Oxytetracycline-hydrocortisone ointment reduces the occurrence of both dry socket and post-extraction pain after third molar extraction: An observational study.

OBJECTIVES: Dry socket and post-extraction pain are typical discomforts experienced by patients after tooth extraction. In this study, we inserted gauze coated with oxytetracycline-hydrocortisone ointment into the extraction socket immediately after lower third molar extraction and then evaluated the occurrence of dry socket and post-extraction pain compared with gauze non-insertion. METHODS: This retrospective study was carried out on patients undergoing lower third molar extraction in the Department of Oral Surgery at Shizuoka Prefectural General Hospital in Shizuoka, Japan from November 2018 to October 2019. A comparison was carried out between a gauze-insertion group and a non-insertion group. The occurrence versus non-occurrence of dry socket was determined, and degree of pain was assessed based on a visual analogue scale (VAS) and on patients reporting the number of loxoprofen sodium oral analgesic tablets (60mg/tablet) that they had taken. Dry socket was defined as patient-reported spontaneous pain that did not subside 1 to 3 days postoperatively. Spontaneous post-extraction pain was recorded four times: on the operative day, on the first postoperative day (POD1), on POD3, and during suture removal (POD7). RESULTS: The occurrence of dry socket was lower in the gauze-insertion group than in the non-insertion group (0.9%, 2/215 vs. 19.6%, 9/46, p<0.001). The results also showed that both VAS-defined pain level and the number of analgesic tablets taken were lower in the gauze-insertion group than in the non-insertion group on POD3 and POD7. CONCLUSIONS AND CLINICAL RELEVANCE: Inserting gauze coated with oxytetracycline-hydrocortisone ointment into the extraction socket immediately after third molar extraction reduces the occurrence of both dry socket and post-extraction pain.

Invasiveness of Tibial Bone Graft Harvesting for Secondary Alveolar Bone Grafting: Can Harvesting Be Performed at the Age of Less Than 10 Years Without Complications?

PURPOSE: In this study, particulate cancellous bone marrow was harvested from the tibia for alveolar bone grafting, and postoperative complications at the donor site were compared between patients aged 10 years or older (29 tibias) and those aged younger than 10 years (42 tibias). PATIENTS AND METHODS: Enrolled patients were those who underwent tibial bone graft harvesting at the Department of Oral and Maxillofacial Surgery, Aichi Gakuin University, during a period of 3 years and 1 month from March 2012 through March 2015. We examined clinical findings at the time of harvesting and changes in symptoms during hospital admission in study 1. Follow-up examinations and survey questionnaires on symptoms also were investigated to clarify medium- to long-term postoperative outcomes in study 2. RESULTS: In both age groups, medium- to long-term postoperative findings showed no apparent adverse events, except for acceptable levels of scar tissue. Clinical findings on harvesting and early postoperative findings showed that intraoperative blood loss, early postoperative pain, and gait disorders were similar between the group aged younger than 10 years and the group aged 10 years or older. However, the latter group needed a considerably longer time for ambulation and weight-bearing pain to disappear and for every movement in daily activities to return to normal. Regarding patients with a bilateral alveolar cleft, we found no significant difference between the first and second harvesting in the factors affecting postoperative morbidity. CONCLUSIONS: Our findings suggest that tibial bone graft harvesting is safe and requires a shorter recovery period even in patients aged between 8 and 10 years.