental Association. 1974;88(4):802–806.
    1. Field EA, Speechley JA, Rotter E, Scott J. Dry socket incidence compared after a 12 year interval. British Journal of Oral and Maxillofacial Surgery. 1985;23(6):419–427.
    1. MacGregor AJ. Aetiology of dry socket: a clinical investigation. British Journal of Oral Surgery. 1968;6(1):49–58.
    1. Swanson AE. Prevention of dry socket: an overview. Oral Surgery Oral Medicine and Oral Pathology. 1990;70(2):131–136.
    1. Fridrich KL, Olson RAJ. Alveolar osteitis following surgical removal of mandibular third molars. Anesthesia Progress. 1990;37(1):32–41.
    1. Vezeau PJ. Dental extraction wound management: medicating postextraction sockets. Journal of Oral and Maxillofacial Surgery. 2000;58(5):531–537.
    1. Shafer WE, Hine MK, Levy BM. Textbook of Oral Pathology. 4th edition. Philadelphia, Pa, USA: Saunders; 1993.
    1. Hindle MO, Gibbs A. The incidence of dry socket following the use of an occlusive dressing. Journal of Dentistry. 1977;5(4):288–293.
    1. Thoma KH. Oral Surgery. 5th edition. Saint Louis, Mo, USA: CV Mosby; 1969.
    1. Ritzau M, Swangsilpa K. The prophylactic use of propylic ester of p hydrobenzoic acid on alveolitis sicca dolorosa. A preliminary report. Oral Surgery Oral Medicine and Oral Pathology. 1977;43(1):32–37.
    1. Sweet JB, Butler DP. Predisposing and operative factors: effect on the incidence of localized osteitis in mandibular third-molar surgery. Oral Surgery, Oral Medicine, Oral Pathology. 1978;46(2):206–215.
    1. Rood JP, Murgatroyd J. Metronidazole in the prevention of ’dry socket’. British Journal of Oral Surgery. 1979;17(1):62–70.
    1. Butler DP, Sweet JB. Effect of lavage on the incidence of localized osteitis in mandibular third molar extraction sites. Oral Surgery Oral Medicine and Oral Pathology. 1977;44(1):14–20.
    1. Krekmanov L, Hallander HO. Relationship between bacterial contamination and alveolitis after third molar surgery. International Journal of Oral Surgery. 1980;9(4):274–280.
    1. Catellani JE. Review of factors contributing to dry socket through enhanced fibrinolysis. Journal of Oral Surgery. 1979;37(1):42–46.
    1. Krekmanov L. Alveolitis after operative removal of third molars in the mandible. International Journal of Oral Surgery. 1981;10(3):173–179.
    1. Nitzan DW. On the genesis of ’dry socket’. Journal of Oral and Maxillofacial Surgery. 1983;41(11):706–710.
    1. Brekke JH, Bresner M, Reitman MJ. Effect of surgical trauma and polylactate cubes and granules on the incidence of alveolar osteitis in mandibular third molar extraction wounds. Journal of the Canadian Dental Association. 1986;52(4):315–319.
    1. Heasman PA, Jacobs DJ. A clinical investigation into the incidence of dry socket. British Journal of Oral and Maxillofacial Surgery. 1984;22(2):115–122.
    1. Johnson WS, Blanton EE. An evaluation of 9-aminoacridine/Gelfoam to reduce dry socked formation. Oral Surgery Oral Medicine and Oral Pathology. 1988;66(2):167–170.
    1. Barclay JK. Metronidazole and dry socket: prophylactic use in mandibular third molar removal complicated by non-acute pericoronitis. New Zealand Dental Journal. 1987;83(373):71–75.
    1. Larsen PE. The effect of a chlorhexidine rinse on the incidence of alveolar osteitis following the surgical removal of impacted mandibular third molars. Journal of Oral and Maxillofacial Surgery. 1991;49(9):932–937.
    1. Swanson AE. A double-blind study on the effectiveness of tetracycline in reducing the incidence of fibrinolytic alveolitis. Journal of Oral and Maxillofacial Surgery. 1989;47(2):165–167.
    1. Hooley JR, Golden DP. The effect of polylactic acid granules on the incidence of alveolar osteitis after mandibular third molar surgery. A prospective randomized study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and. 1995;80(3):279–283.
    1. Colby RC. The general practitioner’s perspective of the etiology, prevention, and treatment of dry socket. General Dentistry. 1997;45(5):461–472.
    1. Nusair YM, Abu Younis MH. Prevalence, clinical picture, and risk factors of dry socket in a Jordanian Dental Teaching Center. Journal of Contemporary Dental Practice. 2007;8(3):53–63.
    1. Oginni FO, Fatusi OA, Alagbe AO. A clinical evaluation of dry socket in a Nigerian teaching hospital. Journal of Oral and Maxillofacial Surgery. 2003;61(8):871–876.
    1. Ygge J, Brody S, Korsan-Bengtsen K, Nilsson L. Changes in blood coagulation and fibrinolysis in women receiving oral contraceptives. Comparison between treated and untreated women in a longitudinal study. American Journal of Obstetrics and Gynecology. 1969;104(1):87–98.
