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Han Y, Zhu J, Zhang X, Hu S, Li C. Er:YAG Laser Therapy on Alveolar Osteitis After Mandibular Third Molar Surgery: A Randomized Controlled Clinical Study. Photobiomodul Photomed Laser Surg 2024; 42:238-245. [PMID: 38416636 DOI: 10.1089/photob.2023.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Background: Alveolar osteitis (AO) or "dry socket" affects the quality of life of patients, and there is a high clinical demand for its effective treatment. Objective: To evaluate the effect of Er:YAG laser therapy (ErLT) on AO after mandibular third molar surgery. Methods: Eighty-three patients were randomly divided into Er (n = 43) and control groups (n = 40). In the Er group, the Er:YAG laser (2940 nm; AT Fidelis Fotona, Ljubljana, Slovenia) was used to irradiate the AO site directly in micro short-pulsed mode (pulse duration 0.1 ms, pulse energy 100 mJ, frequency 40 Hz, water 4, and air 2) until all debris and necrotic material had been removed, exposing fresh bone and soft tissue surfaces with blood exudation. The control group received mechanical therapy until the treated lesions resembled those in the Er group. Pain assessment was performed at baseline and on days 1-7 post-intervention using the visual analog scale (VAS). Wound healing was assessed using the wound healing index (WHI). The operating times of the two therapies were also recorded. Results: Group Er had lower VAS scores than the control group on days 1-3 (p = 0.00). There was no significant difference between the two groups on days 4-7 (p = 0.15). The WHI scores were better in the Er group than those in the control group (t = 2.65, p = 0.01), especially in terms of redness (t = 2.70, p = 0.01). There was no significant difference in the operating time between the two groups (t = 0.76, p = 0.45). Conclusions: Compared with mechanical therapy, ErLT for AO provides rapid pain relief and improved wound healing.
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Affiliation(s)
- Yang Han
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Jie Zhu
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Xiqian Zhang
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Suning Hu
- Department of Stomatology, Peking University International Hospital, Beijing, China
| | - Cong Li
- Department of Stomatology, Peking University International Hospital, Beijing, China
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Alghriany AA, Ali AU, Khallaf ISA, Hassan AS, Sayed MA, Fikry AM. Clinical effectiveness of orange peel polymethoxy-flavonoids rich fraction as a palatal dressing material compared to Alveogyl: randomized clinical trial. Sci Rep 2024; 14:3067. [PMID: 38321179 PMCID: PMC10847459 DOI: 10.1038/s41598-024-53511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/01/2024] [Indexed: 02/08/2024] Open
Abstract
This study assessed the clinical effectiveness of orange peel polymethoxy-flavonoids rich fraction (OPMF) solid dispersion as a palatal dressing material, compared with Alveogyl, in a randomized clinical trial. After harvesting free gingival grafts for 18 patients in three groups, the donor site in group I received OPMF; group II received Alveogyl; and group III received placebo dough material. The visual analog scale (VAS) pain score in group I showed the lowest value in week one without a significant difference. In week 2, there was a substantial decrease in pain in group I compared to group III. Week 4 showed reduced pain scores in all groups without significant differences. The results of the number of analgesic pills revealed, after 1 week, the lowest number of pills consumed in group I, with a considerable difference compared to group III. Healing process results showed that group I had the highest healing values in each interval, with a significant difference between group I and group III at 1 and 2 weeks. Color matching parameter showed slight differences between the groups' readings in favor of group I in all intervals without a statistically significant difference. The results suggest OPMF as a palatal dressing material that facilitates hemostasis, pain relief, and palatal wound healing.
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Affiliation(s)
- Alzahraa A Alghriany
- Department of Oral Medicine, Periodontology, and Diagnosis, Faculty of Dentistry, Assiut University, Assiut, Egypt.
| | - Ahmed U Ali
- Department of Pharmaceutics, Faculty of Pharmacy, Merit University, Sohag, Egypt
| | - Iman S A Khallaf
- Pharmacognosy and Natural Products Department, Faculty of Pharmacy, Menoufia University, Shibin Elkom, Egypt
| | - Abeer S Hassan
- Department of Pharmaceutics, Faculty of Pharmacy, South Valley University, Qena, Egypt
| | - Marwa A Sayed
- Department of Industrial Pharmacy, Faculty of Pharmacy, Assiut University, Assiut, Egypt
| | - Ahmed Mortada Fikry
- Department of Oral Medicine, Periodontology, and Diagnosis, Faculty of Dentistry, Assiut University, Assiut, Egypt
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Khan ZA, Prabhu N, Maqsood A, Issrani R, Ahmed N, Abbasi MS, Heboyan A, Marya A. Frequency and etiological denominators of alveolar osteitis at Northern Province of Kingdom of Saudi Arabia-An observational study. SAGE Open Med 2023; 11:20503121231219420. [PMID: 38146494 PMCID: PMC10749515 DOI: 10.1177/20503121231219420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/17/2023] [Indexed: 12/27/2023] Open
Abstract
Objective 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. Methods 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. Results 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. Conclusion 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.
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Affiliation(s)
- Zafar Ali Khan
- Department of Oral and Maxillofacial Surgery, Frontier Medical and Dental College, Abbottabad Khyber Pukhtonkhwa, Pakistan
| | - Namdeo Prabhu
- Department of Oral, Maxillofacial Surgery, and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Afsheen Maqsood
- Department of Oral Pathology, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Maria Shakoor Abbasi
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University After Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Anand Marya
- Faculty of Dentistry, Department of Orthodontics, University of Puthisastra, Phnom Penh, Cambodia
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Domic D, Bertl K, Lang T, Pandis N, Ulm C, Stavropoulos A. Hyaluronic acid in tooth extraction: a systematic review and meta-analysis of preclinical and clinical trials. Clin Oral Investig 2023; 27:7209-7229. [PMID: 37963982 PMCID: PMC10713798 DOI: 10.1007/s00784-023-05227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/16/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication management compared to any other treatment or no treatment. MATERIALS AND METHODS Three databases were searched until April 2022. The most relevant eligibility criteria were (1) local application of HyA as adjunct to tooth extraction or as treatment of alveolar osteitis, and (2) reporting of clinical, radiographic, histological, or patient-reported data. New bone formation and/or quality were considered main outcome parameters in preclinical studies, while pain, swelling, and trismus were defined as main outcome parameters in clinical studies. RESULTS Five preclinical and 22 clinical studies (1062 patients at final evaluation) were included. In preclinical trials, HyA was applied into the extraction socket. Although a positive effect of HyA was seen in all individual studies on bone formation, this effect was not confirmed by meta-analysis. In clinical studies, HyA was applied into the extraction socket or used as spray or mouthwash. HyA application after non-surgical extraction of normally erupted teeth may have a positive effect on soft tissue healing. Based on meta-analyses, HyA application after surgical removal of lower third molars (LM3) resulted in significant reduction in pain perception 7 days postoperatively compared to either no additional wound manipulation or the application of a placebo/carrier. Early post-operative pain, trismus, and extent of swelling were unaffected. CONCLUSIONS HyA application may have a positive effect in pain reduction after LM3 removal, but not after extraction of normally erupted teeth. CLINICAL RELEVANCE HyA application may have a positive effect in pain reduction after surgical LM3 removal, but it does not seem to have any impact on other complications or after extraction of normally erupted teeth. Furthermore, it seems not to reduce post-extraction alveolar ridge modeling, even though preclinical studies show enhanced bone formation.
