La alveolitis y sus factores de riesgo en la población adulta joven / Dry socket and its risk factors in a young adult population

Introducción: La alveolitis es la complicación más frecuente de la extracción dental, y constituye la causa más común de las consultas de Urgencias, pues los pacientes presentan dolor en el período postoperatorio. Aunque la etiología de esta afección no es muy conocida, se considera que es un trastorno multifactorial. Objetivos: Determinar el tipo de alveolitis más frecuente en la muestra objeto de estudio, así como establecer la relación entre los factores de riesgo y el tipo de alveolitis. Métodos: Se realizó un estudio descriptivo y trasversal en el Servicio de Urgencias de la Clínica Estomatológica «Celia Sánchez Manduley», de Santa Clara, Villa Clara, desde febrero de 2020 a junio de 2021. El estudio se realizó en un total de 51 pacientes diagnosticados con alveolitis dental. Se estudiaron las siguientes variables: tipo de alveolitis y factores de riesgo (edad, sexo, antecedentes de enfermedades, el uso de tabletas anticonceptivas, hábitos tóxicos, condiciones del medio bucal, características de la maniobra quirúrgica y cuidados postoperatorios); los datos fueron recogidos en un formulario. Resultados: Predominó la alveolitis seca en las pacientes del sexo femenino. El hábito de fumar y la práctica de una maniobra quirúrgica compleja fueron los factores de riesgo preponderantes. Conclusiones: Existe una relación significativa entre la presencia de alveolitis seca y las pacientes del sexo femenino asociadas a los hábitos tóxicos, el uso de tabletas anticonceptivas, y haber sido sometidas a una maniobra quirúrgica compleja.

Introduction: dry socket is the most frequent complication after a dental extraction and constitutes the most common cause of emergency consultations, since patients have pain in the postoperative period. It is considered to be a multifactorial disorder although the etiology of this condition is not well known. Objectives: to determine the most common type of dry socket in the sample under study, as well as to establish the relationship between risk factors and the type of dry socket. Methods: a descriptive and cross-sectional study was carried out in the emergency department at "Celia Sánchez Manduley" Dental Clinic, in Santa Clara, Villa Clara, from February 2020 to June 2021. The study was carried out in a total of 51 patients who were diagnosed with dry socket. Type of dry socket and risk factors such as age, gender, history of diseases, use of contraceptive tablets, toxic habits, conditions of the oral environment, characteristics of the surgical procedure and postoperative care were the variables studied; the data was collected in a form. Results: dry socket predominated in female patients. Smoking and performing a complex surgical maneuver were the predominant risk factors. Conclusions: there is a significant relationship among the presence of dry socket and female patients associated with toxic habits, the use of contraceptive tablets, and having undergone a complex surgical maneuver.

Literature review of dry socket: etiology, pathogenesis, prevention, and management

Dry socket/alveolar osteitis is a detrimental and excruciatingly painful post-extraction condition of the socket caused by the breakdown of a clot leading to the denudation of the socket that exposes underlying bone that is not protected by a blood clot or healing tissue and persists within or around the alveolus for days after the surgical tooth extraction with or without halitosis and suppuration. It is inevitable that dry socket will develop during routine oral surgery or dental procedures. The common factors that cause dry socket are smoking, poor oral hygiene, traumatic extractions caused by inexperienced dentists, previous bacterial infection, inflammation, fibrinolysis, and systemic disorders, in conjunction with oral contraceptives, menstrual cycle, and rapid irrigation of the socket after extraction with normal saline. The management of dry socket is directed towards palliative care. A substantial amount of research is required to provide a definitive treatment choice for dry socket. This literature review focuses on the pathogenesis, prevention, and management of dry socket.

Prevalencia de alveolitis seca asociada a urgencias dolorosas durante el aislamiento social preventivo y obligatorio de la pandemia COVID-19 en un servicio de urgencias del área bonaerense metropolitana en la República ArgentinaPrevalence of dry socket associated with urgent dental extractions due to pain performed at an emergency service in the Buenos Aires Metropolitan Area during the mandatory preventive social isolation for the COVID-19 pandemic in Argentina / Prevalence of dry socket associated with urgent dental extractions due to pain performed at an emergency service in the Buenos Aires Metropolitan Area during the mandatory preventive social isolation for the COVID-19 pandemic in Argentina

Objective: To evaluate the prevalence of dry socket as a postoperative complication in cases where there was intense local pain in the preoperative state, during the preventive mandatory social isolation (PMSI) for the COVID-19 pandemic in Argentina. Methods: This was a descriptive study, which included 1209 walk-in patients at the emergency and orientational service at Buenos Aires University School of Dentistry during the PMSI from March 20 to June 20, 2020, with indication for dental extraction as well as intense acute pain at the surgical site. The presence of dry socket was exploratoryly associated with the variables age, sex, smoking and chronic medication use. Results: 1209 patients were operated, resulting in a total 1372 dental extractions. Average patient age was 41 years. The prevalence found in this study was 1.06%. Conclusion: The prevalence of dry socket was 1%, not being higher than other experiences where pain was not considered a condition prior to extraction.

