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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 36-year-old man was referred with a 4-day history of ulceration in the mouth and soreness and crusting of the lips and surrounding skin. Twenty days previously, his lower left first premolar tooth had been extracted under general anaesthesia because of a periapical abscess. After 15 days, alveolar osteitis was diagnosed and the socket was packed with ribbon gauze impregnated with bismuth subnitrate and iodoform paste (iodoform 33%, bismuth subnitrate 17% and liquid paraffin 50%, abbreviated BIPP). On the following day, the patient developed mouth ulceration, swelling of the tongue and inflammation of the lips and perioral skin. He remembered having had a rash from iodine antiseptic previously. On examination, the patient had a severe left-sided stomatitis with ulceration of the left side of the tongue with an acute cheilitis and dermatitis of the perioral skin. Cervical lymphadenopathy was present. After successful treatment, an open patch test with BIPP gauze produced an area of erythema and edema 8x7 centimeter with central vesiculation after 2 days, persisting at D4, but without the vesiculation. Later, patch tests were positive to potassium iodide 5% pet. (6).
Retinoids and Concomitant Surgery
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
In a clinical study on the relationship between interventional therapies and systemic retinoid use, a case of wisdom tooth extraction was reported. Healing was satisfactory after wisdom tooth extraction in this patient, despite the fact that the patient was on systemic isotretinoin therapy (17). In a clinical study on the relationship between systemic retinoid use and surgical outcome, two cases were reported where problematic healing after dental procedures occurred. Poor, edematous, and erythematous healing at the incision site was observed following wisdom tooth extraction in a patient who had discontinued systemic retinoid therapy 2 months prior to surgical intervention. Alveolar osteitis developed following tooth extraction in a patient who was using systemic retinoids at the time of surgical procedure. These cases were detected retrospectively out of 76 patients who underwent surgery following recent (less than or equal to 2 years) use of systemic retinoids (18).
Benign Oral and Dental Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Konrad S. Staines, Alexander Crighton
Alveolar osteitis is a localized osteitis which develops following a minority of dental extractions and is associated with breakdown of the tooth socket clot. Pain is severe, deep seated and localized to the socket and represents inflammation in the bone rather than infection. The cause is unclear but may represent ischaemia of the tissues as the condition is much more common in smokers. There also seems to be a familial tendency to develop a dry socket.
Prevotella species as oral residents and infectious agents with potential impact on systemic conditions
Published in Journal of Oral Microbiology, 2022
Eija Könönen, Dareen Fteita, Ulvi K. Gursoy, Mervi Gursoy
Alveolar osteitis, accompanied by poorly integrated blood clot in the alveolar socket, is a common complication after tooth extraction, resulting in severe postoperative pain. Prevotella has been found to be the most frequent genus in sockets with and without alveolar osteitis (22% and 18%, respectively) [163]. Prevotella recoveries from alveolar osteitis sites were only P. nanceiensis, P. pleuritidis, and P. veroralis, and occasionally, P. copri, P. multiformis, and P. oulorum. P. melaninogenica and P. intermedia were over-represented but P. loescheii and P. salivae were under-represented at alveolar osteitis sites compared to sockets without complications. In tooth sockets without complications, P. bivia and P. marshii, and occasional P. aurantiaca, P. baroniae, P. bergensis, and P. oralis were found [163].
The pharmacological management of dental pain
Published in Expert Opinion on Pharmacotherapy, 2020
Joseph V. Pergolizzi, Peter Magnusson, Jo Ann LeQuang, Christopher Gharibo, Giustino Varrassi
Alveolitis or alveolar osteitis, sometimes called ‘dry socket,’ is a form of localized osteomyelitis which occurs with inflammation of the alveolar bone. In many cases, alveolar osteitis occurs two to 4 days following a dental extraction and is more common with traumatic than surgical tooth extractions. Alveolar osteitis demands prompt treatment and is associated with excruciating pain [66]. Oral NSAIDs are typically required and prescription antibiotics may be appropriate if there is systemic infection, but often there is no underlying infection. [78]. A topical formulation of lidocaine 2% in a viscous jelly can be applied directly to the extraction socket to provide pain control until the socket heals [79]. Alveolar osteitis results from the disintegration of a blood clot in the extraction socket and is best treated when the socket can be cleansed of necrotic debris by irrigating the socket with sterile saline and then applying a medicated dressing. Curettage of the socket is not recommended, as it may expose the bone [80]. The incidence of alveolar osteitis ranges from 0.5% to 5% for routine dental extractions and may be as high as 37.5% for mandibular third molar extractions. Surgical dental extractions have higher rates of alveolar extraction, which typically occurs one to 3 days following the tooth extraction. The exact pathogenesis of alveolar osteitis has not been elucidated [81].
Incidence of alveolar osteitis after mandibular third molar surgery. Can inflammatory cytokines be identified locally?
Published in Acta Odontologica Scandinavica, 2021
Hauk Øyri, Janicke L. Jensen, Pål Barkvoll, Olga H. Jonsdottir, Janne Reseland, Tore Bjørnland
During the study period 584 third molars were removed in 445 patients, out of which 27 patients were diagnosed with alveolar osteitis. The relative incidence of alveolar osteitis was 4.6%. Residents in oral surgery performed most of the operations (88.9%, n = 24). Supervised dental students (final year of undergraduate training) performed two (7.4%) operations. One (3.7%) patient was treated by a staff surgeon. Mean surgical time was 22.9 min (range 8–45 min). Twenty-one patients (18 females, 3 males) consented to participate in the study and were followed prospectively until subjective symptoms resolved. The AO female:male ratio was 6:1. Patient demographics are presented in Table 1. A flow chart of patient inclusion is presented in Figure 1.