A double-blind study on the effectiveness of tetracycline in reducing the incidence of fibrinolytic alveolitis

This study presents the results of a double-blind study evaluating the effectiveness of topical tetracycline used as a suspension in a square of gelatin sponge and placed in the sockets of extracted mandibular third molars for the prevention of dry socket. An assessment of the relationship between the amount of bone relief (trauma) incidental to the surgery and the occurrence of dry socket also is made. Dry socket occurred in 20.4% of the placebo-treated sockets, whereas the incidence in the tetracycline-treated sockets was 3.9%. No correlation was observed between the amount of bone relief attendant to the surgery and the incidence of dry socket. It is concluded that tetracycline is an effective prophylaxis for fibrinolytic alveolitis.

The effect of chlorhexidine irrigation on the incidence of dry socket: a pilot study

A pilot study was conducted to measure the reported incidence of dry socket following pre-operative irrigation and mouthrinsing with either 0.2% (w/v) chlorhexidine gluconate or normal saline or with no irrigation (control). Three hundred and twenty-four patients presenting for the single extraction of a lower premolar or molar under local anaesthesia were divided into three equal groups; no irrigation, irrigation with saline and irrigation with a 0.2% (w/v) chlorhexidine gluconate solution. After administration of the local anaesthetic agent, 10 ml of the test solutions were applied to the gingival crevice using a blunted needle. The solutions were retained in the patients mouth for 2 min following irrigation. Pre-operative irrigation of the gingival crevice and mouthrinsing with 0.2% (w/v) chlorhexidine gluconate significantly reduced the number of dry sockets. There was no significant reduction in the number of dry socket cases following irrigation and rinsing with normal saline. The irrigation technique, using 0.2% (w/v) chlorhexidine gluconate is safe, inexpensive, easy to apply and can be recommended for routine use in dental practice, to reduce the incidence of dry socket.

An evaluation of 9-aminoacridine/Gelfoam to reduce dry socket formation

This clinical study was undertaken to evaluate the effectiveness of locally applied 9-aminoacridine in Gelfoam in reducing the incidence of dry socket formation after third molar extractions. Results indicated that this technique was not effective. The incidence of dry socket formation in smokers and nonsmokers was compared. Also, the influence of surgical trauma on dry socket formation was examined.

The effect of tetracycline on the incidence of postextraction alveolar osteitis

Four hundred twenty-four mandibular third molar extractions of varied surgical difficulty were evaluated for the occurrence of alveolar osteitis. In 219 of these sockets, tetracycline powder was placed immediately after the tooth was removed. This resulted in a significant reduction in the incidence of alveolar osteitis from 28.7% to 14.6%. There was also a positive correlation between the rate of alveolar osteitis and the increasing depth of the impaction and the degree of surgical difficulty.

Fibrinolytic alveolitis and its prevention

This study aimed at testing the clinical efficacy of a topical prevention of FA, the sample comprising 300 cases of extractions. A sponge was inserted in the socket of each of them, dividing the sample into 3 equal groups: group A (gelatine), group B (gelatine + Solcoseryl) and group C (gelatine + Solcoseryl + propyl-hydroxy-benzoic-acid). The global incidence of FA was a comparatively high, 7.6%, which could be related to the pool of patients included in the study as to the presence of teeth and techniques more prone to complications. No specific clinical characteristic has been isolated (distribution within sex, age, teeth, etc.) which could contradict data collected from other authors. The incidence was lower in the groups B (3%) and C (7%) as compared to group A (13%), but only sponges of group B demonstrated a clinical and statistical efficacy, according to the high number of lower third molar extractions. In contrast, the addition of Solcoseryl proves efficient and does not delay healing, according to previous histological studies. This last characteristic has to be confirmed in the experimental conditions described in our study, as has its mode of action. The ultimate mechanism of FA has still, in our opinion, to be better defined well before the restatement of a topical prevention of FA.

[Tooth-socket dressing in the treatment of postextraction complications (alveolitis sicca dolorosa). 1. The influence of glycerol and polyoxyethyleneglycol 200 on the physicochemical properties of tablets with acetylsalicylic acid and nipagine P]

Using methylcellulose with an addition of glycerol or of polyoxyethylene glycol 200 tablets were made which produce after swelling a dressing designed for treatment of Alveolitis sicca dolorosa. The pharmaceutical availability of acetylsalicylic acid and of Nipagine P as well as the swelling degree increase on a parallel line to increasing quantities of hydrophylizators in a tablet. However the washing out time as well as that of half liberation remain in a reversed proportionality to the content of glycerol and of polyoxyethylene glycol 200. The dressings show non ideally plastic viscosity, they possess thixotropic properties and are characterized by a high flow limit. Below the flow limit the dressing possess in properties of on elastic body.

Influence of polylactic acid mesh on the incidence of localized osteitis

A biodegradable polylactic acid surgical implant, designed to facilitate dental extraction wound heading, is described. Animal studies have proved the safety and tissue compatibility of the implanted polylactic acid material. A clinical study using this material in mandibular third molar extraction sites in human subjects is reviewed. Results of that study reveal the implant to be effective in reducing the incidence of localized osteitis following mandibular third molar extractions.

A comparative study of polylactic acid, Gelfoam, and Surgicel in healing extraction sites

The search for a biodegradable material which may be placed in a fresh extraction socket to facilitate healing and prevent localized osteitis is a project which continues to hold much interest for oral surgeons. Polylactic acid is a biodegradable material which appears to have some promise in this area. The present study was devised to compare polylactic acid with two commonly used biodegradable substances and natural healing in order to determine the tissue response and suitability of polylactic acid as a treatment modality in fresh extraction sites. The over-all results were very satisfactory. The polylactic acid was well tolerated and did not interfere with the healing process.