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PubMed1988

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.

Adolescent↗

PubMed2007

Influence of trans-operative complications on socket healing following dental extractions.

AIM: Extraction healing complications have been attributed to several factors. The influence of trans-operative complications on an extraction site wound healing was the focus of this investigation. METHODS AND MATERIALS: This prospective study was conducted at the Oral Surgery Clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (LUTH) in Nigeria . Subjects selected were those referred for one or two adjacent extractions and who satisfied the inclusion criteria for the study. The relevant pre-operative information recorded for each patient were age and sex of patient, indications for extraction, time taken to extract the tooth, tooth/teeth removed, and any trans-operative complications. Extractions were performed with dental forceps, elevators, or both under local anaesthesia. Patients were blindly evaluated on the third and seventh post-operative day for socket healing assessment without reference to pre-operative information on the patients. RESULTS: Seventy-three (24.25%) of 301 teeth considered for socket healing assessment had various trans-operative complications due to accidental crown, root, or alveolar bone fractures. Of the 73 extractions with trans-operative complications during extraction, 18 developed a socket healing complication, while 17 of the 228 extractions without trans-operative complications developed socket healing complications (p = .000). The mean (SD) time taken to extract teeth developing healing complications was also found to be significantly longer than those without healing complications (p < .01). CONCLUSIONS: The study demonstrated the combination of tooth/bone fragments in the socket and increased time of extraction due to trans-operative complications and accidents predispose to the development of extraction site wound healing disturbance.

Adolescent↗

PubMed1979

Influence of Alvogyl on the healing of extraction wound in man.

Eight volunteer patients free of any systamic disease underwent extraction of two teeth on the same day. One extraction socket was packed with Alvogyl, the other served as a control wound. Biopsies for histological assessment were taken from both sockets 1 and 2 weeks after extraction. Histological study revealed the normal sequence of wound healing in the sockets allowed to heal spontaneously. On the other hand, the signs of retarded wound healing (acute inflammatory infiltrate, persistent granulation tissue, failure to form connective tissue scar and frequent foreign bodies/foreign body giant cells) were encountered in the sockets packed with Alvogyl. On the basis of these preliminary results, it seems warranted to state that the systematic use of Alvogyl as a preventive and curative treatment for postextraction alveolar infections cannot be advocated.

Adult↗

PubMed1975

Extraction socket healing in the calcium deficient rat.

The healing of extraction sockets was studied in normal and calcium deficient rats. New bone formation occurred earlier and proceeded more rapidly in the deficient rats, and the newly formed trabeculae were sparse and delicate but with a similar osteoporotic appearance to the alveolar bone.

Animals↗

PubMedDate not supplied

Ridge preservation: important buzzwords in dentistry.

Ridge preservations is the prevention of the 40-60% jawbone atrophy that normally takes place two to three years postextraction. It is the new paradigm in patient care that is effective, simple, and beneficial for a multitude of reasons. It is achieved by the immediate grafting of the extraction socket with or without the use of an immediate implant. The ability to not only preserve the alveolar ridge for future restorative dentistry but also to preserve and restore esthetics and prevent postoperative pain and bleeding makes this modality important for all practicing dentists.

Alveolar Bone Loss↗

PubMed1994

Prophylactic application of an intra-alveolar socket medicament to reduce postextraction complications in HIV-seropositive patients.

A prospective, controlled trial was performed to investigate the effect of a prophylactic socket medicament containing chlortetracycline, aspirin, and local anesthetics, in reducing the incidence of postextraction pain and infection in patients who are HIV-seropositive. Fifty patients were in the study; 25 received the experimental dressing and 25 had no dressing. Patients were asked to complete a questionnaire rating the pain at 24 hours and 48 hours after surgery. Seven days after extraction, socket healing was scored, and sockets with delayed healing sampled for culture. Four of 25 (16%) patients who received the experimental dressing and 8 of 25 (32%) controls experienced pain during the 48 hours after extraction (p = not significant). None of the group who received the experimental dressing and 7 of 25 (28%) in the control group had delayed healing, of these 4 had alveolar osteitis and three had infected sockets (p = 0.0096). We conclude that the experimental agent is useful as a prophylactic agent to reduce delayed healing in HIV-positive patients who undergo exodontia.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Dental extraction wound management: medicating postextraction sockets.