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Affiliation(s)
- Danijel Domic
- Division of Oral Surgery, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Kristina Bertl
- Department of Periodontology, Dental Clinic, Faculty of Medicine, Sigmund Freud University, Freudplatz 3, 1020, Vienna, Austria
- Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs Väg 34, 205 06, Malmö, Sweden
| | - Tobias Lang
- Division of Oral Surgery, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Christian Ulm
- Division of Oral Surgery, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Andreas Stavropoulos
- Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs Väg 34, 205 06, Malmö, Sweden.
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
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Sinhorelli BS, Oliveira SD. Antimicrobial Prophylaxis in Dentistry: Survey among Dental Surgeons in Porto Alegre, Brazil, and the Metropolitan Region. Am J Trop Med Hyg 2023; 108:1071-1077. [PMID: 36940669 PMCID: PMC10160882 DOI: 10.4269/ajtmh.22-0580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/19/2022] [Indexed: 03/23/2023] Open
Abstract
The irrational use of antimicrobial drugs has become a serious epidemiological problem due to the development of bacterial resistance, causing consequences for global health. In dentistry, antibiotics are the second most common pharmacological class prescribed. Thus, we evaluated the use of antimicrobial prophylaxis by dentists in Porto Alegre, Brazil, and the metropolitan region using an online questionnaire. Dentists were asked to complete an anonymous questionnaire concerning antimicrobial prescription. The questionnaire was prepared on the Microsoft Forms platform and shared with dentists through social media and was available for a period of 40 days. The questionnaire was answered by 82 dentists, and 85.3% of them reported prescribing antibiotic prophylaxis (AP). Many different protocols were observed, but the majority of dentists prescribe amoxicillin (2 g) 1 hour before a procedure. The greatest diversity was found in the prescriptions for post-procedure prophylaxis, but most professionals prescribe 500 mg of antibiotics every 8 hours for 7 days. An overwhelming 91.5% of participants think that guidelines for prescribing antibiotics in dentistry are necessary, and 62.2% believe that the use of AP can have some impact on bacterial resistance. There is a wide range of different prescriptions for antimicrobials, suggesting a need for better aligned guidelines and education of professionals on the proper use of antimicrobials and its consequences on bacterial resistance to antibiotics.
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Affiliation(s)
- Bethina S. Sinhorelli
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Sílvia D. Oliveira
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
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ALHarthi SS, Ali D, Alamry NZ, Alshehri MK, Divakar DD, BinShabaib MS. Photobiomodulation for Managing "Dry Socket": A Randomised Controlled Trial. Int Dent J 2023; 73:267-273. [PMID: 35803777 PMCID: PMC10023530 DOI: 10.1016/j.identj.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE There are no studies that have evaluated the effect of Alveogyl with and without adjunct photobiomodulation therapy (PBMT) in reducing self-rated post-operative pain (SPP) in patients with alveolar osteitis (AO; dry socket). The aim of the present randomised controlled trial was to assess the effectiveness of Alveogyl with and without PBMT for the management of SPP in patients with AO. METHODS Adult nonsmokers with diagnosed AO were included. Patients were randomly divided into 4 groups. In Group 1, patients underwent mechanical curettage (MC) with copious normal saline irrigation. In Group 2, patients underwent MC + Alveogyl dressings in extraction sites which were changed every 48 hours until cessation of pain. In Group 3, patients underwent MC + Alveogyl followed by PBMT using a 660-nm indium-gallium-aluminum-phosphide diode laser. In Group 4, patients were treated solely with PBMT. The visual analogue scale was used up to 3 postoperative days to assess SPP up to 3 days at 6- (T0) and 12-hour (T1) intervals. Statistical analyses were performed using the analysis of variance and Bonferroni post hoc adjustment tests. Correlation between SPP scores and age, sex, and eruption status of teeth was assessed using logistic regression models. P values <.01 were nominated as being statistically significant. RESULTS In all, 14, 13, 14, and 14 individuals with AO were included in groups 1, 2, 3 and 4, respectively. All patients had undergone extraction of mandibular third molars. At baseline and on day 1, there was no difference in SPP in all groups. On days 2 and 3, mean visual analogue scale (VAS) scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 2 compared with Group 3. On days 2 and 3, mean VAS scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 4 compared with Group 3. There was no difference in SPP in groups 3 and 4 on day 3 at T0 and T1 intervals. CONCLUSIONS PBMT following MC and Alveogyl dressing is more efficient in reducing SPP compared with MC with or without Alveogyl dressing in patients with AO.
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Affiliation(s)
- Shatha S ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Dena Ali
- Department of General Dental Practice, Kuwait University, Safat, Kuwait
| | - Nujud Zayed Alamry
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Majed K Alshehri
- Department of Preventive Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Darshan D Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University, Ministry of Health, Lusaka, Zambia
| | - Munerah S BinShabaib
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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Asif M, Ullah A, Mujtaba H, Umer MF, Khurshid Z. Comparative Study of Frequency of Alveolar Osteitis, with and without using Platelet-Rich Fibrin in Mandibular Third Molar Surgery. Int J Dent 2023; 2023:2256113. [PMID: 37033125 PMCID: PMC10081905 DOI: 10.1155/2023/2256113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/20/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction. Alveolar ostitis (AO) is the dissolution of blood clot due to enhanced local fibrinolysis and is caused by trauma to the jaw (direct) or because of bacterial involvement (indirect), which result in the activation of plasminogen pathway. Platelet-rich fibrin (PRF) is a platelet concentrate that comprises numerous autologous growth factors, and immune cells hence has the potential to expedite the healing process. The objective of the study was to determine the efficacy of PRF in the surgically extracted third molar in the context of its potential progress to AO. Materials and Methods. A total of 180 patients of 18–65 years with unilateral painful mandibular third molars due to caries, failed endodontics treatment, and pericoronitis were included in the study. Exclusion criteria were patients who were medically compromised, smokers, alcoholic, poor oral hygiene, third molar having associated periapical pathology, and receiving antibiotic regime in the last 2 weeks. Before starting surgical procedure, patients were randomly divided into two groups using lottery method. Group I received PRF in the extraction socket, while in Group II, the extraction site was left for normal healing as practiced in a standard procedure. Pain was assessed in terms of pain score, and it was recorded on a 10 mm visual analog scale on the first and third postoperative days. Results. Mean age of the patients was 41.35 ± 9.87 years. The mean age in Group I was 42.84 ± 10.52 years, and in Group II, it was 40.54 ± 9.52 years. Out of 180 patients, 90 (50.0%) were male and 90 (50.0%) were female, with a male-to-female ratio of 1 : 1. Frequency of AO following mandibular third molar surgery in Group I receiving PRF was 2.22% and in non-PRF group 12.22% (p-value = 0.010). Conclusion. The incidence of AO following mandibular third molar surgery was lower when PRF was used.