Objetivo: Evaluar la prevalencia de alveolitis seca como complicación postquirúrgica, cuando existió dolor intenso local en el preoperatorio, durante el Aislamiento Social Preventivo y Obligatorios (ASPO) de la pandemia COVID-19 en la República Argentina. Material y Métodos: Se realizó un estudio descriptivo en el que fueron incluidos 1209 pacientes, que presentaron indicación de exodoncia y concurrieron al servicio de urgencias y orientación de pacientes de la Facultad de Odontología de la universidad de Buenos Aires, durante el ASPO en un periodo comprendido entre el 20 de marzo y el 20 de junio de 2020, con dolor agudo e intenso en el sitio quirúrgico. La presencia de alveolitis seca fue asociada de forma exploratoria con las variables edad, sexo, tabaquiamo y medicación de uso crónico. Resultados: Fueron operados 1209 pacientes a los que se les realizaron un total de 1372 exodoncias, con un promedio de edad 41 años. La prevalencia fue de 1,06%. Conclusión: La prevalencia de alveolitis seca fue del 1%, no siendo superior a otras experiencias donde no se consideró al dolor como una condición previa a la exodoncia.

Assessment of Incidence and Risk Factors of Dry Socket

Background: Alveolar osteitis (AO) is one of the extractions wound healing disorder. Most authors agree that surgical trauma and difficulty of surgery play a significant role in the development of AO. Hence, under the light of above - mentioned data, the present study was undertaken for assessing the incidence and risk factors of dry socket. Methods: A total of 200 subjects scheduled to undergo dental extraction procedures under local anesthesia were included in the p resent study. Complete demographic and clinical details of all the patients were obtained. All the procedures were carried out under the hands of experienced surgeons. Follow - up was done and incidence of dry socket was recorded. Results: Overall, incidenc e of dry socket in the present study was 17.5 percent. Positive tobacco smoking/chewing habit, Oral contraceptives, Female gender, Existing tooth/gum infection, Past history of dry socket, Traumatic extraction and Mandibular molar extraction were the risk factors in 62.85 %, 34.28 %, 71.42 %, 14.28 %, 25.71 %, 42.85 % and 54.28 % of the patients. Conclusion: Dry socket is a commonly encountered phenomenon and can occur the under the hands of skilled and experienced oral surgeons also. Hence, early recogniti on is necessary.

Aplicación de una jalea de caléndula al 1% en pacientes con alveolitis / Application of a 1% calendula jelly in patients with alveolitis

Objetivo: demostrar los beneficios terapéuticos del uso de una jalea de caléndula al 1% en pacientes con alveolitis. Métodos: se realizó una intervención terapéutica en el Policlínico Julián Grimau, provincia Santiago de Cuba, Cuba, entre enero y junio de 2019. Por muestreo no probabilístico se reclutó una muestra de 24 pacientes con diagnóstico de alveolitis seca o húmeda, distribuyéndose en dos grupos: A (control) y B (estudio), los cuales recibieron tratamiento convencional y jalea de caléndula al 1%, respectivamente. Se analizaron las variables: edad, sexo, tipo de alveolitis, tiempo de remisión del dolor y de cicatrización, respuesta al tratamiento (mejorado y no mejorado) y beneficios terapéuticos. Se empleó el porcentaje como medida de resumen y el test estadístico Ji al cuadrado de Independencia con un nivel de significación (a) de 0,05. Resultados: se evidenció un predominio de la alveolitis en pacientes con 19-59 años de edad (50,0%), del sexo femenino (66,7%) y del tipo húmeda (75,0%). En ambos grupos de tratamiento, el mayor porcentaje de los pacientes (17) refirió alivio del dolor a las 48 horas. En el 83,3% de los pacientes, incluidos en el grupo B, se observó menor tiempo de cicatrización. El 100% de los pacientes se categorizó como mejorado. Conclusiones: la jalea de caléndula al 1% resulta beneficiosa, dada su capacidad analgésica y cicatrizante en el tratamiento de pacientes con alveolitis.