    1. Schow SR. Evaluation of postoperative localized osteitis in mandibular third molar surgery. Oral Surgery Oral Medicine and Oral Pathology. 1974;38(3):352–358.
    1. Chapnick P, Diamond LH. A review of dry socket: a double-blind study on the effectiveness of clindamycin in reducing the incidence of dry socket. Journal of the Canadian Dental Association. 1992;58(1):43–52.
    1. Sweet JB, Butler DP. Increased incidence of postoperative localized osteitis in mandibular third molar surgery associated with patients using oral contraceptives. American Journal of Obstetrics and Gynecology. 1977;127(5):518–519.
    1. Cohen ME, Simecek JW. Effects of gender-related factors on the incidence of localized alveolar osteitis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 1995;79(4):416–422.
    1. Hermesch CB, Hilton TJ, Biesbrock AR, et al. Perioperative use of 0.12% chlorhexidine gluconate for the prevention of alveolar osteitis: efficacy and risk factor analysis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 1998;85(4):381–387.
    1. Lehner T. Analysis of one hundred cases of dry socket. Dental Practitioner and Dental Record. 1958;8:275–279.
    1. Tsirlis AT, Iakovidis DP, Parissis NA. Dry socket: frequency of occurrence after intraligamentary anesthesia. Quintessence International. 1992;23(8):575–577.
    1. Rud J. Removal of impacted lower third molars with acute pericoronitis and necrotising gingivitis. British Journal of Oral Surgery. 1970;7(3):153–160.
    1. Peñarrocha-Diago M, Sanchis JM, Sáez U, Gay C, Bagán JV. Oral hygiene and postoperative pain after mandibular third molar surgery. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2001;92(3):260–264.
    1. Simpson HE. The healing of extraction wounds. British Dental Journal. 1969;126(12):550–557.
    1. Turner PS. A clinical study of ’dry socket’. International Journal of Oral Surgery. 1982;11(4):226–231.
    1. Krough HW. Incidence of dry socket. Journal of the American Dental Association. 1937;24, article 1829
    1. Swanson AE. Reducing the incidence of dry socket: a clinical appraisal. Journal of the Canadian Dental Association. 1966;32(1):25–33.
    1. Lucas MA, Fretto LJ, McKee PA. The binding of human plasminogen to fibrin and fibrinogen. Journal of Biological Chemistry. 1983;258(7):4249–4256.
    1. Birn H. Fibrinolytic activity of normal alveolar bone. Acta Odontologica Scandinavica. 1971;29(2):141–153.
    1. Southam JC, Moody GH. The fibrinolytic activity of human and rat dental pulps. Archives of Oral Biology. 1975;20(12):783–786.
    1. Amaratunga NA, Senaratne CM. A clinical study of dry socket in Sri Lanka. British Journal of Oral and Maxillofacial Surgery. 1988;26(5):410–418.
    1. Jaafar N, Nor GM. The prevalence of post-extraction complications in an outpatient dental clinic in Kuala Lumpur Malaysia–a retrospective survey. Singapore Dental Journal. 2000;23(1):24–28.
    1. Catellani JE, Harvey S, Erickson SH, Cherkin D. Effect of oral contraceptive cycle on dry socket (localized alveolar osteitis) Journal of the American Dental Association. 1980;101(5):777–780.
    1. Sweet JB, Butler DP. The relationship of smoking to localized osteitis. Journal of Oral Surgery. 1979;37(10):732–735.
    1. Rozanis J, Schofield ID, Warren BA. Is dry socket preventable? Dental Journal. 1977;43(5):233–236.
    1. Nitzan D, Sperry JF, Wilkins TD. Fibrinolytic activity of oral anaerobic bacteria. Archives of Oral Biology. 1978;23(6):465–470.
    1. Blondeau F, Daniel NG. Extraction of impacted mandibular third molars: postoperative complications and their risk factors. Journal of the Canadian Dental Association. 2007;73(4, article 325)
    1. Laird WR, Stenhouse D, Macfarlane TW. Control of post-operative infection. A comparative evaluation of clindamycin and phenoxymethylpenicillin. British Dental Journal. 1972;133(3):106–109.
    1. Bystedt H, Nord CE, Nordenram A. Effect of azidocillin, erythromycin, clindamycin and doxycycline on postoperative complications after surgical removal of impacted mandibular third molars. International Journal of Oral Surgery. 1980;9(3):157–165.
    1. Ataoǧlu H, Öz GY, Çandirli C, Kiziloǧlu D. Routine antibiotic prophylaxis is not necessary during operations to remove third molars. British Journal of Oral and Maxillofacial Surgery. 2008;46(2):133–135.
    1. Krekmanov L, Nordenram A. Postoperative complications after surgical removal of mandibular third molars. Effects of penicillin V and chlorhexidine. International Journal of Oral and Maxillofacial Surgery. 1986;15(1):25–29.
    1. Lynch DP, Newland JR, McClendon JL. Myospherulosis of the oral hard and soft tissues. Journal of Oral and Maxillofacial Surgery. 1984;42(6):349–355.