The rather impressive percentage of extraction sites undergoing clot loss and deranged healing results in significant morbidity for the patient and frequent visits to the surgeon to effect relief of discomfort, most often by the use of anodyne dressings. The amount of work lost by patients needing such palliative treatment, and loss of productive time for the surgeon, translate into an unknown, but potentially large, economic loss to society. This would mandate that economical methods of ensuring normal extraction socket healing with minimal morbidity be developed. The most useful socket medicaments to prevent socket healing derangements would include broad-spectrum antibiotics, specifically clindamycin and tetracycline. Not discussed in this article, but possibly germane to the subject of clot stabilization and healing, is consideration of resorbable substances such as gelatin sponge, polylactic acid, and methylcellulose as clot-stabilizing socket implants. The record of such substances in preventing AO is mixed, but the combinations of these inexpensive materials with topical socket medicaments may yield a decreased tendency for clot lysis and greater mechanical strength to the bulk blood clot, as has been demonstrated with difficult mandibular third molar impactions in one study involving polylactic acid, tetracycline, and hydrocortisone.

Anti-Bacterial Agents↗

PubMed1987

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.

Dexamethasone↗

PubMed1995

The effect of polylactic acid granules on the incidence of alveolar osteitis after mandibular third molar surgery. A prospective randomized study.

OBJECTIVE: To evaluate the effect of polylactic acid granules placed in third molar sockets on the incidence of alveolar osteitis. STUDY DESIGN: A prospective randomized study with 161 patients (322 bilaterally impacted mandibular third molars). RESULTS: The sockets in which the polylactic acid granules were placed had a significantly higher rate of alveolar osteitis (23.6%) than did the control sockets (13.58%). In all subgroups analyzed, the incidence of alveolar osteitis was higher in the experimental (polylactic acid) group. CONCLUSION: On the basis of the findings of this study, polylactic acid granules do not reduce the incidence of alveolar osteitis and may actually contribute to a higher incidence of alveolar osteitis.

Adolescent↗

PubMed1997

Trabecular bone formation in the healing of the rodent molar tooth extraction socket.

The aim of this study was to investigate the nature of the template structure on which trabecular bone formation occurs during healing of the rodent tooth extraction socket, a well studied bone healing system. The presence of collagen type II mRNA has previously been described in the healing socket, although the formation of the protein or cartilage has not been observed. However, recent evidence from developmental and other bone healing studies indicates that collagen type III may be important in forming the preliminary scaffold on which bone trabeculae are formed. The maxillary right molar teeth were removed from rats under general anaesthesia and the animals killed at various times afterward. The tissues were examined using histological, in situ hybridization, and immunohistochemical staining techniques. It was concluded that collagen type IIA mRNA was produced by osteoblast cells of the socket, but that collagen type II, if present, would account for less than 0.01% of the total proteins extracted. During bone formation, Sharpey's fibers were seen radiating from the peripheral bone toward the center of the socket. These optically active collagen fibers were inserted into the forming bone trabeculae and were recognized by antibodies raised against collagen type III. The arrangement and composition of these fibers therefore suggest that they form a preliminary framework on which deposition of woven bone trabeculae occurs.

Animals↗

PubMed1991

A monitoring and evaluation study of third molar surgery complications at a major medical center.

This monitoring and evaluation study of third molar surgery complications took place over a 6-month period of time. The goal of the study was to determine complication rates following third molar extraction. A comparison was made between the staff's and residents' post-operative complication rates and patients receiving tetracycline powder in the extraction sockets vs. no antibiotics. Complication rates were compared in males vs. females, and in four different age groups. The study helped improve patient care by showing that alveolar osteitis rates decreased when all patients received topical tetracycline. It also confirmed that the experience of the surgeon, patient age, and gender influence complication rates.

Adolescent↗

PubMedDate not supplied

[The healing characteristics of the sockets following surgery in tooth extraction in workers in viscose manufacturing].

The study of cicatrization after the teeth extraction in workers of viscous rayon industry which had had a long contact with sulfuric carbon revealed a lower regeneration potential and increased complication incidence as compared to control patient group. Preventive measures are designed providing for control check-ups 3 to 5 days after the intervention and the use of rehabilitation period in presurgical preparation of the patients.

