La alveolitis dental en pacientes adultos del Policlínico René Bedia Morales. Municipio Boyeros / Dental Alveolitis in adult patients in René Bedia Morales policlinic at Boyeros municipality

RESUMEN Introducción: la alveolitis dentaria es una complicación pos-textracción dental, local, dolorosa y reversible del alveolo. Objetivo: caracterizar la alveolitis dental en pacientes adultos del Policlínico "René Bedia Morales", perteneciente al municipio Boyeros. Mareriales y métodos: se realizó un estudio descriptivo de corte transversal, en el Policlínico "René Bedia Morales", municipio Boyeros, provincia La Habana, en el periodo comprendido de septiembre de 2016 a septiembre de 2017. El universo estuvo constituido por 250 pacientes, de ambos sexos. Diagnosticados con alveolitis dental tras haberse realizado exodoncia durante ese periodo. La muestra quedó conformada por 187 pacientes que cumplieron con los criterios de inclusión y exclusión. Se estudiaron las variables: edad, sexo, tipo de alveolitis y factores asociados a las mismas. La información fue recogida en un modelo de recogida de datos, bajo su consentimiento informado. Resultados: el grupo de edad más afectado fue el de 35-59 años, con 47,59 %. Predominó el sexo femenino, con un 66,84 %. Prevaleció la alveolitis seca, en un 55,08 %. Relacionado con las conductas inadecuadas del paciente, la afectación fue de un 40,64 %. El no cumplimiento de las indicaciones postoperatorias y fumar, luego de la exodoncia, fueron los factores más asociados a la alveolitis seca; con un 53,48 % y un 41,18 %, respectivamente. Conclusiones: la alveolitis afectó fundamentalmente a los pacientes de 35-59 años de edad, del sexo femenino. Con mayor frecuencia predominó la alveolitis seca relacionada a las conductas inadecuadas del paciente (AU).

ABSTRACT Introduction: Dental alveolitis is a local, painful dental pos extraction complication which is reversible. Objective: Provide a characterization of dental alveolitis in René Bedia Morales policlinic at Boyeros Municipality. Materials and methods: A descriptive transversal study was performed in René Bedia Morales policlinic at Boyeros Municipality, in Havana Province. The study was performed in a time span between September 2016 to September 2017. The study universe was constituted by 250 patients of both sexes diagnosed with dental alveolitis after have made extractions in that period of time and the sample remained formed for 187 patients , that met with the criteria of inclusion and exclusion. Age, sex, type of alveolitis and associated factors were the variables considered in the present study. The data was collected in a input data form, under the patients concern. Results: The most affected age group was from 35 to 59 years old which represents a 47,59 %, being the feminine sex the predominant group which represents a 66,84 %. Dry alveolitis was predominant in 55,08 % related to inadequate behaviors within a 40,64 % The most frequent factors associated to the non-fulfillment of the pos operatory orders, such as smoking after having performed the procedure of exodontia with a 53,48 % and 41,18 % respectively. Conclusions: Alveolitis mainly affects patients within 35-59 years old, feminine sex, and also related to inadequate behaviors of the patients (AU).

Chlorhexidine for prevention of alveolar osteitis: a randomised clinical trial

Abstract Objective To determine the effectiveness of chlorhexidine 0.12% mouthwash (CHX) after tooth extraction for the prevention of alveolar osteitis (AO). Material and methods We conducted a double-blind randomised clinical trial stratified by risk factors. We enrolled a cohort of 822 patients who underwent dental extractions, and were considered to be at risk of developing AO (previous surgical site infection, traumatic extraction, and tobacco smoking). After extraction, patients were randomly allocated for CHX group or placebo group, matched by risk factors. The primary outcome was clinical diagnosis of AO: increasing postoperative pain for 4 d within and around the socket, and total or partial breakdown of the blood clot in the socket with or without bone exposure. Results Follow-up was completed by 744 participants (372 chlorhexidine and 372 placebo). We detected no significant differences between the two groups at baseline. After completed follow-up, risk factors were equally distributed between the two groups. Overall incidence of OA was 4.97%, in which 27 participants treated with placebo (7.26%) and 10 participants treated with CHX (2.69%) developed AO. CHX reduced the incidence of AO by 63% [Absolute Risk Reduction: 4.57 (95% CI 1.5-7.7), Number Needed to Treat: 21.88 (95% CI 13.0-69.3), Fisher's exact test: p=0.006]. No adverse effects were reported. Conclusion The use of chlorhexidine 0.12% mouthwash after tooth extraction is safe and effective in reducing the incidence of AO in high-risk patients.

