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Dry Socket and Its Management - An Overview

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Santhosh kumar, Suhas Manoharan, Nabeel Nazar. Dry Socket and Its Management - An Overview. Int J Dentistry Oral Sci. 2021;08(04):2158-2161.
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Dry Socket and Its Management - An Overview
Research Article
International Journal of Dentistry and Oral Science (IJDOS)
ISSN: 2377-8075
*Corresponding Author:
Santhosh kumar,
Reader, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University
162, Poonamallee High Road, Velappanchavadi, Chennai 600077 Tamil Nadu, India.
Tel: 9994892022
Email Id: santhoshsurgeon@gmail.com
Received: March 01, 2021
Accepted: March 20, 2021
Published: April 02, 2021
Citation: Santhosh kumar, Suhas Manoharan, Nabeel Nazar. Dry Socket and Its Management - An Overview. Int J Dentistry Oral Sci. 2021;08(04):2158-2161.
Copyright: Santhosh kumar©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distri-
bution and reproduction in any medium, provided the original author and source are credited.
Introduction
Alveolar Osteitis (AO) or dry socket is a complication that oc-
curs after extraction of tooth especially third molars. This post-
surgical complication also called as dry socket is most commonly
seen after 2-3 days after extraction of the tooth. The terminology
‘dry socket’ was rst specied in literature in 1896 [1]. Other com-
monly used terms include alveolitissicca dolorosa, localised Ostei-
tis, alveolar Osteitis, necrotic socket or septic socket and alveola-
gia. This complication may cause repeated visits to the clinician
and maybe of great inconvenience to both patient and clinician.
Such a complication results in severe pain and eventually lead-
ing to increased cost of treatment for both patient and operator.
Dry socket generally results in pain on the second to fourth day
following dental extraction. Post extraction ache normally occurs
after the anaesthesia or analgesia has worn off, or has a more
delayed onset [2]. Examination normally entails gentle irrigation
with warm saline and probing of the socket to establish the diag-
nosis. On occasion, part of the root of the teeth or a chunk of
bone fractures off and is retained in the socket.
Alveolar Osteitis (AO) is simply an inammation of the alveolar
process of maxilla or mandible. Though self-limiting, the condi-
tion sometimes lasts up to 7 days post extraction characterized by
dull aching radiating pain which may reach the temple, eye or neck.
At times the pain can be so severe that it cannot even be relieved
by analgesics [3]. Halitosis is a common symptom. The term al-
veolar Osteitis is taken into consideration synonymous with "dry
socket"; however, some believe that dry socket means a focal or
localized alveolar Osteitis [4]. An instance of any other kind of
Osteitis is focal sclerosing/condensing Osteitis. The phrase dry
socket is used due to the fact that the socket has a dry appear-
ance once the blood clot is lost and particles are washed away.
Alveolar Osteitisusually does not show any signs such as fever or
Abstract
Alveolar Osteitis (AO) is an inammation of the alveolar process of maxilla or mandible. Though self-limiting, the condition
sometimes lasts up to 7 days post extraction characterized by dull aching radiating pain which may reach the temple, eye or
neck. This article discusses the etiology, pathogenesis, risk factors for dry socket and also elaborates the various methods and
techniques in the prevention and management of dry socket. Etiology of alveolar Osteitis has not been well established; with
ranging descriptive denitions and diagnostic criteria exist to elucidate alveolar Osteitis. Alveolar Osteitis is a complication that
can be avoided by taking necessary preventive measures. It can be prevented by use of antibiotics, irrigation, and maintenance
of oral hygiene. Despite lots of research being done, there is no clarity regarding the management of dry socket. Though
there is no specic treatment for alveolar osteitis, eugenol dressings and curettage cut back the incidence of it. Studies did lack
proper analysis and clear answers regarding the management of dry socket. There is yet no universally accepted preventive
measure or management and further detailed studies are necessary to establish concrete conclusions.
Keywords: Dry socket; AlveolarOsteitis; Management; Fibrinolysis; Dental Extractions; Alvogyl; Eugenol; Complication.
Santhosh kumar1*, Suhas Manoharan2, Nabeel Nazar3
1 Reader, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha University.
2 Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha University.
3 Reader, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha University.
Santhosh kumar, Suhas Manoharan, Nabeel Nazar. Dry Socket and Its Management - An Overview. Int J Dentistry Oral Sci. 2021;08(04):2158-2161.