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Alabdullah M, Kara Beit ZZ, Shehada A. Comparative Clinical Study of the Effect of Nigella Sativa Oil on Soft Tissue Healing and Inflammation Reduction Compared to Eugenol in the Context of Dry Socket. Cureus 2023; 15:e35375. [PMID: 36994285 PMCID: PMC10040295 DOI: 10.7759/cureus.35375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 02/25/2023] Open
Abstract
Research background Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but despite its high incidence, there is no established treatment for this condition. Nigella sativa oil has anti-inflammatory properties and enhances wound healing. Thus, we have decided to conduct a study to evaluate the efficacy of Nigella sativa oil in the context of dry sockets. Aim of the study This study aims to evaluate the effect of a Nigella Sativa oil dressing compared with an Eugenol dressing for the treatment of dry sockets in terms of accelerating soft tissue healing and reducing the intensity of inflammation. Materials and methods A total of 36 patients (19 males, 17 females), ranging between 20 and 50 years, 40 sockets with Alveolar osteitis randomized into 20 sockets for each group. In the first group, Eugenol with a Gelfoam carrier was used, in the second group, Nigella Sativa oil with a Gelfoam carrier was used and after copious irrigation with normal saline in both groups. Soft tissue healing and the degree of inflammation were monitored on the third (T1) and seventh (T2) days. Results The results of our study showed clinical and statistical superiority in favor of the Nigella Sativa oil group compared to the Eugenol group at time T2, where the P-value was less than 0.05. Conclusions Within the limits of our study, we found that Nigella Sativa oil led to better healing of soft tissues and reduced the intensity of inflammation in the context of dry socket, and was superior in effectiveness to Eugenol, and we recommend its use for the treatment of dry socket.
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Al-Shamiri HM, Al-Maweri SA, AlAhmary AW, Aljunayh MS, Aldosari AO, Alqahtani NM, Alabdulaziz JI, Al-Sharani HM. EFFICACY OF LASER THERAPY FOR ALVEOLAR OSTEITIS: A SYSTEMATIC REVIEW OF THE AVAILABLE EVIDENCE. J Evid Based Dent Pract 2022; 22:101711. [DOI: 10.1016/j.jebdp.2022.101711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 10/18/2022]
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Yan M, Pan Y, Lu S, Li X, Wang D, Shao T, Wu Z, Zhou Q. Chitosan-CaP microflowers and metronidazole loaded calcium alginate sponges with enhanced antibacterial, hemostatic and osteogenic properties for the prevention of dry socket after tooth removal. Int J Biol Macromol 2022; 212:134-145. [PMID: 35588978 DOI: 10.1016/j.ijbiomac.2022.05.094] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 02/06/2023]
Abstract
Tooth removal, particularly for patients with severe periodontitis, can frequently cause massive bleeding, postoperative infection, and bone resorption, resulting in a dry socket. Thus, developing bio-multifunctional materials with excellent antibacterial, hemostatic, and osteogenic characteristics for the prevention of dry sockets after tooth removal is highly desirable in clinical applications. Herein, chitosan-CaP microflowers (CM) and metronidazole (MD) loaded calcium alginate (CA) sponges (CA@CM/MD) with enhanced antibacterial, hemostatic, and osteogenic properties were developed via Ca2+ crosslinking, lyophilization, and electrostatic interaction for the prevention of dry socket after tooth removal. The fabricated CM particles display 3-dimensional, relatively homogeneous, and flower-shaped architectures. The CA@CM/MD composite sponges were facilely shaped into the tooth root as well as exhibit interconnected porous and lamellar structures with remarkable porosity, suitable maximum swelling ratio, as well as excellent compressive and hemostatic performance. Besides, the in vitro cellular assessment demonstrates that the prepared CA@CM/MD composite sponges possess satisfactory cytocompatibility. Importantly, the designed sponges significantly suppress the growth of S. aureus and E. coli, as well as promote cellular osteogenic differentiation by upregulating the formation of alkaline phosphatase. Our findings indicate that the tooth root-shaped composite sponges hold great promise for wound management after tooth removal.
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Affiliation(s)
- Mingzhe Yan
- Department of Human Anatomy, Histology and Embryology, School of basic medicine, Qingdao University, Qingdao 266073, China; Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266021, China
| | - Yingxiao Pan
- School of Stomatology, Qingdao University, Qingdao 266003, China; Oral department of Qingdao Municipal Hospital, Qingdao 266011, China
| | - Shulai Lu
- Oral department of Qingdao Municipal Hospital, Qingdao 266011, China
| | - Xin Li
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Danyang Wang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266021, China; School of Stomatology, Qingdao University, Qingdao 266003, China
| | - Tianyi Shao
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266021, China
| | - Zhihang Wu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266021, China; Department of Biomedical Engineering, The University of Melbourne, Victoria 3010, Australia
| | - Qihui Zhou
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266021, China; School of Stomatology, Qingdao University, Qingdao 266003, China.
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Pain Relief and Antimicrobial Activity in Alveolar Osteitis after Platelet-Rich Fibrin Application—A Non-Randomized Controlled Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
The objective was to compare pain relief in alveolar osteitis achieved by the application of platelet-rich fibrin (PRF) and aspirin cones, and to assess the influence of both treatments on bacterial concentrations in post-extraction wounds. A split-mouth, single-center, non-randomized controlled trial was conducted in 30 patients. Pain relief was assessed using the visual analog scale at three time points (before, 24 h after, and 48 h after intervention). Bacterial concentrations were evaluated from cultures of swab samples collected at the three time points. A Wilcoxon matched-pairs signed-rank test was performed to detect differences in distributions of scalar variables between treatment with PRF and aspirin cones. Pain relief at 24 h and 48 h after treatment was significantly higher (p = 0.003) with PRF application than with aspirin cone placement. Additionally, PRF application caused a significantly higher reduction in aerobic bacteria concentration, an average increase, instead of a decrease, in lactic acid bacilli concentration in the first 24 h, and a significantly greater increase in streptococci concentration at 48 h follow-up. PRF provides better pain relief than aspirin cones in alveolar osteitis. Bacterial concentrations in the extraction wounds are consistent with the pain relief achieved after PRF or aspirin application.