Objective: demonstrate the therapeutic benefits of a 1 % calendula jelly in patients with alveolitis. Methods: a therapeutic intervention was carried out at the Julián Grimau Polyclinic, Santiago de Cuba province, Cuba, between January and June 2019. By non-probabilistic sampling, a sample of 24 patients with a diagnosis of dry or wet alveolitis was recruited, distributed in two groups: A (control) and B (study), who received conventional treatment and 1% calendula jelly, respectively. The variables were analyzed: age, sex, type of alveolitis, time of remission of pain and healing, response to treatment (improved and not improved) and therapeutic benefits. The percentage was used as a summary measure and the Chi-square test of Independence with a significance level (a) of 0.05. Results: a predominance of alveolitis was evidenced in patients aged 19-59 years (50.0 %), female (66.7 %) and of the wet type (75.0 %). In both treatment groups, the highest percentage of patients (17) reported pain relief at 48 hours. In 83.3% of the patients included in group B, a shorter healing time was observed. 100 % of the patients categorized as improved. Conclusions: Calendula jelly 1 % is beneficial as an analgesic and healing in the treatment of patients with alveolitis.

Eficacia de la profilaxis antibiótica en la prevención de infecciones posquirúrgicas en la cirugía del tercer molar impactado / Efficacy of antibiotic prophylaxis to prevent postoperative infections in impacted third molar surgery

Introducción: La profilaxis antibiótica es controvertida, además que su uso inapropiado expone a los pacientes en riesgo de reacciones adversas y desarrollo de resistencia bacteriana. Objetivo: Realizar una revisión sistemática de ensayos clínicos aleatorizados que evaluaron le eficacia de la profilaxis antibiótica en la reducción de infecciones posoperatorias luego de la extracción de terceros molares impactados. Métodos: Fueron utilizadas las bases de datos ScienceDirect, Clinical trials.gov y Scopus para ubicar ensayos clínicos. Las variables primarias incluyeron: presencia de infecciones posoperatorias (de la herida y/o alveolitis), reacciones adversas, trismo y dolor. Se realizó un metaanálisis con los estudios homogéneos a través del análisis de efectos aleatorios. El riesgo de sesgo de los ensayos incluidos fue evaluado a través de la guía Cochrane. El riesgo relativo global fue calculado utilizando el enfoque del inverso de la varianza con el método de efectos aleatorios. Resultados: Fueron analizados cualitativamente 14 ensayos clínicos y 9 cuantitativamente. De un total de 874 pacientes, 49 (5,6 por ciento) presentaron infecciones posoperatorias (16/446 para el grupo experimental y 33/428 para el grupo placebo). El metaanálisis arrojó un riesgo relativo global de 0,5 (IC 95 por ciento: 0,27-0,94). El riesgo de sesgo para los estudios que utilizaron solo amoxicilina como medida profiláctica fue de 0,53 (IC 95 por ciento: 0,27-1,03). Las principales reacciones adversas incluyeron: diarreas, reacciones gastrointestinales, fiebre y dolor gástrico. Conclusiones: Los antibióticos sistémicos administrados antes de la cirugía fueron eficaces para reducir las frecuencias de aparición de infecciones posoperatorias luego de la extracción de terceros molares impactados(AU)

Introduction: Antibiotic prophylaxis is controversial, and its inappropriate use exposes patients to the risk of adverse reactions and the development of bacterial resistance. Objective: Carry out a systematic review of randomized clinical trials evaluating the efficacy of antibiotic prophylaxis for the reduction of postoperative infections after extraction of impacted third molars. Methods: The search for clinical trials was conducted in the databases ScienceDirect, Clinicaltrials.gov and Scopus. The primary variables considered were presence of postoperative infections (of the wound and/or alveolitis), adverse reactions, trismus and pain. A meta-analysis was made of homogeneous studies applying the random effects model. The risk of bias in the trials included was evaluated using the Cochrane guide. The inverse variance approach and the random effects method were used for estimation of the global relative risk. Results: Fourteen clinical trials were analyzed qualitatively and 9 quantitatively. Of the total 874 patients, 49 (5.6 percent:) developed postoperative infections (16 / 446 for the experimental group and 33 / 428 for the placebo group). The meta-analysis found a global relative risk of 0,5 (CI 95 percent: 0,27-0,94). Bias risk for studies using only amoxicillin as a prophylactic measure was 0,53 (CI 95 percent:: 0,27-1,03). The main adverse reactions were diarrhea, gastrointestinal reactions, fever and abdominal pain. Conclusions: The systemic antibiotics administered before the surgery were effective to reduce the frequency of appearance of postoperative infections after extraction of impacted third molars(AU)

Incidencia de complicaciones post quirúrgicas en cirugía bucal / Incidence of post-surgical complications in oral surgery

OBJETIVO: El objetivo principal de este estudio fue determinar la incidencia de complicaciones post cirugía bucal. METODOLOGÍA: Se desarrolló un estudio observacional, descriptivo, con el uso del registro prospectivo de la totalidad de pacientes ingresados para cirugía bucal del Complejo Hospitalario San Borja-Arriarán durante doce meses de observación (abril 2017 a marzo 2018). RESULTADOS: La muestra estuvo conformada por 532 pacientes sometidos a procedimientos quirúrgicos de cirugía bucal y 29 casos de complicación postquirúrgica. La incidencia de complicaciones alcanzó un 5,5% y se observó de manera predominante en intervenciones de tipo exodoncia. La complicación mayormente observada fue la alveolitis alcanzando un 2,5% de las cirugías de terceros molares y un 3,7% de las exodoncias de otros dientes. Las hemorragias postoperatorias se observaron en un 1,1% de las cirugías de terceros molares. Otras complicaciones postquirúrgicas fueron abscesos de espacios faciales, parestesia del nervio alveolar inferior, hematomas, equimosis y periostitis. CONCLUSIÓN: Los resultados fueron similares a los reportados en la literatura tanto en su frecuencia como en el tipo de complicación.