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lymphadenitis; only erythema and minimal oedema is present in
the soft tissues around the socket. Signs may include an empty
socket, which is partially or totally devoid of blood clot. Bone
may be visible or the socket may contain food debris which on
removal exposes the bone [5]. The exposed bone is sensitive and
painful on touch. Inamed soft tissues surrounding the socket
may overlie the socket and hide the dry socket from examination.
Etiology Of Dry Socket
Most authors concur that surgical injury assume a huge part in
formation of AO. Surgical extractions, in contrast with nonsurgi-
cal extractions, result in higher incidence rate of AO [6]. Lilly et
al. [7] found that surgical extractions involving reection of ap
and removal of bone will probably cause AO. Numerous investi-
gations assert that administrator's experience is a hazard factor for
development of AO. Larsen [8] presumed that specialist's naiveté
could be identied with a greater injury amid the extraction, par-
ticularly surgical extraction of mandibular third molars. Alexan-
der [1] and Oginni et al. [9] announced a higher occurrence of AO
following extractions performed by the less experienced admin-
istrators. Subsequently the aptitude and experience of the admin-
istrator ought to be contemplated. It is also believed that alveolar
Osteitis is a common occurrence post extraction of mandibular
third molars. It isexplained that reduced vascularity, decreased
ability to produce granulation tissue and increased bone density
maybe the causative factors [10]. However, there is no proof re-
garding decreased vascularity and alveolar Osteitis. The reason for
such site-specic occurrence maybe due to alarge percentage of
mandibular third molar extractions [11].
Physical removal or dislodgement of the clot is also a popularly
discussed theory which maybe probably due to negative pressure
created during situation like sucking through a straw. However,
there is no solid evidence regarding this issue. The cause of dry
socket is not absolutely understood [12]. Typically, following ex-
traction of a tooth, blood is extravagated into the socket, and a
blood clot is formed. This blood clot is replaced with granulation
tissue which consists of broblasts and endothelial cells derived
from remnants of the periodontal membrane, surrounding alveo-
lar bone and gingival mucosa. In time this in turn is changed to
coarse, brillar bone and ultimately to mature, woven bone. The
clot may fail to form due to poor blood supply. The poor blood
supply maybe due tofactors such as smoking, anatomical site,
bone density and conditions which cause sclerotic bone to form.
The clot can also be misplaced due to excessive mouth rinsing,
or collapse in advance due to brinolysis [13] Fibrinolysis is the
degeneration of the clot and can be because of the conversion
of plasminogen to plasmin and formation of kinins. Elements
which promote brinolysis include local trauma, oestrogens, and
pyroxenes from microorganism [14].
Microorganism may additionally colonize the socket, and result in
dissolution of the clot. Bacterial breakdown and brinolysis are
the important contributing factors to the lack of the clot. Bone
tissue is uncovered to the oral environment, and a localized in-
ammatory reaction takes vicinity with in the adjoining marrow
areas. This localizes the irritation to the walls of the socket, which
becomes necrotic. The necrotic bone in the socket is slowly sepa-
rated by osteoclasts and fragmentary sequestra may also form.
The bones of the jaws seem to have a few evolutionary resist-
ances to this procedure [15].
Pathogenesis Of Dry Socket
Recovery from Alveolar Osteitis is slow and gradual because tis-
sue should develop from the surrounding gingival mucosa, which
takes longer than the regular formation of a blood clot.
Rozantis et al [16] studied the relationship between streptococ-
cus mutans and alveolar Osteitis. Delayed healing was seen in
extraction sites after microorganisms were inoculated in to the
extraction sites. Bacteria and microorganisms are known to cause
alveolar Osteitis. Patients with poor oral hygiene, periodonti-
tis, pericoronitis and other advanced periodontal conditions are
known to show increased incidence of alveolar Osteitis [17].
Violent curettage or irrigation of the socket may also cause dis-
lodgement of the clot formed and cause a dry socket. There also
theories suggestive of a female predilection. Alveolar Osteitis is
associated with the usage of oral contraceptives. Oral contracep-
tives became popular in the early 1960s and a positive correlation
was seen between occurrence of alveolar Osteitis and usage of
oral contraceptives [18]. This correlation is due to oestrogen lev-
els as the oestrogen hormone plays a major role in brinolysis. It
is believed that oestrogen activates the brinolytic process lead-
ing to increases in certain factors such as II. VII, VIII and X and
plasminogen causing lysis of the blood clot.