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Khan ZA, Prabhu N, Ahmed N, Lal A, Issrani R, Maqsood A, Vohra F, Alam MK. A Comparative Study on Alvogyl and a Mixture of Black Seed Oil and Powder for Alveolar Osteitis: A Randomized Double-Blind Controlled Clinical Trial. Int J Clin Pract 2022; 2022:7756226. [PMID: 35685605 PMCID: PMC9159183 DOI: 10.1155/2022/7756226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/09/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Alveolar osteitis (AO) is the most common complication faced by exodontia patients and is usually seen 24-74 hours after tooth extraction, heralded by severe throbbing pain. Nigella sativa is commonly known as black seed known to have anti-inflammatory and antibacterial properties along with other reparative properties that enhance bone formation. This study aimed to evaluate and compare the effects of Alvogyl and a mixture of Nigella sativa powder and oil in the treatment of dry sockets. MATERIALS AND METHODS Sixty patients above the age of 18 and below 70 years, from both genders, who underwent extraction of teeth and were clinically diagnosed with a dry socket at the clinic of the College of Dentistry, Jouf University, Saudi Arabia, were included in this study. Pain scores were assessed after placement of the dressing at the following intervals: 5 minutes, 30 minutes, 60 minutes, 2nd day, 4th day, and 7th day. Patients were randomly allocated to three groups, namely, Group 1 (Alvogyl), Group 2 (mixture of Nigella sativa's powder and oil), and Group 3 (control). Pain relief and healing of the socket were compared between the three groups. The collected data were subjected to statistical analysis through Spearman's correlation test, independent t-test, ANOVA, and post hoc test. RESULTS A mixture of Nigella sativa powder and oil showed a statistically significant difference in relieving pain compared to the Alvogyl group. A mixture of Nigella sativa's powder and oil required fewer dressings when compared to the Alvogyl group. CONCLUSION A mixture of Nigella sativa powder and oil is the more efficacious dressing material for the management of dry sockets compared to Alvogyl. It provides immediate and complete pain relief and fewer numbers of repeated visits.
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Affiliation(s)
- Zafar Ali Khan
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Namdeo Prabhu
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Abhishek Lal
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Al Jouf 72345, Saudi Arabia
| | - Afsheen Maqsood
- Department of Oral Pathology, Bahria University Dental College, Karachi 75530, Pakistan
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Al Jouf 72345, Saudi Arabia
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
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Garola F, Gilligan G, Panico R, Leonardi N, Piemonte E. Clinical management of alveolar osteitis. A systematic review. Med Oral Patol Oral Cir Bucal 2021; 26:e691-e702. [PMID: 34704976 PMCID: PMC8601644 DOI: 10.4317/medoral.24256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/27/2021] [Indexed: 11/06/2022] Open
Abstract
Background Alveolar Osteitis (AO) is one of the most common complications of tooth extraction. Several therapeutic interventions have been described for the treatment of AO, however, there are no treatment standardized protocols. The aim of this study was to conduct a systematic review on the efficacy in pain control of the different treatments for AO. The feasibility of the application of these interventions is also discussed. Material and Methods A structured electronic and hand search strategy was applied to PubMed, Scopus, Cochrane Library, OpenGrey, and Google Scholar between January 2010 and July 2020 to identify studies according to PRISMA guidelines. The inclusion criteria were original English and Spanish clinical trials that analyzed pain-control parameters according to visual analog scale (VAS, 0-10 scale), or pain relief patients’ percentages. Those treatments that reach VAS ≤ 4 on day 2 or before; or ≥ 85% of patients with absence of pain symptoms at day 7 or before were considered accepTable for their recommendation. Results The final review included 17 clinical trials. Among them, there were analyzed a total of 39 different AO treatments. 53,8% of the treatments fulfill the proposed parameters for pain control. Conclusions Treatment alternatives are multiple, heterogeneous, and difficult to compare. The management of AO is summarized in basic (intra-alveolar irrigation) and specific procedures (Alveogyl®, Neocones®, SaliCept Patch®, Low-Level Laser, Platelet-Rich Fibrin) that reach pain control success. They could be selected according to their availability and advantages or disadvantages. Key words:Dry socket, alveolar osteitis, treatment, management, pain control, pain relief.
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Affiliation(s)
- F Garola
- Haya de la Torre SN PA: 5000. Ciudad Universitaria Córdoba, Argentina
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14
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Reeshma S, Dain CP. Comparison of platelet-rich fibrin with zinc oxide eugenol in the relief of pain in alveolar osteitis. Health Sci Rep 2021; 4:e354. [PMID: 34401528 PMCID: PMC8358232 DOI: 10.1002/hsr2.354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND AIMS Alveolar osteitis (AO) is the most common painful post-operative complication after tooth extraction. The common modalities used in the management of AO are lavage, placement of medicated dressings, analgesics, and antibiotics. The present study was undertaken to compare platelet-rich fibrin (PRF) and zinc oxide eugenol (ZOE) for pain relief in AO. METHODS All cases meeting the eligibility criteria received two different treatment modalities over a span of 18 months. At the analysis stage, the final sample size comprised 70 patients, with 35 patients appropriated in each group. Group A patients received ZOE and Group B received PRF. Pain scores were measured on "1st, 3rd, 5th, and 7th" days based on a visual analogue scale (VAS) and compared in both groups of patients. The collected data were analyzed using the chi-square test, t test, and Mann-Whitney U test. RESULTS In patients treated with ZOE dressing, the average VAS scores observed were 7.4 ± 1.5, 5.1 ± 1.1, 3.4 ± 0.9, and 2.1 ± 0.7, respectively, on the "1st, 3rd, 5th, and 7th" follow-up days. In patients treated with PRF, the average VAS score observed were 4.1 ± 1.2, 2.6 ± 0.9, 1.7 ± 0.9, and 0.8 ± 0.8 respectively. CONCLUSION Both ZOE and PRF were effective in pain control during the follow-up period. However, the pain intensity measured as a pain score using VAS was, lower in the PRF group than in the ZOE group on all follow-up days.
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Affiliation(s)
- Satheesh Reeshma
- Department of Oral and Maxillofacial SurgeryGovernment Dental CollegeTrivandrumIndia
| | - Chacko Pearl Dain
- Department of Oral and Maxillofacial SurgeryGovernment Dental CollegeTrivandrumIndia
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15
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Initial Observation of Factors Interfering with the Treatment of Alveolar Osteitis Using Hyaluronic Acid with Octenidine-A Series of Case Reports. Biomolecules 2021; 11:biom11081157. [PMID: 34439823 PMCID: PMC8391686 DOI: 10.3390/biom11081157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 12/15/2022] Open
Abstract
Alveolar osteitis (AO) is a common complication following the extraction of the teeth, particularly the lower third molars. It starts within a few days after the extraction and manifests mainly as pain in the extraction site. Several strategies of treatment are available in order to relieve pain and heal the extraction wound. Recently, a novel medical device combining hyaluronic acid (HA) and octenidine (OCT) was introduced for the treatment of AO. This series of case reports aims to summarize the initial clinical experiences with this new device and to highlight factors possibly interfering with this treatment. The medical documentation of five patients with similar initial situations treated for AO with HA + OCT device was analyzed in detail. Smoking and previous treatment with Alveogyl (Septodont, Saint-Maur-des-Fossés, France) were identified as factors interfering with the AO treatment with the HA + OCT device. In three patients without these risk factors, the treatment led to recovery within two or three days. The patient pretreated with Alveogyl and the smoker required six and seven applications of the HA + OCT device, respectively. According to these initial observations, it seems smoking and previous treatment with Alveogyl prolong the treatment of AO using the HA + OCT device that, in turn, shows a rapid effect if these risk factors are not present.