OBJECTIVE: The main objective of this investigation was to determine the incidence of postoperative complications in oral surgery. MATERIALS AND METHODS: An observational and descriptive study was developed with the use of the prospective registry of the patients admitted for oral surgery in the San Borja Arriarán Hospital Complex for a twelve-month period of observation (April 2017 to March 2018). RESULTS: The sample consisted of 532 patients undergoing surgical procedures of oral surgery and 29 cases of postoperative complications. The incidence of complications reached 5,5% and it was observed predominantly in interventions of tooth extraction. The most commonly observed complication was dry socket, reaching 2,5% of third molar surgeries and 3,7% of extractions of other teeth. Postoperative hemorrhages were observed in 1,1% of third molar surgeries. Other postoperative complications were facial spaces abscesses, paresthesia of the inferior alveolar nerve, bruising, ecchymosis and periostitis. CONCLUSIONS: The results were similar to those reported in the literature both in their frequency and in the type of complication.

Consideration of Risk Factors Allied with Dry Socket: A Clinical Study

Dry socket (DS) is frequent complication seen in patients undergoing extraction. The present study was conducted to evaluate the risk factors associated with DS. Methods: This study was conducted in department of dentistry. It consisted of 520 teeth in 840 patients requiring extraction of teeth. General information such as name, age, gender, smoking status and systemic diseases were recorded. Patients were divided into 4 age groups. Patients were divided into medically fit and with systemic disorder. Results: Out of 840 patients, 480 were males and 360 were females. The difference was non- significant (P- 0.1). 50 patients had DS, the prevalence was 6%. The number of patients with DS in <18 years was 8, 18-30 years (20), 31-50 years (15) and >50 years (7). The difference was nonsignificant (P>0.05). 10 patients had DS among 150 patients medically fit and 40 patients had DS among 640 systemic ill patients. The difference was significant (P< 0.05). Smokers were 210 out of which 18 had DS. Nonsmokers were 630 out of which 32 had DS. The difference was significant (P<0.05). Conclusion: Dry socket is one of the complications seen following extraction of teeth. Medical condition affects the outcome of the treatment. Smoking is one of the contributory factors leading to DS.

Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

OBJECTIVES: To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing. MATERIALS AND METHODS: Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed. RESULTS: Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05). CONCLUSION: PRF is a better alternative than ZOE for the effective management of alveolar osteitis.

Effects of Kangfuxin Solution Combined with Chuangyangling and Gelatin Sponge on Dry Socket Disease in Type 2 Diabetes Mellitus Patients after the Extraction of Impacted Teeth / 中国药房

OBJECTIVE: To investigate the effects of Kangfuxin solution combined with Chuangyangling and gelatin sponge on dry socket disease in patients with type 2 diabetes mellitus after the extraction of impacted teeth. METHODS: A total of 85 patients with impacted teeth and type 2 diabetes mellitus during Jan. 2016-Jan. 2017 were divided into group A (29 cases), B (25 cases), C (31 cases) according to random number table. All patients were treated with turbine drill method; in group A, Kangfuxin solution + Absorbable gelatin sponge was used to fill the wound site; in group B, Chuangyangling+compound preparation of Kangfuxin solution and gelatin sponge were used to fill the wound site; in group C, the wounds were filled with gauze but without any drugs. All patients received routine anti-infective treatment after surgery for 5-7 d. The time of impacted teeth extraction was observed in 3 groups; granulation tissue coverage integrity rate of tooth socket and the incidence of dry socket disease 7 d after surgery, the incidence of other postoperative complications, treatment cost, satisfaction scores were also comparod. RESULTS: There was no statistical significance in the time of impacted teeth extraction or treatment cost among 3 groups (P＞0. 05). Seven days after surgery, granulation tissue coverage integrity of tooth socket and satisfaction scores were in descending order: group B＞group A＞group C; the incidence of dry sockets were in ascending order: group B＜group A＜group C, with statistical significance (P＜0. 05). The incidence of other postoperative complications as bleeding, pain, swelling, limitation of mouth opening in group A and B were significantly lower than group C, with statistical significance (尸＜0. 05). There were no statistical significance between group A and B (P＞0. 05). CONCLUSIONS: Kangfuxin solution combined with Chuangyangling and gelatin sponge can effectively increase granulation tissue coverage integrity of tooth socket, and reduce the incidence of dry socket disease and other postoperative complications in patients with type 2 diabetes mellitus, but do not increase economic burden of patients and obtain high patient satisfaction.

