Blood fibrinolytic activity before and after oral surgery

The effect of a chlorhexidine rinse on the incidence of alveolar osteitis following the surgical removal of impacted mandibular third molars

A prospective randomized double-blind placebo-controlled study was conducted with 139 patients (278 bilaterally impacted mandibular third molars) to determine the effect of a perioperative 0.12% chlorhexidine gluconate rinse on the incidence of alveolar osteitis following surgical removal of impacted mandibular third molars. A statistically significant 60% reduction in the incidence of alveolar osteitis was obtained in the chlorhexidine group compared with the placebo group. In most subgroups analyzed, chlorhexidine was associated with at least a 50% reduction in alveolar osteitis compared with control groups.

The effect of smoking on immediate post-extraction socket filling with blood and on the incidence of painful socket

The effect of habitual smoking on post-extraction socket filling with blood and on the incidence of painful socket, was investigated. Data were collected from 2417 adult dental out-patients in whom 3541 extractions were performed under local anaesthesia. Post-operative socket filling with blood was significantly reduced in smokers, compared with non-smokers (p less than 0.01). There was a higher incidence of painful socket in heavy smokers (20 or more cigarettes per day), compared with nonsmokers (p less than 0.05). There was a significant relationship between immediate post-extraction socket blood level and the incidence of painful socket; sockets which showed poorer filling were more likely to develop painful socket (p less than 0.02). Smoking appeared to have an adverse effect upon the healing of extraction wounds.

Local anaesthesia and dry socket. A clinical investigation of single extractions in male patients

1533 single intra-alveolar permanent tooth extractions in males were investigated in a study to determine if the type and technique of local anaesthesia influenced the occurrence of dry socket. The results show that the incidence of dry socket was significantly greater after the use of Xylocaine compared to Citanest and that the use of repeated injections or intraligamental techniques increased the likelihood of this painful post-extraction condition.

Alveolitis sicca dolorosa after removal of impacted mandibular third molars

The aim of the investigation was to study the occurrence of alveolitis and other side effects in women taking oral contraceptives after surgical removal of impacted mandibular third molars. Reactions to surgical removal of 156 bilateral third molars were examined in 78 patients. The material was divided into 2 groups. In 1 group, the patients took oral contraceptives of the combined type and in the other group the patients took no contraceptives. Each group was further divided into 2 subgroups: (1) removal of a molar during menstruation; and (2) removal of the contralateral molar in the same patient at the middle of the menstrual cycle. The results showed significantly more alveolitis in the group taking oral contraceptives and in women who were operated on during menstruation. These findings would suggest that oral surgery involving fertile women should be undertaken during periods free from oral contraceptives and menstruation.

A new combination of drugs intended to be used as a preventive measure for the postextraction complications. A preliminary report

Fifteen extraction sockets packed with a new drug combination, including a local anesthetic (cincain chloride), a local antiseptic (tri-iodomethane) and two drugs with a potent antifibrinolytic activity (tranexamic acid and propyl-hydroxybenzoic acid) in Gelfoam as a vehicle, were assessed clinically with special reference to the development of the postextraction symptoms, dry socket included. As a control series, 15 extraction sockets allowed to undergo a spontaneous healing were similarly evaluated. All the sockets in both series were found to heal according to the normal sequence. There were, however, statistically highly significant differences between the two series with regard to the clotting time, postextraction pain and the need for adjunct analgesics, in favor of the sockets packed with the compound in test. The observed beneficial effects of the test compound are discussed in the light of the recently elucidated etiologic and pathogenetic mechanisms leading to the development of dry socket, and a conclusion is drawn that the present results, although preliminary due to the limited number of patients, advocate further evaluation of the new drug combination and its applicability in the prevention of the troublesome postextraction complications, including dry socket.