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Buonavoglia A, Leone P, Solimando AG, Fasano R, Malerba E, Prete M, Corrente M, Prati C, Vacca A, Racanelli V. Antibiotics or No Antibiotics, That Is the Question: An Update on Efficient and Effective Use of Antibiotics in Dental Practice. Antibiotics (Basel) 2021; 10:antibiotics10050550. [PMID: 34065113 PMCID: PMC8151289 DOI: 10.3390/antibiotics10050550] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 12/17/2022] Open
Abstract
The antimicrobial resistance (AMR) phenomenon is an emerging global problem and is induced by overuse and misuse of antibiotics in medical practice. In total, 10% of antibiotic prescriptions are from dentists, usually to manage oro-dental pains and avoid postsurgical complications. Recent research and clinical evaluations highlight new therapeutical approaches with a reduction in dosages and number of antibiotic prescriptions and recommend focusing on an accurate diagnosis and improvement of oral health before dental treatments and in patients’ daily lives. In this article, the most common clinical and operative situations in dental practice, such as endodontics, management of acute alveolar abscesses, extractive oral surgery, parodontology and implantology, are recognized and summarized, suggesting possible guidelines to reduce antibiotic prescription and consumption, maintaining high success rates and low complications rates. Additionally, the categories of patients requiring antibiotic administration for pre-existing conditions are recapitulated. To reduce AMR threat, it is important to establish protocols for treatment with antibiotics, to be used only in specific situations. Recent reviews demonstrate that, in dentistry, it is possible to minimize the use of antibiotics, thoroughly assessing patient’s conditions and type of intervention, thus improving their efficacy and reducing the adverse effects and enhancing the modern concept of personalized medicine.
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Affiliation(s)
- Alessio Buonavoglia
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Patrizia Leone
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Antonio Giovanni Solimando
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Rossella Fasano
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Eleonora Malerba
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Marcella Prete
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | | | - Carlo Prati
- Endodontic Clinical Section, Department of Biomedical and NeuroMotor Sciences, Dental School, University of Bologna, 40125 Bologna, Italy;
| | - Angelo Vacca
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Vito Racanelli
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
- Correspondence:
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17
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Dalirsani Z, Ghazi N, Delavarian Z, Pakfetrat A, Esmaily H, Davaji M, Alavi H, Salari Sedigh H, Shafieian R. Effects of diode low-level laser therapy on healing of tooth extraction sockets: a histopathological study in diabetic rats. Lasers Med Sci 2021; 36:1527-1534. [PMID: 33644838 DOI: 10.1007/s10103-021-03270-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/10/2021] [Indexed: 11/29/2022]
Abstract
Diabetes mellitus is mostly interrelated to deficiency in wound healing. Low-level laser therapy has been shown to exert reliable effects on the acceleration of wound healing process. This study aimed to determine the potential influence of low-level laser therapy (LLLT) on the healing of extraction sockets in diabetic rats. A total of 24 healthy male Wistar rats were selected for this study. After diabetes induction, the maxillary first molars of all rats were extracted bilaterally. Then, the animals were subjected either to Ga-Al-As laser at 808 nm or to Al-Ga-In-P laser at 660 nm at the right extracted socket every day for the next 14 days. The left sockets served as controls. Rats were sacrificed on the 3rd, 5th, 7th, and 14th days after tooth extraction. The samples were examined by a pathologist. LLLT at 808 nm was able to significantly repress inflammation, improve osteoid formation, and promote vascularization in comparison to the non-treated sockets. LLLT at 660 nm significantly suppressed inflammation and developed vascularization in comparison to the non-treated sockets, but failed to improve osteoid formation in the treated sockets. This study suggests that LLLT could be considered as a reliable treatment for wound healing in diabetic experimental rats.
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Affiliation(s)
- Zohreh Dalirsani
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Ghazi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atessa Pakfetrat
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mina Davaji
- Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Alavi
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Salari Sedigh
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.
| | - Reyhaneh Shafieian
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Guida A, Perri F, Ionna F, Ascierto PA, Grimaldi AM. New-generation anticancer drugs and medication-related osteonecrosis of the jaw (MRONJ): Late onset 3 years after ipilimumab endovenous administration with a possible role of target therapy. Clin Case Rep 2021; 9:61-66. [PMID: 33489133 PMCID: PMC7813008 DOI: 10.1002/ccr3.3418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/28/2020] [Accepted: 10/04/2020] [Indexed: 12/24/2022] Open
Abstract
Association of immunotherapy and/or chemotherapy and/or targeted therapy, in sequence or as single therapies, may induce osteonecrosis of the jaw. Multidisciplinary team management of these patients should be provided.
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Affiliation(s)
- Agostino Guida
- Maxillo‐facial and ENT Surgery UnitINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Francesco Perri
- Head & Neck/Thyroid Medical Oncology UnitINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Franco Ionna
- Maxillo‐facial and ENT Surgery UnitINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Paolo A. Ascierto
- Melanoma, Oncological Immunotherapy and Innovative Therapies DepartmentINT – IRCCS “Fondazione G. Pascale”NaplesItaly
| | - Antonio M. Grimaldi
- Melanoma, Oncological Immunotherapy and Innovative Therapies DepartmentINT – IRCCS “Fondazione G. Pascale”NaplesItaly
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Shafaee H, Bardideh E, Nazari MS, Asadi R, Shahidi B, Rangrazi A. The effects of photobiomodulation therapy for treatment of alveolar osteitis (Dry Socket): Systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2020; 32:102000. [PMID: 32919077 DOI: 10.1016/j.pdpdt.2020.102000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/13/2020] [Accepted: 09/04/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Dry socket (alveolar osteitis) is one of the most common complications that occur after the extraction of permanent teeth. The aim of this review was to evaluate and compare the effectiveness of photobiomodulation (PBT) with other treatment methods on alveolar osteitis. METHODS AND MATERIALS MEDLINE, Web of Science, EMBASE, Scopus and Cochrane's CENTRAL online databases were searched based on the search strategy. Also, the prominent laser journals and the references of relevant studies were hand searched for eligible studies and then the data were extracted from the retrieved studies were extracted using piloted custom forms. The data were combined and analyzed using inverse-variance random-effect meta-analysis. RESULTS For the treatment of dry socket, pain perception based on the VAS score, PBT on average has a 3.41 higher pain level reduction compared to alveogyl which seems to be both statistically and clinically significant. In addition, based on the GRADE score, the evidence seems to be of moderate quality. Also, in the individual studies which were included in this systematic review, PBT seems to be more effective than other methods (Salicept, zinc-oxide eugenol, ozone, and photodynamic therapy) in pain reduction of patients with alveolar osteitis. CONCLUSIONS PBT, in general, has a higher ability in decreasing pain levels for patients with alveolar osteitis (dry socket) compared to alveogyl. Therefore, PBT could be used as an appropriate method for treatment and controlling the signs of dry socket.