Angiogenesis and the prevention of alveolar osteitis: a review study

Angiogenesis is one of the essential processes that occur during wound healing. It is responsible for providing immunity as well as the regenerative cells, nutrition, and oxygen needed for the healing of the alveolar socket following tooth extraction. The inappropriate removal of formed blood clots causes the undesirable phenomenon of alveolar osteitis (AO) or dry socket. In this review, we aimed to investigate whether enhanced angiogenesis contributes to a more effective prevention of AO. The potential pro- or anti-angiogenic activity of different materials used for the treatment of AO were evaluated. An electronic search was performed in the PubMed, MEDLINE, and EMBASE databases via OVID from January 2000 to September 2016 using the keywords mentioned in the PubMed and MeSH (Medical Subject Headings) terms regarding the role of angiogenesis in the prevention of AO. Our initial search identified 408 articles using the keywords indicated above, with 38 of them meeting the inclusion criteria set for this review. Due to the undeniable role of angiogenesis in the socket healing process, it is beneficial if strategies for preventing AO are directed toward more proangiogenic materials and modalities.

Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques

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.

Efectividad de la magnetoterapia en la terapéutica de las alveolitis / Effectiveness of magnet therapy in the treatment of alveolitis

Fundamento: la elevada incidencia de las alveolitis en los servicios estomatológicos precisa emplear técnicas de tratamiento eficaz e inofensivo que logren, en el menor tiempo posible, la curación del paciente. La magnetoterapia constituye una opción terapéutica. Objetivo: demostrar la efectividad de la magnetoterapia en la terapéutica de las alveolitis. Métodos: se realizó un estudio cuasi-experimental en la Clínica Estomatológica Ormani Arenado Llonch, de la provincia Pinar del Río, de septiembre de 2014 a agosto de 2015. El universo coincide con la muestra de estudio, que estuvo constituida por 100 pacientes con diagnóstico de alveolitis que cumplieron con los criterios de inclusión y exclusión. Se establecieron dos grupos de estudio comprendidos por 50 pacientes cada uno. En ellos se evaluaron las variables: grupo etario, sexo biológico, evolución y comparación del tratamiento en ambos grupos. Resultados: predominó el sexo femenino, entre 35 y 54 años de edad en ambos grupos. Prevaleció la variante de tratamiento curado en los grupos I y II con 80 % y 42 %. Se destacó la evolución satisfactoria con 96 % de pacientes curados en el grupo I y 92 % en el grupo II sin diferencias significativas. Conclusiones: se demostró la efectividad de la magnetoterapia en las alveolitis como alternativa de tratamiento seguro, técnico e inofensivo para los pacientes que acuden a consulta estomatológica.

Background: the high impact of alveolitis in the dentistry service requires the use of effective and harmless treatment techniques that achieve in less possible time the recovery of the patient. Magnet therapy constitutes a therapeutic option. Objective: to demonstrate the effectiveness of magnet therapy in the treatment of alveolitis. Methods: a quasi-experimental study was carried out in Ormani Arenado Llonch clinic, Pinar del Río, from September 2014 to August 2015. The universe coincides with the sample of study. The latter was made up of 100 patients with diagnosis of alveolitis. They all met inclusion and exclusion criteria. Two groups of study composed of 50 patients were created. In them the following variables were assessed: age group, sex, evolution and comparison of the treatment followed by both groups. Results: female sex prevailed, between 35 and 54 years of age in both groups. Variant of cured treatment in groups I and II was predominant, with 80 % and 42 %. Satisfactory evolution with 96 % of the cured patients in group I was highlighted as well as in group II, without significant differences. Conclusions: effectiveness of magnet therapy in alveolitis as a high save, technical and harmless alternative treatment for patients who attend the dentist’s.

Comportamiento de las alveolitis en los servicios de urgencias estomatológicas / Alveolitis in Emergency Dental Services

Fundamento: La alveolitis es la complicación postoperatoria más frecuente y dolorosa que acontece tras la extracción dentaria.Objetivo: determinar el comportamiento de las alveolitis en los servicios de urgencias estomatológicas.Métodos: se realizó un estudio descriptivo, de serie de casos, en la Clínica Estomatológica Ormani Arenado, provincia Pinar del Río, en el año 2014. Se trabajó con 80 pacientes, que cumplieron con los criterios de diagnóstico. Las variables analizadas fueron: edad, sexo, tiempo de aparición de la alveolitis, región anatómica afectada y factores de riesgo. Los datos fueron recogidos en un formulario confeccionado para este fin.Resultados: el sexo femenino fue el más afectado, representando el 60 %. Prevaleció el grupo de edades de 48 a 62 años. Se diagnosticó alveolitis con mayor frecuencia entre el segundo y tercer día después de realizada la extracción, 28,7 % y 38,75 % respectivamente. Fue la mandíbula la región anatómica más afectada (61,25 %) y la extracción traumática el factor predisponente más frecuente (47,50 %).Conclusión: en la población estudiada, las extracciones dentarias traumáticas constituyeron un factor de riesgo importante para el desarrollo de alveolitis; esta apareció mayormente en el transcurso del segundo y tercer días luego de la extracción, principalmente en la mandíbula.