Moreover, in a series of 4000 extractions, it was found that there
was clear female predilection irrespective of the usage of oral
contraceptives [18]. A brin clot is made of thromb in and -
brinogen in a post extraction socket and over this, the epithelium
migrates. New blood vessels grow into the clot during granulation
tissue formation and this clot degrades through the activity of
broblast and brinolysis through the plasmin before the start
of osteoproliferation. Birn [19] discovered that the plasmin like
activity in dry sockets was not present at normal extraction sites.
Kinases are liberated during inammation through direct or indi-
rect activation of plasminogen in the blood. These kinases cause
lysis and destruction of the blood clot. Tissue or plasma activa-
tors activate and convert the plasminogen to brin, resulting in
the dissolution of the clot by disintegration of brin. This plasmi-
nogen pathway activation, can be direct (physiologic) or indirect
(non-physiologic). Direct activators are released to the alveolar
bone cells after trauma. Indirect activators are released by bacte-
ria. Direct extrinsic activators are tissue plasminogen activators
and endothelial plasminogen activators. Direct intrinsic activators
include the components of plasma such as factor XII, urokinase
[20].
Risk Factors For Dry Socket
Patients with systemic illness such as diabetes or otherimmuno-
compromised conditions also have higher incidences of alveolar
Osteitis due to impaired healing of the wound. It is also seen that
incidence of dry socket increases with age. Hence it is advised to
perform any mandibular third molar extraction before the age of
24yrs especially among females to prevent occurrence of alveolar
Osteitis. Smoking is alsoa major risk factor for alveolar Osteitis.
Remnants of tooth root or bone fragments can also result in dis-
turbed or poor wound healing which may cause alveolar Osteitis.
Radiotherapy might decrease the blood supply to alveolar bone
which may lead to occurrence of a dry socket [21].
It was inferred that utilization of local anaesthesia with vaso-
Santhosh kumar, Suhas Manoharan, Nabeel Nazar. Dry Socket and Its Management - An Overview. Int J Dentistry Oral Sci. 2021;08(04):2158-2161.
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constrictors will increase the incidence of AO. It was also found
that AO frequency will increase with inltration anaesthesia as
a result of the ischemia that ends up in poor or reduced blood
supply [22]. However, the studies that followed indicated that the
ischemia remains for only about two hours and is replaced by
reactive hyperaemia, which makes it inapplicable for disintegra-
tion of the blood clot [23]. One study conveyed that there is no
signicant difference in AO prevalence following extraction of
teeth requiring inltration anaesthesia versus regional block an-
aesthesia with vasoconstrictor [24]. It is presently accepted that
local ischemia owing to vasoconstrictve effect of local anaesthesia
has no role in the development of AO. Limited proof suggests
higheroccurrence of AO during single extractions on contrast to
multiple extractions. According to one study, AO prevalence was
7.3% following single extractions and 3.4% following multiple
extractions [25]. This difference could be as a result of less pain
tolerance in patients who come for single tooth extractions. Also,
it could be that most patients with multiple extractions have peri-
odontally compromised teeth or unhealthy dentition.
Prevention Of Dry Socket
As AO is a commonly occurring complication after tooth extrac-
tions, a lot studies have been done and many theories and tech-
niques have been put forward to help in preventing alveolar os-
teitis. But still no single method or technique has been universally
accepted in the prevention of AO. Systemic and topical antibiot-
ics have been proposed to prevent AO, however there are argu-
ments claiming that regular use of topical antibiotics have led to
resistance among certain strains of bacteria. Topical tetracycline
claimed to be effective but it showed foreign body reaction on
topical application. Commonly used systemic antibiotics to treat
AO are clindamycin, erythromycin and metronidazole [26].