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Affiliation(s)
- Hooman Shafaee
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Erfan Bardideh
- Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohammad Sadegh Nazari
- Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Asadi
- Community Medicine Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahareh Shahidi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Tehran, Iran
| | - Abdolrasoul Rangrazi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Özveri Koyuncu B, Işık G, Özden Yüce M, Günbay S, Günbay T. Effect of concentrated growth factors on frequency of alveolar Osteitis following partially-erupted mandibular third molar surgery: a randomized controlled clinical study. BMC Oral Health 2020; 20:222. [PMID: 32807173 PMCID: PMC7433081 DOI: 10.1186/s12903-020-01210-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 08/09/2020] [Indexed: 01/01/2023] Open
Abstract
Background The aim of this prospective study was to assess the effectiveness of concentrated growth factors (CGF) in preventing the development of alveolar osteitis (AO) after the extraction of partially-erupted mandibular third molars. Methods Seventy patients (26 men and 44 women) 18 years or older (mean age 25.86; range 18–35) underwent 140 third molar extractions. All the patients presented with bilateral, partially-erupted mandibular third molars and underwent surgical extractions. In each case, one socket received CGF and the other served as a control. The predictor variable was the CGF application and the sides were categorized as ‘CGF’ and ‘non-CGF’. The outcome variable was the development of AO during the first postoperative week. Other study variables included age and gender. Data were analyzed using Cochran’s Q test with the significance level set at a P value less than 0.05. Results The overall frequency of AO was 11.4% for the control group. The frequency of AO in the CGF group was significantly lower than in the non-CGF group (p < 0.001). Conclusions Based on the results of this study, application of CGF fibrin gel may decrease the risk of AO development after mandibular third molar surgery. Trial registration This study was registered in ClinicalTrials.gov database on November 1, 2019 (ID: NCT04151147, retrospectively registered).
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Affiliation(s)
- Banu Özveri Koyuncu
- Department of Oral Surgery, Faculty of Dentistry, Ege Univeristy, Bornova, İzmir, Turkey.
| | - Gözde Işık
- Department of Oral Surgery, Faculty of Dentistry, Ege Univeristy, Bornova, İzmir, Turkey
| | - Meltem Özden Yüce
- Department of Oral Surgery, Faculty of Dentistry, Ege Univeristy, Bornova, İzmir, Turkey
| | - Sevtap Günbay
- Department of Oral Surgery, Faculty of Dentistry, Ege Univeristy, Bornova, İzmir, Turkey
| | - Tayfun Günbay
- Department of Oral Surgery, Faculty of Dentistry, Ege Univeristy, Bornova, İzmir, Turkey
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The Efficacy of Concentrated Growth Factor in the Healing of Alveolar Osteitis: A Clinical Study. Int J Dent 2020; 2020:9038629. [PMID: 32454827 PMCID: PMC7240629 DOI: 10.1155/2020/9038629] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/10/2020] [Indexed: 11/17/2022] Open
Abstract
Background A dry socket also referred to as alveolar osteitis (AO) is a common postoperative complication following tooth extraction, due to the disruption of the clot within the wound. This study aimed to evaluate the efficacy of concentrated growth factor (CGF) in the healing of alveolar osteitis following tooth extraction. Methods The study was conducted at University Dental Hospital Sharjah, UAE. Patients undergoing tooth extraction at the oral surgery clinic were advised to return immediately if they suffer from pain. Over the following first week after tooth extraction, patients who reported pain symptoms were recalled and all dry sockets were identified. The patients were divided into two groups. Group I patients received conventional treatment with socket curettage and saline irrigation only, while in group II CGF was inserted into the socket. Both groups were observed for pain score and quantification of granulation tissue formation. Results A total of 40 dry socket patients, aged between 18 and 60 years, from a total of 1,250 patients, were included in the study. 30 patients were given conventional treatment while another 10 patients were given CGF. Patients who received CGF had a pain score of 7-10 at presentation, and the pain score dropped to 0-3 on day 4 and further improved to 0-1 on day 7 (p = 0.001). Granulation tissue formation appeared in the conventional group I on day 7 while the CGF group II showed earlier granulation tissue formation by day 4 (p = 0.001). The posttreatment pain score is inversely proportional to the amount and rate of granulation tissue formation in the socket. Conclusion The study suggests that delivery of CGF into a dry socket helps relieve pain and expedite the wound healing process as shown by a statistically much lower pain score and earlier and more rapid formation of granulation tissue when compared to the conventional alveolar osteitis therapy.
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Alveolar Osteitis: A Review of Current Concepts. J Oral Maxillofac Surg 2020; 78:1288-1296. [PMID: 32348729 DOI: 10.1016/j.joms.2020.03.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of the present review was to explore the pathogenesis and etiology of alveolar osteitis (AO) to obtain a more intuitive understanding of the clinical prevention and management of the condition. The different treatment modalities were discussed through both the mechanistic understanding of AO and the evidence regarding the different modes of prevention and management. MATERIALS AND METHODS The Ovid Medline, PubMed, and Cochrane Central Register online databases were used to complete an advanced search using the MeSH term "dry socket," generating 756 results. RESULTS A total of 8 studies on the prevention of AO were included, with 66 studies included for review of the reported data overall. The information was categorized into incidence, etiology and pathogenesis, prevention, and management. The relevant background information and evidence for each category were summarized. CONCLUSIONS Understanding of the pathogenesis and etiology of AO has improved in recent years, which has been helpful for developing effective evidence-based treatment and prevention of the condition. Clinicians should be aware of the complexity and multifactorial nature of the etiology of AO and the current concepts regarding the prevention and treatment of AO.
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Ehab K, Abouldahab O, Hassan A, Fawzy El-Sayed KM. Alvogyl and absorbable gelatin sponge as palatal wound dressings following epithelialized free gingival graft harvest: a randomized clinical trial. Clin Oral Investig 2020; 24:1517-1525. [PMID: 32144515 DOI: 10.1007/s00784-020-03254-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/26/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES This randomized controlled trial compares for the first time effects of Alvogyl versus absorbable gelatin sponge as palatal wound dressings on postoperative pain, amount of analgesic consumption, post-surgical bleeding, and wound re-epithelization. MATERIALS AND METHODS Following sample size calculation, 36 systemically healthy patients requiring palatal mucosal graft harvesting were randomized to receive Alvogyl (intervention group, 18 patients) or absorbable gelatin sponge (control group, 18 patients) palatal dressings. Patient-reported VAS pain scores over 2 weeks were defined as primary outcome. Post-surgical bleeding, number of analgesics consumed, and complete re-epithelialization of the palatal wound for up to 5 weeks were defined as secondary outcomes. RESULTS Although significantly higher VAS pain scores were reported in the control as compared with the intervention group up to 12 days post-surgically (from (median [range]) 8.5 [2-10] to 1 [0-2] and from 6 [0-10] to 0 [0-2] respectively), with higher analgesics consumption (from 2 [1-3] to 1 [0-3] and from 1 [0-3] to 0 [0-2] tablets respectively), a multivariate regression analysis considering age, gender, graft width/length, tissue thickness, analgesics intake, and dressing type demonstrated no statistically significant effect of any factor, including dressing type on VAS pain scores. At 4 weeks, 22.2% of patients in the intervention group versus 11.1% in the control group demonstrated complete re-epithelization of their palatal engraftment site, before complete re-epithelization in both groups at 5 weeks. No post-surgical bleeding was reported with both dressings. CONCLUSIONS Within the study's limitations, results suggest Alvogyl as a practical palatal surgical dressing, comparable with absorbable gelatin sponge in cost, pain reduction, hemostasis, and re-epithelization properties. TRIAL REGISTRATION www.ClinicalTrials.gov Identifier: NCT03402321 CLINICAL RELEVANCE: Alvogyl could present a novel palatal wound dressing material, comparable with gelatin sponge.