Background: alveolitis is the most common and painful postoperative complication after tooth extraction.Objective: to determine the characteristics of alveolitis in emergency dental services. Methods: a case series study was conducted at the Ormani Arenado Dental Clinic in Pinar del Rio province during 2014. The sample included 80 patients who met the diagnostic criteria. The variables analyzed were: age, sex, time of onset, affected region, and risk factors. Data were collected in a form designed for this purpose.Results: women were most affected by alveolitis, accounting for 60% of all cases. The 48-62 age group predominated. Alveolitis was most commonly diagnosed the second and third day after tooth extraction, 28.7% and 38.75%, respectively. The lower jaw was the most affected region (61.25%) and the most frequent predisposing factor was a traumatic extraction (47.50%).Conclusions: in the population studied, traumatic tooth extractions were an important risk factor for the development of alveolitis. This condition appeared mostly during the second and third day after extraction, mainly in the lower jaw.

Honey in the Management of Dry Socket.

Background: The most common post-operative complications following extraction of tooth is dry socket or alveolar osteitis. The aim of our study is to evaluate the efficacy of honey in the management of dry socket. Methods: Sixty patients of dry socket were selected from the outpatient department of oral and maxillofacial surgery. A diagnosis of dry socket was made clinically. Honey was used as a dry socket dressing in all the patients. The parameters like pain, swelling, hyperemia, lymphadenopathy and formation of granulation tissue were assessed in the postoperative period upto 3 weeks. Results: In this study there was significant reduction in inflammation, hyperemia, and swelling after honey dressing that resulted in soothing effect and reduction in pain and discomfort. .No side effect of honey was observed in our study, so it can be used as an alternative for the management of dry socket. Conclusions: There are no side effects of honey. Excess use of eugenol can lead to necrosis of bone. The honey can be used as medicament for the management of dry socket.

Complicaciones postoperatorias asociadas a la cirugía del tercer molar inferior retenido / Postoperative complications associated with impacted lower third molar surgery

Antecedentes: La cirugía del tercer molar inferior retenido es unprocedimiento de rutina en la práctica de la cirugía bucal. Varias complicaciones surgen como resultado de esta intervención quirúrgica. Entre las más frecuentes se encuentran: dolor, infl amación, trismo, hemorragia, equimosis, alveolitis, infección, parestesia y dificultad para comer. Objetivos: El propósito de este estudio fue evaluar la incidencia de complicaciones postoperatorias en la cirugía del tercer molar inferior retenido en pacientes de la Unidad Académica deOdontología de la Universidad Autónoma de Nayarit a fin de tenerlas en cuenta y tomar las respectivas precauciones, ya sea para tratar de evitarlas en lo sucesivo o bien, para reconocerlas y darles tratamiento. No se incluye dolor, infl amación ni trismo. Material y métodos: Este estudio fue longitudinal y prospectivo de siete días consecutivos y de 30 días en total en 38 pacientes entre 16 y 38 años de edad. Se evaluaron las complicaciones postoperatorias relacionadas con la cirugía del tercer molar inferior. Resultados: Participaron 38 pacientes; 29 del género femenino (76.3 por ciento) y 9 del masculino (23.7 por ciento) de entre 16 y 38 años, con un promedio de edad de 23.16 ± 5.2 años. La complicación más frecuente fue la difi cultad para masticar seguida de equimosis...

Background: Impacted lower third molar surgery is a routine pro-cedure in the practice of oral surgery. However, there are various complications associated with the extraction of impacted mandibular third molars, the most common being pain, swelling, trismus, hemor-rhaging, ecchymosis, dry socket, infection, paresthesia, and diffi culty with chewing. Objectives: The aim of this study was to evaluate the incidence of postoperative complications following impacted lower third molar surgery in patients at the Academic Unit of Dentistry of the Autonomous University of Nayarit, so as to ensure these are taken into account and that the respective precautions are taken, either by attempting to avoid them in the future or to recognize and treat them. Pain, infl ammation and trismus are not analyzed in this paper. Material and methods: A longitudinal prospective study of 38 patients between the ages of 16 and 38 years old (with an average age 23.1) was carried out over seven consecutive days, with follow up examination performed at 15 and 30 days. The postoperative complications associated with lower third molar surgery were assessed. Results: 38 patients took part; 29 females (76.3%) and 9 males (23.7%) between the ages of 16 and 38 years, with a mean age of 23.16 ± 5.2 years old. The most common complication was diffi culty with chewing followed by ecchymosis...