    1. Davis W, Jr., Buchs AU, Davis W. The use of granular gelatin-tetracycline compound after third molar removal. Journal of Oral Surgery. 1981;39(6):466–467.
    1. Moore JW, Brekke JH. Foreign body giant cell reaction related to placement of tetracycline-treated polylactic acid: report of 18 cases. Journal of Oral and Maxillofacial Surgery. 1990;48(8):808–812.
    1. Sorensen DC, Preisch JW. The effect of tetracycline on the incidence of postextraction alveolar osteitis. Journal of Oral and Maxillofacial Surgery. 1987;45(12):1029–1033.
    1. Zuniga JR, Leist JC. Topical tetracycline-induced neuritis: a case report. Journal of Oral and Maxillofacial Surgery. 1995;53(2):196–199.
    1. Akota I, Alvsaker B, Bjørnland T. The effect of locally applied gauze drain impregnated with chlortetracycline ointment in mandihular third-molar surgery. Acta Odontologica Scandinavica. 1998;56(1):25–29.
    1. Tjernberg A. Influence of oral hygiene measures on the development of alveolitis sicca dolorosa after surgical removal of mandibular third molars. International Journal of Oral Surgery. 1979;8(6):430–434.
    1. Berwick JE, Lessin ME. Effects of a chlorhexidine gluconate oral rinse on the incidence of alveolar osteitis in mandibular third molar surgery. Journal of Oral and Maxillofacial Surgery. 1990;48(5):444–448.
    1. Caso A, Hung L-K, Beirne OR. Prevention of alveolar osteitis with chlorhexidine: a meta-analytic review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2005;99(2):155–159.
    1. Birn H. Antifibrinolytic effect of Apernyl in "dry socket". International Journal of Oral Surgery. 1972;1(4):190–194.
    1. Kjellman O. Apernyl as alveolar inlay in connection with the removal of impacted third molars of the lower jaw. A clinical double blind investigation in 100 patients. Swedish Dental Journal. 1973;66(2):197–201.
    1. Schatz J-P, Fiore-Donno G, Henning G. Fibrinolytic alveolitis and its prevention. International Journal of Oral and Maxillofacial Surgery. 1987;16(2):175–183.
    1. Ritzau M. The prophylactic use of tranexamic acid (Cyklokapron) on alveolitis sicca dolorosa. International Journal of Oral Surgery. 1973;2(5):196–199.
    1. Gersel-Pedersen N. Tranexamic acid in alveolar sockets in the prevention of alveolitis sicca dolorosa. International Journal of Oral Surgery. 1979;8(6):421–429.
    1. Rutledge JL, Marcoot RM. Terra-Cortril/Gelfoam for reduction of the incidence of localized osteitis following mandibular third molar removal. Journal of Oral Medicine. 1984;39(1):51–53.
    1. Lele MV. Alveolar osteitis. A controlled trial with dental preparation. II. Journal of the Indian Dental Association. 1969;41(3):69–72.
    1. Bloomer CR. Alveolar osteitis prevention by immediate placement of medicated packing. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2000;90(3):282–284.
    1. Cheung LK, Chow LK, Tsang MH, Tung LK. An evaluation of complications following dental extractions using either sterile or clean gloves. International Journal of Oral and Maxillofacial Surgery. 2001;30(6):550–554.
    1. Adeyemo WL, Ogunlewe MO, Ladeinde AL, Bamgbose BO. Are sterile gloves necessary in nonsurgical dental extractions? Journal of Oral and Maxillofacial Surgery. 2005;63(7):936–940.
    1. Kirk DG, Liston PN, Tong DC, Love RM. Influence of two different flap designs on incidence of pain, swelling, trismus, and alveolar osteitis in the week following third molar surgery. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2007;104(1):e1–e6.
    1. Ragno JR, Jr., Szkutnik AJ. Evaluation of 0.12% chlorhexidine rinse on the prevention of alveolar osteitis. Oral Surgery Oral Medicine and Oral Pathology. 1991;72(5):524–526.
    1. Carroll PB, Melfi RC. The histologic effect of topically applied acetylsalicylic acid on bone healing in rats. Oral Surgery, Oral Medicine, Oral Pathology. 1972;33(5):728–735.
    1. Mitchell L. Topical metronidazole in the treatment of ’dry socket’. British Dental Journal. 1984;156(4):132–134.
    1. Fazakerley M, Field EA. Dry socket: a painful post-extraction complication (a review) Dental Update. 1991;18(1):31–34.
    1. Mitchell R. Treatment of fibrinolytic alveolitis by a collagen paste (Formula K). A preliminary report. International Journal of Oral and Maxillofacial Surgery. 1986;15(2):127–133.
    1. Syrjanen SM, Syrjanen KJ. Influence of Alvogyl on the healing of extraction wound in man. International Journal of Oral Surgery. 1979;8(1):22–30.
    1. Summers L, Matz LR. Extraction wound sockets. Histological changes and paste packs–a trial. British Dental Journal. 1976;141(12):377–379.

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