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Affiliation(s)
| | - Omneya Abouldahab
- Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
| | - Abdallah Hassan
- Periodontology Department, School of Dentistry, New Giza University, Giza, Egypt
| | - Karim M Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt.
- Oral Medicine and Periodontology Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt.
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Suchánek J, Ivančaková RK, Mottl R, Browne KZ, Pilneyová KC, Pilbauerová N, Schmidt J, Suchánková Kleplová T. Hyaluronic Acid-Based Medical Device for Treatment of Alveolar Osteitis-Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193698. [PMID: 31581430 PMCID: PMC6801692 DOI: 10.3390/ijerph16193698] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 11/16/2022]
Abstract
Alveolar Osteitis (AO) is a complication following the extraction of a tooth. AO manifests through localized pain in, and around, the extraction site, where the post-operative blood clot has been disintegrated. The aim of this single cohort study was to evaluate the outcome of a treatment of AO, using a pharmacological device composed of hyaluronic acid and octenidine dihydrochloride. The tested device is a sponge-like material, composed solely of a fully dissoluble medicaments (hyaluronic acid, calcium chloride, and octenidine dihydrochloride). It was designed to serve as a non-toxic, slow-dissolving antiseptic, that adheres to mucosa and obturates the wound. This study includes 58 subjects who were diagnosed with AO. The tested device was administered once daily until local pain subsided to < 20 mm of the Visual Analog Scale (VAS). The treatment was considered effective when the pain subsided to < 20 mm VAS in < 8 days of treatment; as per comparative studies. Our findings provide a statistically significant success rate of 96.0% (95.0% confidence interval of 75.75% to 97.8%) after pharmacological device administrations. No adverse medical effects were detected. Acquired data confirmed that lyophilized hyaluronic acid, combined with octenidine, is effective for the treatment of AO. The results are clinically important as AO is a common complication after third molar extractions.
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Affiliation(s)
- Jakub Suchánek
- Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
- Department of Histology and Embryology, Charles University - Faculty of Medicine in Hradec Králové, Šimkova 870, 500 03 Hradec Králové, Czech Republic
| | - Romana Koberová Ivančaková
- Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
| | - Radovan Mottl
- Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Klára Zoe Browne
- Department of Histology and Embryology, Charles University - Faculty of Medicine in Hradec Králové, Šimkova 870, 500 03 Hradec Králové, Czech Republic
| | - Kristýna Charlotte Pilneyová
- Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Nela Pilbauerová
- Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Jan Schmidt
- Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Tereza Suchánková Kleplová
- Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
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Aulestia-Viera PV, Gontijo SML, Gomes ADM, Sinisterra RD, Rocha RG, Cortés ME, Dos Santos MF, Borsatti MA. Guaiacol/β-cyclodextrin for rapid healing of dry socket: antibacterial activity, cytotoxicity, and bone repair-an animal study. Oral Maxillofac Surg 2019; 23:53-61. [PMID: 30737608 DOI: 10.1007/s10006-019-00747-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Dry socket (DS) is one the most common and symptomatic post-extraction complications; however, no consensus on its treatment has been reached. This study aimed to develop a novel dressing material for DS containing the phenolic agent guaiacol and evaluate its biological properties. METHODS An inclusion complex of guaiacol and β-cyclodextrin (Gu/βcd) was prepared by freeze-drying. Its antibacterial activity over six oral bacteria was analyzed using the microdilution method, and its cytotoxicity in osteoblasts was assessed with the MTT assay. The alveolar healing process induced by Gu/βcd was evaluated histologically after the treatment of DS in rats. RESULTS βcd complexation potentiated Gu's antibacterial effect and reduced its cytotoxicity in osteoblasts. Bone trabeculae were formed in the alveolar apices of rats treated with Gu/βcd by day 7. On day 14, woven bone occupied the apical and middle thirds of the sockets; on day 21, the entire alveolus was filled by newly formed bone, which was in a more advanced stage of repair than the positive control (Alvogyl™). CONCLUSION The improvement in Gu's biological properties in vitro and the rapid alveolar repair in comparison with Alvogyl™ in vivo demonstrated the benefits of the Gu/βcd complex as a future alternative for the treatment of DS.
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Affiliation(s)
- Patricia Verónica Aulestia-Viera
- Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - Sávio Morato Lacerda Gontijo
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Alinne Damásia Martins Gomes
- Department of Chemistry, Exact Sciences Institute, Federal University of Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Rubén Dario Sinisterra
- Department of Chemistry, Exact Sciences Institute, Federal University of Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Rodney Garcia Rocha
- Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - Maria Esperanza Cortés
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Marinilce Fagundes Dos Santos
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Professor Lineu Prestes, 1524, Cidade Universitária, São Paulo, SP, Brazil
| | - Maria Aparecida Borsatti
- Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
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Mamoun J. Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques. J Korean Assoc Oral Maxillofac Surg 2018; 44:52-58. [PMID: 29732309 PMCID: PMC5932271 DOI: 10.5125/jkaoms.2018.44.2.52] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/28/2017] [Accepted: 06/10/2017] [Indexed: 01/30/2023] Open
Abstract
Dry socket, also termed fibrinolytic osteitis or alveolar osteitis, is a complication of tooth exodontia. A dry socket lesion is a post-extraction socket that exhibits exposed bone that is not covered by a blood clot or healing epithelium and exists inside or around the perimeter of the socket or alveolus for days after the extraction procedure. This article describes dry socket lesions; reviews the basic clinical techniques of treating different manifestations of dry socket lesions; and shows how microscope level loupe magnification of 6× to 8× or greater, combined with co-axial illumination or a dental operating microscope, facilitate more precise treatment of dry socket lesions. The author examines the scientific validity of the proposed causes of dry socket lesions (such as bacteria, inflammation, fibrinolysis, or traumatic extractions) and the scientific validity of different terminologies used to describe dry socket lesions. This article also presents an alternative model of what causes dry socket lesions, based on evidence from dental literature. Although the clinical techniques for treating dry socket lesions seem empirically correct, more evidence is required to determine the causes of dry socket lesions.
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Kawecki F, Clafshenkel WP, Fortin M, Auger FA, Fradette J. Biomimetic Tissue-Engineered Bone Substitutes for Maxillofacial and Craniofacial Repair: The Potential of Cell Sheet Technologies. Adv Healthc Mater 2018; 7:e1700919. [PMID: 29280323 DOI: 10.1002/adhm.201700919] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/02/2017] [Indexed: 12/21/2022]
Abstract
Maxillofacial defects are complex lesions stemming from various etiologies: accidental, congenital, pathological, or surgical. A bone graft may be required when the normal regenerative capacity of the bone is exceeded or insufficient. Surgeons have many options available for bone grafting including the "gold standard" autologous bone graft. However, this approach is not without drawbacks such as the morbidity associated with harvesting bone from a donor site, pain, infection, or a poor quantity and quality of bone in some patient populations. This review discusses the various bone graft substitutes used for maxillofacial and craniofacial repair: allografts, xenografts, synthetic biomaterials, and tissue-engineered substitutes. A brief overview of bone tissue engineering evolution including the use of mesenchymal stem cells is exposed, highlighting the first clinical applications of adipose-derived stem/stromal cells in craniofacial reconstruction. The importance of prevascularization strategies for bone tissue engineering is also discussed, with an emphasis on recent work describing substitutes produced using cell sheet-based technologies, including the use of thermo-responsive plates and the self-assembly approach of tissue engineering. Indeed, considering their entirely cell-based design, these natural bone-like substitutes have the potential to closely mimic the osteogenicity, osteoconductivity, osteoinduction, and osseointegration properties of autogenous bone for maxillofacial and craniofacial reconstruction.