Tissue patch for prevention of dry socket after extraction of the mandibular molars：a sysrematic review / 中国组织工程研究

BACKGROUND:Tissue patch is used to increase bone mass after mandibular molar extraction, which is conducive to late-stage repair, but it is unexpectedly found that after implantation of tissue patch, incidence of dry socket is significantly reduced.OBJECTIVE:To assess the efficacy of tissue patch for the control of dry socket caused by mandibular molar extractionvia the method of systematic review. METHODS:MEDLINE (OVID), CENTRAL, EMBASE and CBM were searched for clinical randomized controled trials and clinical controled trials. The keywords were “dry socket, tissue patch, acelular dermis matrix, tooth extraction” in English and Chinese. The references of the included studies and 19 Chinese dental journals were hand-searched. Two reviewers independently assessed the risk of bias using Cochrane Colaboration’s tool, and extracted data. Meta-analysis was delivered with Revman 5.1.RESULTS AND CONCLUSION:Eight studies, including five randomized controled trials and three clinical controled trials, were included. Totaly 2 052 participants were involved. Seven of the included studies had moderate risk of bias and one had high risk of bias. Meta analysis showed that implantation of the tissue patch into the extraction socket could reduce 86% of the risk of dry socket (relative risk=0.14, 95% confidence interval [0.08, 0.26], P < 0.000 01). Sensitivity analysis showed that this outcome was relatively stable. Implantation of tissue patch into extraction socket could significantly reduce the risk of dry socket, but more randomized controled trials are needed.

Factores asociados a la alveolitis en mayores de 18 años / Factors associated to alveolitis in people over 18 years old

Mediante un estudio descriptivo transversal, fueron estudiados 362 adultos que padecían de alveolitis, con el objetivo de describir la asociación de diferentes factores con la aparición de alveolitis seca y húmeda en mayores de 18 años; los pacientes recibieron atención en la clínica “Celia Sánchez Manduley” de Santa Clara, de diciembre del 2007 a diciembre del 2009. La deficiente labor del estomatólogo mostró diferencias muy significativas entre ambos tipos de alveolitis, y existió predominio de la modalidad seca. Se encontró una asociación muy significativa entre el uso excesivo de anestesia y la alveolitis seca, y entre la incorrecta maniobra de extracción y la alveolitis húmeda. De las conductas inadecuadas del paciente, se asociaron de manera significativa a la alveolitis seca, el hábito de fumar después de la extracción y, muy significativamente, la exposición al sol luego de la exodoncia y el no cumplimiento de las indicaciones pre- y postoperatorias.

A number of 362 adults who suffered from alveolitis were studied through a descriptive and transversal study, which has as objective to describe the association of different factors with the apparition of dry and humid alveolitis in people over 18 years old; these patients received care in "Celia Sánchez Manduley" Clinic from December, 2007 to December, 2009.The deficient work of the stomatologist showed very significant differences between both types of alveolitis, and dry type predominated. A very significant association between the excessive use of anaesthesia and dry alveolitis was found, as well as, between the inappropriate manoeuvre of extraction and dry one. Smoking habit after extraction was associated significantly to dry alveolitis in patients with inadequate conducts, as well as, sun exposure after exodontic procedure and non fulfilment of pre and postoperative indications.

Recombinant bovine basic fibroblast growth factor gel prevents dry socket syndrome after toothextraction / 中国组织工程研究

BACKGROUND:Recombinant bovine basic fibroblast growth factor is a manifold effect cytokine which can promote angiogenesis, wound healing, tissue repair and bone regeneration. Recombinant bovine basic fibroblast growth factor with good histocompatibility is easy to operate and has been widely used in oral and maxil ary surgery. OBJECTIVE:To evaluate the effect of recombinant bovine basic fibroblast growth factor against dry socket syndrome after tooth extraction. METHODS:A total of 160 patients who had been extracted mandibular third molar were selected and randomly divided into two groups. In the experimental group, recombinant bovine basic fibroblast growth factor was put into the sockets after mandibular third molars were extracted, while in the control group, we let the wounds to be healed natural y without any materials. The incidence of dry socket syndrome was observed and compared between two groups at 3 days, 5 days and 1 week after tooth extraction. RESULTS AND CONCLUSION:One patient had dry socket after operation in the experimental group, and the incidence was 1.25%. In the control group, 10 patients suffered from dry socket, and the incidence was 12.5%. There was a significant difference in the incidence of dry socket between the two groups (P<0.01). There was visible granulation tissue within the tooth socket after tooth extraction in the experimental group, and extraction sockets narrowed and were fil ed with granulation tissues, which was 1-2 days earlier than the control group. No al ergies, tissue hyperplasia and other local and systemic reactions occurred in patients receiving implantation of recombinant bovine basic fibroblast growth factor gel. These findings indicate that local implantation of recombinant bovine basic fibroblast growth factor gel after mandibular tooth extractions can speed up the healing of dental extraction wounds.