Acutely infected teeth: to extract or not to extract?

Abstract: Not only laymen but also dentists generally believe that extraction of acutely infected teeth should be avoided until the infection subdues by using systemic antibiotics. The aim of this study was to compare perioperative complications in routine extractions of acutely infected teeth with extractions of asymptomatic teeth. This prospective study was performed with 82 patients. Severe pain on percussion of the relevant tooth was considered as basic criteria for acute infection. The acutely infected teeth were labeled as the study group (n = 35) and the asymptomatic teeth as the control group (n = 47). The extractions were done using standard procedures. The amount of anesthetic solution used and duration of extractions were recorded. Postoperative severe pain and exposed bone with no granulation tissue in the extraction socket were indications of alveolar osteitis (AO). The level of statistical significance was accepted as 0.05. Symptoms that could indicate systemic response, including fever, fatigue, and shivering were not found. There was no statistically significant difference between groups in terms of AO, amount of anesthetic solution used, and duration of extraction. The presence of an acute infection characterized by severe percussion pain is not a contraindication for tooth extraction. Infected teeth should be extracted as soon as possible and the procedure should not be postponed by giving antibiotics.

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...

Effectiveness of HemCon Dental Dressing versus conventional method of haemostasis in 40 patients on oral antiplatelet drugs

The purpose of the study was to evaluate the effectiveness of the HemCon Dental Dressing [HDD] in controlling post extraction bleeding and to ascertain its role in healing of extraction wounds, as compared to control. The 40 participants in the study were all receiving oral antiplatelet therapy [OAT]. A total of 80 extractions were conducted without altering the patients' drug therapy. The extraction sites were divided into 2 groups: one group received a HDD, and the control group where the conventional method of pressure pack with sterile gauze under biting pressure [followed by suturing if required] was used to achieve haemostasis. All HemCon treated sites achieved haemostasis sooner [mean = 53 seconds] than the control sites [mean = 918 seconds] which was statistically significant [P <0.001]. Postoperative pain in the HDD group [1.74] was also significantly lower than in the control group [5.26] [P <0.001]. Approximately 72.5% of HDD-treated sites showed significantly better postoperative healing when compared to the control site [P <0.001]. HDD proved to be an excellent haemostatic agent that significantly shortened the bleeding time following dental extraction in patients on OAT. Additionally, HDD offered significantly improved post-operative healing of the extraction socket and less postoperative pain

Pathogenesis and management of dry socket [alveolar osteitis]

Alveolar osteitis is a common post extraction complication developing within 1-4 days following surgery.1-3. It is characterized by intense pain that is not relieved by analgesics. 1 The most frequent site of occurrence is the mandibular third molar region. Females are known to show a higher incidence of occurrence. 4 Studies indicate smoking, traumatic extractions, leaving tooth and bone debrisin extraction sockets, excessive irrigation of socket, compromised blood supply and use of contraceptives, as possible predisposing factors.5-25. Inflammation of the socket is believed to be a result of dislodgment or disintegration of the blood clot that forms within the socket immediately after extraction. 11, 26-27 Dry socket can be prevented by ensuring sterile surgery and by the use of numerous non-pharmacological measures; good history, identification and elimination of risk factors, and pharmacological agents; systemic antibiotics, antiseptics, antifibrinolytics, obtundant dressings and photodynamic therapy.8,28-34 Once the condition develops it is treated symptomatically and by use of obtundant dressings. Initial results of a study carried out in Khyber College of Dentistry, Peshawar are showing promising results with surgical management. This literature review summarizes the current understanding of etiology, pathogenesis, prevention and management of alveolar osteitis

prevalence and risk factors of dry socket in dental surgery clients following tooth extraction at Qazvin Faculty of Dentistry

