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Retinoids and Concomitant Surgery
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
A clinical study reported a higher rate of alveolar osteitis (11.4%) than the average cited rates (3%–5%) among 26 patients who underwent wisdom tooth extraction while they were concomitantly taking isotretinoin or had completed treatment 1 month prior to the procedure. A causal relationship between isotretinoin use and complications of wisdom tooth removal could not be concluded due to the limited sample size. All patients with dry sockets healed without further complications. The results obtained from this study on the effects of systemic isotretinoin use on wisdom tooth removal suggest that patients do not need to refrain from third molar tooth removal during treatment with isotretinoin (35). It can be concluded that wisdom tooth extraction is a safe procedure in patients who are on systemic retinoid therapy.
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.
Tooth extraction
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Alveolar osteitis (dry socket) is an acutely painful condition which can complicate dental extractions. It is characterized by the onset of pain 24–72 hours post-operatively. Examination reveals halitosis, erythema of surrounding soft tissues and an exposed bony socket from which the clot has been lost and which has often become filled with debris. Treatment involves debridement of the socket into which an antiseptic, obtundant dressing should be placed and the prescription of analgesia. Recent systematic reviews have examined the efficacy of therapeutic interventions undertaken to reduce the incidence of alveolar osteitis after oral surgery. These demonstrated that mouth washing with chlorhexidine pre-operatively and then for 7 days post-operatively and the placement of chlorhexidine gel into sockets immediately following extraction are both effective in reducing the occurrence of alveolar osteitis, although clinicians should be aware of the possibility of anaphylaxis as a result of such topical use of chlorhexidine products. There is no evidence to support the prescription of antibiotics to prevent alveolar osteitis or post-operative infection following dental extraction in healthy patients.
Salivary VEGF and post-extraction wound healing in type 2 diabetic immediate denture wearers
Published in Acta Odontologica Scandinavica, 2022
Katarina Radović, Božidar Brković, Jelena Roganović, Jugoslav Ilić, Aleksandra Milić Lemić, Boris Jovanović
Dental records for all participants were provided at the Department of Prosthodontics and Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade. Regular follow-up of the post-extraction wound healing in healthy and T2D immediate denture wearers was scheduled on the 3rd, 7th, 14th and 21st-day post-extraction, in order to obtain the records of post-extraction wound healing and discomfort under the immediate denture. The investigator, who was unaware of diabetic status, evaluated post-extraction socket width, obtained by measuring buccolingual diameter (using dental calliper). The reduction in the socket width (socket closure) is expressed as a percentage of the width measured immediately after the extraction (day 0). At the same observational time-points, wound healing outcomes such as gingival hyperaemia (ranged as slight middle or severe and presented by 3-point scale), gingival ulceration and gingival superficial necrosis (both recorded as yes or no and presented as frequency) as well as post-extraction pain (measured by a 100-mm visual analogue scale –VAS, from value 0- no pain to 100-max pain) were recorded. The presence of any side effects or complications (symptoms of dry socket and infection) were recorded. No pharmacologic therapy was prescribed and recourse to antibiotics was considered a negative postoperative parameter, a sign of postoperative complications from infections. The use of anti-inflammatory drugs was avoided and paracetamol was recommended for pain control.
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].
Oral isotretinoin (Roaccutane) use during incisional surgery: safe or risky?
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Matthew J. Davies, Darrell Perkins
A 2012 retrospective cohort study focused on mucosal healing following wisdom tooth extraction [7]. About 26 patients who were taking or had recently ceased (within 1 month) Roaccutane, who had wisdom tooth extraction, had higher rates of alveolar osteitis, however all patients demonstrated otherwise normal mucosal healing. Lack of statistical power and incomplete data collection in the study makes it difficult to demonstrate a causal link between Roaccutane and dry sockets. A more recent prospective cohort study featured a subgroup analysis of 20 patients who demonstrated normal healing with cutaneous surgery including excision, subcision, biopsy, punch elevation and dental extraction [8].