Caracterização morfométrica e molecular do papel de citocinas pró e anti-inflamatórias no processo de reparo ósseo alveolar em condições homeostáticas e infecciosas / Morphometric and molecular characterization of the role of pro- and anti-inflammatory cytokines in alveolar bone repair process under homeostatic and infectious conditions

O metabolismo ósseo é influenciado por fatores endócrinos, genéticos, de crescimento, sistema RANK/RANKL/OPG, além de uma variedade de moléculas regulatórias, como as citocinas. Citocinas têm sido implicadas na patogênese de doenças ósseas, no entanto, ainda pouco se sabe sobre os mecanismos envolvidos na interação entre o sistema ósseo e imunológico no processo de reparo ósseo. O objetivo deste estudo foi caracterizar o papel de TNF-α e IL-10 no reparo ósseo alveolar em condições homeostáticas (controle [C]) e infecciosas (alveolite experimental [A]) pós exodontia em camundongos C57Bl/6 (WT), TNFp55KO e IL-10KO. Após a cirurgia nos grupos infectados foi induzida a alveolite por meio de isquemia do alvéolo e uma suspensão de secreção purulenta. As maxilas foram coletadas em 0h, 7, 14 e 21 dias após a extração do incisivo superior para análises histológica, histomorfométrica e molecular (RealTimePCR). Na análise histomorfométrica foram quantificados os parâmetros coágulo, células inflamatórias, fibras, fibroblastos, vasos sanguíneos, matriz óssea, osteoblastos, osteoclastos, e outros espaço do líquido intersticial e medula óssea. Na análise molecular (RealTimePCR) foram quantificados a expressão de fatores de crescimento, marcadores ósseos e de matriz extracelular, citocinas e quimiocinas envolvidos no processo. Os dados obtidos foram submetidos ao teste OneWay ANOVA seguido do teste de comparação múltipla de Tukey. Os resultados demonstraram que nos camundongos WT-C houve a formação inicial de coágulo (0 hora) com início da expressão de BMP2, BMP4, BMP7, TGFb1 and VEGFa que tiveram aumento gradativo com pico em 7 dias. A expressão de TNF-α e IL10 também tiveram seus picos aos 7 dias em paralelo com contagem de leucócitos, associado com a expressão de CCL2, CCL5 e CXCL1. Nos períodos seguintes houve uma diminuição inflamatória e o aumento de marcadores osteoblásticos/osteogênicos. A indução da alveolite experimental em WT-A resultou no aumento marcante...

Bone metabolism is influenced by endocrine, genetic and growth factors, RANK/RANKL/OPG system, besides a variety of regulatory molecules, such as cytokines. Cytokines have been implicated in pathogenesis of bone diseases, however, little is known about the mechanisms involved in the interaction between skeletal and immune system in the bone repair process. The objective of this study was characterized the role of TNF-α and IL-10 in alveolar bone repair under homeostatic (control [C]) and infectious (experimental alveolitis [A]) conditions in C57Bl/6 (WT), TNFp55KO and IL-10KO mice. After surgery, in infectious groups was induced by ischemia alveolitis the well and a suspension of pus. The maxillas were collected at 0h, 7, 14 and 21 days after extraction of the maxillary incisor for histologic, histomorphometric and molecular (RealTimePCR). In histomorphometric analysis parameters were measured clot, inflammatory cells, fibers, fibroblasts, blood vessels, bone matrix, osteoblast, osteoclast, and other space - the interstitial fluid and bone mar row. Molecular analysis (RealTimePCR) were quantified the expression of growth factors, bone markers and extracellular matrix, cytokines and chemokines involved in the process. The data were submitted to the OneWay ANOVA test followed by Tukey's multiple comparison test. The results showed that in WT-C initial clot formation (0 hours) with early expression of BMP2, BMP4, BMP7, and TGFb1 VEGFa who had gradual increase peaking in 7 days. The expression of TNF-α and IL10 also peaked at 7 days in parallel with leukocyte count, associated with CCL2, CCL5 and CXCL1. In late periods there were decrease of inflammation and markers osteoblastic / osteogenic increased. Induction of experimental alveolitis in WT resulted in a marked increase in expression of TNF-α accompanied by increased expression of CXCL1 and CCL5, increased leukocyte count and decreased of IL10 expression that peaked at 14d, besides prominent...