Alveolar Process↗

PubMed1992

IMZ implants placed into extraction sockets in association with membrane therapy (Gengiflex) and porous hydroxyapatite: a case report.

A buccal plate destroyed by the inflammatory process as a result of a longitudinal root fracture was completely restored by the combined use of an IMZ implant placed in the alveolus of the fractured maxillary central incisor and the principles of guided tissue regeneration. A Gengiflex membrane was used to cover the implant, and porous hydroxyapatite was used as grafting material. At the 6-month reentry, the defect around the implant was completely filled by mineralized tissue.

Adult↗

PubMed1984

The influence of closure or dressing of third molar sockets on post-operative swelling and pain.

This study compares the influence of complete closure as opposed to partial closure and dressing of lower third molar sockets on post-operative pain and swelling, and on healing. These closure techniques were used on opposite sides of the mouths of each of 70 patients undergoing bilateral third molar surgery. The comparison of the two techniques within each individual patient showed that complete closure resulted in more pain and swelling post-operatively in a significant number of patients, but that the use of a dressing delayed satisfactory healing in a few patients.

Adult↗

PubMed1982

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.

Alveolar Process↗

PubMedDate not supplied

Clinical evaluation of an ointment with 10% metronidazole and 2% lidocaine in the treatment of alveolitis.

AIM: In this study, the authors evaluate the use of a 10% metronidazole and 2% lidocaine ointment, using a lanolin base and mint as flavoring, to treat alveolitis in humans. METHODS: Twenty-five patients, with a diagnosis of alveolitis, were treated in the following way: locoregional anesthesia; surgical cleaning of the socket with alveolar curettes; saline solution irrigation with a 20 ml disposable syringe; and complete filling of the socket with the ointment. RESULTS: The analysis of the results showed that the painful symptoms were severe before and on the day of the treatment in 17 (68%) of the 25 patients treated. Post-treatment analysis presented 2 patients (18%) with severe painful symptoms after 24 h of the treatment and complete remission of painful symptoms after 48 h of the treatment with the ointment. CONCLUSIONS: Based on the results, it is possible to conclude that the 10% metronidazole and 2% lidocaine ointment, with mint flavoring and lanolin as a base, can be used to treat alveolitis.

Adolescent↗

PubMed1999

Autogenous masticatory mucosal grafts in extraction socket seal procedures: a comparison between sockets grafted with demineralized freeze-dried bone and deproteinized bovine bone mineral.

Successful preservation of the edentulous ridge after extractions may eliminate or reduce the need for ridge augmentation procedures. It has been claimed that grafting fresh extraction sockets and sealing them with autogenous soft tissue grafts promote ridge preservation after tooth extraction. In this study, the survival of free autogenous connective tissue grafts sealing extraction sites was evaluated. In 24 healthy patients, 42 maxillary anterior teeth were extracted. After socket debridement, soft tissue margins of the socket orifice were carefully cut to remove epithelial debris, Sockets were filled with either demineralized freeze-dried bone allografts (DFDBA) or deproteinized natural bovine bone mineral xenograft (DBBMX) to the level of the alveolar bone crest. Circular connective tissue grafts, slightly larger in diameter than the soft tissue socket orifice, were obtained and placed on top of the filler graft material sealing the sockets. Grafts were stabilized and secured by sutures and inspected weekly for the first month. The grafts were classified into 3 groups according to clinical parameters: vital, partially vital and non-vital. After 1 week, 18 grafts were vital, 13 partially vital and 11 non-vital. When only 1 sample unit (1 site per patient) was compared between DFDBA and DBBMX grafted sockets, no significant difference in graft vitality was shown (P = 0.34 for vital; P = 0.67 for vital plus partially vital). After 1 month, all socket orifices were sealed with mucosa. Based on the present observations, it seems that connective tissue grafts sealing fresh extraction sites are mainly dependent on underlying tissue vascularization and that sealing grafted fresh extraction sockets filled with bone substitute allograft or xenograft materials may be beneficial but an unpredictable procedure.

Adolescent↗

PubMed1986

[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.

Aspirin↗