Management of dry socket with low-level laser therapy.

OBJECTIVE: The aim of this study is to investigate the efficacy of delivering low-level laser therapy (LLLT) in the management of dry socket at University Dental Hospital Sharjah. MATERIALS AND METHOD: Forty-five patients with dry socket were divided into two treatment groups. Group I dry socket patients (n = 30) received conventional treatment while group II patients (n = 15) were irradiated with LLLT at a setting of 200-mW, 6-J, continuous-wave mode using an R02 tipless handpiece (Fotona Er:YAG, Europe), on the buccal, lingual, and middle surfaces of the socket for 30 s from a delivery distance of 1 cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7 days post-dry socket treatment. RESULTS: Results showed that the LLLT-irradiated group II sockets showed a much lower VAS pain score of 1-2 as early as day 4, and a richer amount of granulation tissue compared to the conventional treated group I socket. The amount and rate of granulation tissue formation in the dry socket are inversely proportional to the pain score showing significant clinical effectiveness of LLLT on promoting the healing of the dry socket, with improvement in symptoms (P = .001). Conventionally treated dry sockets take at least 7 days to match the effective healing of an LLLT-irradiated dry socket. CONCLUSION: LLLT irradiation influences biomodulation of dry socket healing by dampening inflammation, promoting vascularization, stimulating granulation, and controlling pain symptoms. CLINICAL RELEVANCE: LLLT may be an additional effective tool for managing dry sockets in general dental practice.

A Comparative Clinical Study between Concentrated Growth Factor and Low-Level Laser Therapy in the Management of Dry Socket.

OBJECTIVE: A dry socket is a well-recognized complication of wound healing following tooth extraction. Its etiology is poorly understood and commonly occur among healthy patients. As such, management strategies for dry socket has always been empirical rather than scientific with varying outcome. The aim of this study is to investigate the efficacy of concentrated growth factor (CGF) and low-level laser therapy (LLLT) and compared them to the conventional treatment in the management of dry socket. MATERIALS AND METHODS: Sixty patients with one dry socket each, at University Dental Hospital Sharjah, were divided into three treatment groups based on their choice. In group I (n = 30), conventional treatment comprising of gentle socket curettage and saline irrigation was done. Group II (n = 15) dry sockets were treated with CGF and group III (n = 15) sockets were lased with LLLT. All dry socket patients were seen at day 0 for treatment and subsequently followed-up at 4, 7, 14, and 21 days. Pain score, perisocket inflammation, perisocket tenderness, and amount of granulation tissue formation were noted. STATISTICAL ANALYSIS: Data were analyzed as mean values for each treatment group. Comparisons were made for statistical analysis within the group and among the three groups to rank the efficacy of treatment using one-way analysis of variance (ANOVA). Statistically significant difference is kept at p < 0.05. RESULTS: Conventional treatment group I took more than 7 days to match the healing phase of group II CGF treated socket and group III LLLT irradiated socket (p = 0.001). When healing rate between CGF and LLLT are compared, LLLT group III showed a delay of 4 days compared with CGF in granulation tissue formation and pain control. CONCLUSION: CGF treated socket was superior to LLLT in its ability to generate 75% granulation tissue and eliminate pain symptom by day 7 (p = 0.001).

The Efficacy of Concentrated Growth Factor in the Healing of Alveolar Osteitis: A Clinical Study.

BACKGROUND: A dry socket also referred to as alveolar osteitis (AO) is a common postoperative complication following tooth extraction, due to the disruption of the clot within the wound. This study aimed to evaluate the efficacy of concentrated growth factor (CGF) in the healing of alveolar osteitis following tooth extraction. METHODS: The study was conducted at University Dental Hospital Sharjah, UAE. Patients undergoing tooth extraction at the oral surgery clinic were advised to return immediately if they suffer from pain. Over the following first week after tooth extraction, patients who reported pain symptoms were recalled and all dry sockets were identified. The patients were divided into two groups. Group I patients received conventional treatment with socket curettage and saline irrigation only, while in group II CGF was inserted into the socket. Both groups were observed for pain score and quantification of granulation tissue formation. RESULTS: A total of 40 dry socket patients, aged between 18 and 60 years, from a total of 1,250 patients, were included in the study. 30 patients were given conventional treatment while another 10 patients were given CGF. Patients who received CGF had a pain score of 7-10 at presentation, and the pain score dropped to 0-3 on day 4 and further improved to 0-1 on day 7 (p = 0.001). Granulation tissue formation appeared in the conventional group I on day 7 while the CGF group II showed earlier granulation tissue formation by day 4 (p = 0.001). The posttreatment pain score is inversely proportional to the amount and rate of granulation tissue formation in the socket. CONCLUSION: The study suggests that delivery of CGF into a dry socket helps relieve pain and expedite the wound healing process as shown by a statistically much lower pain score and earlier and more rapid formation of granulation tissue when compared to the conventional alveolar osteitis therapy.