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Affiliation(s)
- Fabien Kawecki
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
| | - William P. Clafshenkel
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
| | - Michel Fortin
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Oral and Maxillofacial Surgery Faculty of Dentistry Université Laval Québec QC G1V 0A6 Canada
| | - François A. Auger
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
| | - Julie Fradette
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
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28
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He Y, Chen J, Huang Y, Pan Q, Nie M. Local Application of Platelet-Rich Fibrin During Lower Third Molar Extraction Improves Treatment Outcomes. J Oral Maxillofac Surg 2017; 75:2497-2506. [DOI: 10.1016/j.joms.2017.05.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/27/2017] [Accepted: 05/30/2017] [Indexed: 02/06/2023]
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29
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Taberner-Vallverdú M, Sánchez-Garcés MÁ, Gay-Escoda C. Efficacy of different methods used for dry socket prevention and risk factor analysis: A systematic review. Med Oral Patol Oral Cir Bucal 2017; 22:e750-e758. [PMID: 29053647 PMCID: PMC5813994 DOI: 10.4317/medoral.21705] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 06/29/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Dry socket is one of the most common complications that develops after the extraction of a permanent tooth, and its prevention is more effective than its treatment. OBJECTIVES Analyze the efficacy of different methods used in preventing dry socket in order to decrease its incidence after tooth extraction. MATERIAL AND METHODS A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "prevention", "risk factors", "alveolar osteitis" and "fibrynolitic alveolitis", both individually and using the Boolean operator "AND". The inclusion criteria were: clinical studies including at least 30 patients, articles published from 2005 to 2015 and written in English. The exclusion criteria were case reports and nonhuman studies. RESULTS 30 publications were selected from a total of 250. Six of the 30 were excluded after reading the full text. The final review included 24 articles: 9 prospective studies, 2 retrospective studies and 13 clinical trials. They were stratified according to their level of scientific evidence using SIGN criteria (Scottish Intercollegiate Guidelines Network). CONCLUSIONS All treatments included in the review were aimed at decreasing the incidence of dry socket. Locally administering chlorhexidine or applying platelet-rich plasma reduces the likelihood of developing this complication. Antibiotic prescription does not avoid postoperative complications after lower third molar surgery. With regard to risk factors, all of the articles selected suggest that patient age, history of previous infection and the difficulty of the extraction are the most common predisposing factors for developing dry socket. There is no consensus that smoking, gender or menstrual cycles are risk factors. Taking the scientific quality of the articles evaluated into account, a level B recommendation has been given for the proposed-procedures in the prevention of dry socket.
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Chakravarthi S. Platelet rich fibrin in the management of established dry socket. J Korean Assoc Oral Maxillofac Surg 2017; 43:160-165. [PMID: 28770156 PMCID: PMC5529189 DOI: 10.5125/jkaoms.2017.43.3.160] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/22/2016] [Accepted: 01/26/2017] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Dry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket. MATERIALS AND METHODS Ten patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF. Evaluation was performed by observing the reduction of pain using visual analogue scale, analgesic tablet use over the follow-up period, and healing parameters. RESULTS Pain was reduced on the first day in all patients with decreased analgesic use. Pain was drastically reduced during follow-up on the first, second, third, and seventh days with a fall in pain score of 0 to 1 after the first day alone. The pain scores of all patients decreased to 1 by the first day except in one patient, and the scores decreased to 0 in all patients after 48 hours. Total analgesic intake ranged from 2 to 6 tablets (aceclofenac 100 mg per tablet) over the follow-up period of 7 days. Healing was satisfactory in all patients by the end of the seventh day. CONCLUSION PRF showed early pain reduction in established dry socket with minimal analgesic intake. No patients had allergic reactions to PRF as it is derived from the patient's own blood. PRF showed good wound healing. Our study suggests that PRF should be considered as a treatment modality for established dry socket.
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Affiliation(s)
- Srinivas Chakravarthi
- Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, India
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31
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Maughan BC, Hersh EV, Shofer FS, Wanner KJ, Archer E, Carrasco LR, Rhodes KV. Unused opioid analgesics and drug disposal following outpatient dental surgery: A randomized controlled trial. Drug Alcohol Depend 2016; 168:328-334. [PMID: 27663358 DOI: 10.1016/j.drugalcdep.2016.08.016] [Citation(s) in RCA: 160] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/11/2016] [Accepted: 08/13/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Individuals who abuse prescription opioids often use leftover pills that were prescribed for friends or family members. Dental surgery has been identified as a common source of opioid prescriptions. We measured rates of used and unused opioids after dental surgery for a pilot program to promote safe drug disposal. METHODS We conducted a randomized controlled trial of opioid use patterns among patients undergoing surgical tooth extraction at a university-affiliated oral surgery practice. The primary objective was to describe opioid prescribing and consumption patterns, with the number of unused opioid pills remaining on postoperative day 21 serving as the primary outcome. The secondary aim was to measure the effect of a behavioral intervention (informing patients of a pharmacy-based opioid disposal program) on the proportion of patients who disposed or reported intent to dispose of unused opioids. (NCT02814305) Results: We enrolled 79 patients, of whom 72 filled opioid prescriptions. On average, patients received 28 opioid pills and had 15 pills (54%) left over, for a total of 1010 unused pills among the cohort. The behavioral intervention was associated with a 22% absolute increase in the proportion of patients who disposed or reported intent to dispose of unused opioids (Fisher's exact p=0.11). CONCLUSION Fifty-four percent of opioids prescribed in this pilot study were not used. The pharmacy-based drug disposal intervention showed a robust effect size but did not achieve statistical significance. Dentists and oral surgeons could potentially reduce opioid diversion by moderately reducing the quantity of opioid analgesics prescribed after surgery.
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Affiliation(s)
- Brandon C Maughan
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Elliot V Hersh
- Departments of Oral & Maxillofacial Surgery and Pharmacology, University of Pennsylvania School of Dental Medicine, Philadelphia PA, USA.
| | - Frances S Shofer
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Kathryn J Wanner
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Elizabeth Archer
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Lee R Carrasco
- Departments of Oral & Maxillofacial Surgery and Pharmacology, University of Pennsylvania School of Dental Medicine, Philadelphia PA, USA.
| | - Karin V Rhodes
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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A Systematic Review on Effect of Single-Dose Preoperative Antibiotics at Surgical Osteotomy Extraction of Lower Third Molars. J Oral Maxillofac Surg 2016; 74:693-703. [DOI: 10.1016/j.joms.2015.11.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 11/22/2022]
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