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The aetiology of dry socket: a review

Awang MN

Int Dent J, 1989 Dec;39(4):236-40.
PMID: 2691403

The aetiology of dry socket continues to be the subject of intense research. Local disturbances of fibrinolytic activity appear to be the most satisfactory explanation for the pathogenesis of this disorder. The factors that are responsible for local changes in fibrinolytic activity are reviewed and evaluated. In the management of this disorder attention should be directed towards the prevention of local changes in fibrinolytic activity.

Matched MeSH terms: Dry Socket/etiology*; Dry Socket/physiopathology
Management of dry socket with low-level laser therapy

Kamal A, Salman B, Ar NH, Samsudin AR

Clin Oral Investig, 2021 Mar;25(3):1029-1033.
PMID: 32562076 DOI: 10.1007/s00784-020-03393-3

OBJECTIVE: The aim of this study is to investigate the efficacy of delivering low-level laser therapy (LLLT) in the management of dry socket at University Dental Hospital Sharjah.
MATERIALS AND METHOD: Forty-five patients with dry socket were divided into two treatment groups. Group I dry socket patients (n = 30) received conventional treatment while group II patients (n = 15) were irradiated with LLLT at a setting of 200-mW, 6-J, continuous-wave mode using an R02 tipless handpiece (Fotona Er:YAG, Europe), on the buccal, lingual, and middle surfaces of the socket for 30 s from a delivery distance of 1 cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7 days post-dry socket treatment.
RESULTS: Results showed that the LLLT-irradiated group II sockets showed a much lower VAS pain score of 1-2 as early as day 4, and a richer amount of granulation tissue compared to the conventional treated group I socket. The amount and rate of granulation tissue formation in the dry socket are inversely proportional to the pain score showing significant clinical effectiveness of LLLT on promoting the healing of the dry socket, with improvement in symptoms (P = .001). Conventionally treated dry sockets take at least 7 days to match the effective healing of an LLLT-irradiated dry socket.
CONCLUSION: LLLT irradiation influences biomodulation of dry socket healing by dampening inflammation, promoting vascularization, stimulating granulation, and controlling pain symptoms.
CLINICAL RELEVANCE: LLLT may be an additional effective tool for managing dry sockets in general dental practice.

Matched MeSH terms: Dry Socket*
The prevalence of post-extraction complications in an outpatient dental clinic in Kuala Lumpur Malaysia--a retrospective survey

Jaafar N, Nor GM

Singapore Dent J, 2000 Feb;23(1):24-8.
PMID: 11602946

The aim of this retrospective study is to report on the prevalence of post-extraction complications among patients attending the Oral Surgery outpatient clinic of the Faculty of Dentistry, University of Malaya over a 12-month period from January to December, 1992. The prevalence of post-extraction complications which required further treatment was only 3.4% (n = 100), out of a total of 2968 patients who had extraction of one or more permanent teeth. Analysis based on complete clinical reports (n = 79) showed that dry socket accounted for nine out of ten cases of post-extraction complications. However the aetiology was largely unknown. No obvious association with medical history could be made. Lower teeth were more likely to have complications. The most common teeth associated with dry socket were the molars (76%) and premolars (19%). The most common molars to be affected are the first, followed by the third and lastly the second molars. A brief review of current aetiological factors of dry socket was discussed.

Matched MeSH terms: Dry Socket/etiology; Dry Socket/epidemiology*; Dry Socket/therapy
Fulltext A Comparative Clinical Study between Concentrated Growth Factor and Low-Level Laser Therapy in the Management of Dry Socket

Kamal A, Salman B, Razak NHA, Samsudin ABR

Eur J Dent, 2020 Oct;14(4):613-620.
PMID: 32777838 DOI: 10.1055/s-0040-1714765

OBJECTIVE: A dry socket is a well-recognized complication of wound healing following tooth extraction. Its etiology is poorly understood and commonly occur among healthy patients. As such, management strategies for dry socket has always been empirical rather than scientific with varying outcome. The aim of this study is to investigate the efficacy of concentrated growth factor (CGF) and low-level laser therapy (LLLT) and compared them to the conventional treatment in the management of dry socket.
MATERIALS AND METHODS: Sixty patients with one dry socket each, at University Dental Hospital Sharjah, were divided into three treatment groups based on their choice. In group I (n = 30), conventional treatment comprising of gentle socket curettage and saline irrigation was done. Group II (n = 15) dry sockets were treated with CGF and group III (n = 15) sockets were lased with LLLT. All dry socket patients were seen at day 0 for treatment and subsequently followed-up at 4, 7, 14, and 21 days. Pain score, perisocket inflammation, perisocket tenderness, and amount of granulation tissue formation were noted.
STATISTICAL ANALYSIS: Data were analyzed as mean values for each treatment group. Comparisons were made for statistical analysis within the group and among the three groups to rank the efficacy of treatment using one-way analysis of variance (ANOVA). Statistically significant difference is kept at p < 0.05.
RESULTS: Conventional treatment group I took more than 7 days to match the healing phase of group II CGF treated socket and group III LLLT irradiated socket (p = 0.001). When healing rate between CGF and LLLT are compared, LLLT group III showed a delay of 4 days compared with CGF in granulation tissue formation and pain control.
CONCLUSION: CGF treated socket was superior to LLLT in its ability to generate 75% granulation tissue and eliminate pain symptom by day 7 (p = 0.001).

Matched MeSH terms: Dry Socket
Fulltext Impacted mandibular third molars among patients attending Hospital Universiti Sains Malaysia

Rosfaima Othman Jaffar, Tin-Oo M.M.

Archives of Orofacial Sciences, 2009;4(1):7-12.
MyJurnal

The aim of this study was to identify the position of impacted mandibular third molars based on the classifications of Pell & Gregory and Winter, the indications for extraction, and the relation of post-operative complications and position. Records of patients who attended Hospital Universiti Sains Malaysia between January and December 2007 for surgical removal of mandibular third molars were reviewed. The angulation type, width and depth of impaction were determined by reviewing the orthopantomograms. The indications of extraction and occurrence of any post- operative complications were recorded. A total of 238 impacted teeth were surgically extracted from 194 patients (97 males, 97 females). The reasons for extraction include recurrent pericoronitis (43.1%) followed by prophylactic purposes (33.5%). Mesioangular impactions accounted for 52.3% and Class IIA position of impaction accounted for 45.7% of extractions. The most common post-operative complication was persistent pain and swelling (14.7%) followed by trismus (4.1%) and dry socket (3.0%). There was no significant relationship between the angulation, width and depth of impaction and the occurrence of complication. Mesioangular type and Class IIA position of impaction were the most common impaction. Although the association was not significant, high frequency of post-operative complications was observed in mesioangular, horizontal, IIA and IIC positions.

Matched MeSH terms: Dry Socket