Dry socket is one of the complications occurs following tooth extraction. The prevalence of such condition is reported to be highly different ranging from 0.5-68.4%. The etiology and pathogenesis are not clearly known but many related predisposing factors have been discussed. To evaluate the prevalence and risk factors of dry socket after tooth extraction. This cross-sectional study was carried out at the department of oral and maxillofacial surgery in Qazvin university of medical sciences [Jan 2002 to Jan 2003]. Out of 1402 patients, those having their teeth extracted and returned with dry socket were chosen. Characteristics such as, age, sex, site of extraction, extracted tooth, trauma during extraction, periapical lesion, oral hygiene, smoking, systemic diseases, and OCP in women [oral contraceptive pill] were determined. Over the one-year period of study, 1402 teeth were extracted and in the meantime, 12 patients returned with dry socket. Our results showed that the incidence of dry socket was 0.85% and the ratio of females to males was 2.5 to 1. Dry socket in mandible was two times higher than maxillae [1.12% versus 0.57%]. Mandibular third molars were more often involved than other areas. Periapical lesion, trauma, poor oral hygiene and OCP increased the incidence of dry socket. Prevalence of dry socket after tooth extraction in Qazvin oral and maxillofacial surgery clinic was not higher than other centers. Seemingly, application of atraumatic techniques, aseptic procedures, ability of surgeon, oral hygiene and so on can lead to a lower prevalence of dry socket

Incidência de alveolite seca após exodontias de dentes irrompidos / Incidence of dry socket after extraction of erupted teeth

Foi realizado um estudo clínico com 341 pacientes, que sofreram extraçäo de 526 dentes irrompidos, com o objetivo de analisar a incidência de alveolite seca seus possíveis fatores etiológicos. Diante dos dados obtidos, observou-se que a alveolite surgiu em 3,22 por cento dos casos, demonstrando correlaçäo positiva com o traumatismo cirúrgico e negativa com a má higiene bucal e a condiçäo de tabagista

Incidência de alveolites em exodontias realizadas por alunos da Faculdade de Odontologia da Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS / Incidence of alveolar osteitis after extraction tooh performed by graduation students a the Pontifícia Universidade Católica do Rio Grande do Sul

Neste estudo, foram analisados os resultados do pós-operatório de 511 exodontias, realizadas no ambulátorio de cirurgia da Faculdade de Odontologia da Pontifícia Universidade Católica do Rio Grande do Sul, no decorrer das disciplinas de Cirurgia I e II. Tais extraçöes foram efetuadas pelo alunos de 5§ e 6§ semestres do curso de Odontologia. Avaliou-se a incidência de alveolite de cada dentre, isoladamente, de cada grupo de dentes, por hemiarcadas, e no total. Os resultados sugerem que a menor experiência do profissional pode ser um dos fatores etiológicos da alveolite

Alveolitis: una complicación postoperatoria frecuente: prevención y tratamiento / Dry socket: a frequent postoperative complication: prevention and treatment

Como hemos descripto, la alveolitis está en relación directa a los factores etiopatogénicos. Realizar un correcto diagnóstico y tratamiento aliviará al paciente de una complicación extremedamente dolorosa. Las medidas terapéuticas aconsejadas van dirigidas principalmente a acciones locales sobre las sistémicas

Incidence of dry socket in surgical removal of impacted third molar.

In a search for dry socket five hundred and thirty six (536) impacted third molars were surgically removed among 435 patients. Each patient was examined clinically and radiographically before surgery. 108 impacted teeth were removed for prophylactic and 428 for therapeutic reasons. A standard operating procedure was performed for each case and pre-operative and post-operative regimens was employed. After surgery each case was followed to determine the absence or presence of signs and symptoms of dry socket. It was found that total incidence of alveolar osteitis (dry socket) was 10.26%.

Alveolites post-extractionnelles : a propos de 140 cas observes au service de stomatologie du Centre Medico-Chirurgical Militaire Mama Bobi Ladawa du Camp Lieutnant-Colonel Kokolo a Kinshasa

Une etude retrospective portant sur 3.360 dossiers relatifs aux extractions dentaires pratiquees au Centre Medico-Chirgical Militaire couvrant une periode de 5 ans; a montre que 140 cas avaient developpe une alveolite post-extractionnelle; soit 2;2 pour cent de l'ensemble. L'etude a surtout revele que les 92 pour cent d'alveolites observees etaient seches et que leur etiopathogenie serait imputable en grande partie aux bains de bouche a l'eau salee; pratiques de maniere abusive par les patients apres intervention; sur recommandation de certains praticiens. Une regression sensible de nombre d'alveolites est constatee depuis que la pratique des bains de bouche a l'eau salee a ete decommandee