An author suggested that placing any medicament into the alveo-
lus will show certain degree of improvement in case of alveolar
Osteitis [27]. Analgesics such as acetaminophen with oxycodone,
codeine or hydroxycodone maybe used. Many studies also sug-
gest the usage of 0.12% chlorhexidine mouthwash after extrac-
tion of mandibular third molars result in decreased occurrence
of dry socket [28-32]. Also, usages of antibrinolytic agents such
as para-hydroxybenzoic acid or PHBA and tranexamic acid have
shown to reduce the incidence of alveolar Osteitis. PHBA is
known to have anti-microbial effects but is known to impair bone
healing from animal studies. Meanwhile, tranexamic acid is not
widely accepted and is not proved to reduce the incidence of al-
veolar Osteitis. The usage of an antiseptic agent 9-aminoacridine
was speculated to reduce the incidence of AO however there is
no evidence to support this claim. Eugenol was promoted to be
used along with dressings but the irritant effect leading to delayed
wound healing has been well described in literature and hence
is not commonly preferred to prevent the incidence of alveolar
Osteitis [33-35].
Management Of Dry Socket
Management of alveolar Osteitis is not as speculative as preven-
tion. Alveolar Osteitis is a self-healing condition and there is no
established treatment for alveolar Osteitis. Analgesics and antibi-
otics are recommended to relieve pain. Medicated dressings are
also mentioned in literature however, intra alveolar dressings are
known to delay the wound healing process. Alvogyl containing
butamben ananaesthetic, eugenol an analgesic and iodoforman
antimicrobial agent are used to pack the sockets. However certain
studies claim packing with alvogyl caused marked inammation
and retarded healing [36, 37].
Summary
Alveolar Osteitis is a complication that can be avoided by tak-
ing necessary preventive measures. Despite lots of research be-
ing done, there is no clarity regarding the management of dry
socket. Very little progress has been created in addressing this
usually encountered and unsightly surgical condition in patients.
Literature related to alveolar Osteitis is not consistent and is con-
icting. Studies are poorly done, have variable styles and applied
mathematics, biases, lack analysis, or encompass individual opin-
ions. Etiology of alveolar Osteitis has not been well established;
with ranging descriptive denitions and diagnostic criteria exist
to elucidate alveolar Osteitis. This lack of over simplied answer-
consistent with one author, is the result of the initiation of -
brinolytic method which seems to be associated with associate
interfacing of multiple freelance factors. Analysis done to prevent
this complication have yielded no single universally acceptable
technique or success. However, a large number of intra-alveolar
medicaments are instructed in the literature and are offered on the
market. Even if complications or severe reactions from prepa-
rations placed with in the socket are rare, most have rumoured
some negative reactions. If adverse reactions do occur, this body
of literature does not offer enough support for the treating practi-
cian. The formula to management of this complication ought to
begin with patient education and patients with classiable risk fac-
tors ought to learn intimately concerning this anticipated compli-
cation. Any investigation and well-designed studies are necessary
to draw rm conclusions and to clarify this complication.
Conclusion
The prevalence of dry socket is inevitable. It can be prevented
by use of antibiotics, irrigation, and maintenance of oral hygiene.
Though there is no specic treatment for alveolar osteitis, eugenol
dressings and curettage cut back the incidence of it. Studies did
lack proper analysis and clear answers regarding the management
of dry socket. There is yet no universally accepted preventive
measure or management. Further studies and investigations need
to be done to establish concrete conclusions.
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... Several studies indicate that the use of chlorhexidine mouthwash 0.12% after tooth extraction use of antibiotics, and avoiding smoking reduces the incidence of dry socket [8,9]. The treatment of dry socket is controversial, it is wide ranging including copious irrigation with normal saline, 3% hydrogen peroxide and 2% sodium iodide or placement of intrasocket medication, Alvogyl, zinc oxide eugenol, Absorbable gelatin sponge, metronidazole, olive oil-black seed paste and others [10,11]. ...
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The aim of this study was to evaluate the prevalence of dry socket at the faculty of dentistry in Sana’a University. Patient and methods: 994 patients attended to the Oral Surgery Clinic in the faculty of Dentistry, Sana'a University, to have their teeth extracted in period from October 1, 2022 to January 19, 2023. 26 patients with dry socket were analyzed who underwent tooth extraction. Results: The percentage of the patients who had a dry socket was 2.6%. The percentage of male to female was 1:1.3. According to age the dry socket was more in age between 18-30 years. Conclusion: The incidence of dry socket was more happened in young adult, female, single tooth in mandible and with patients taking non-steroidal anti-inflammatory drugs before extraction.
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Background: Anemia is a common blood disorder where there is a low concentration of hemoglobin in the blood and occurs when there are fewer red blood cells than normal. Most symptoms of anemia arise as a result of the decreased amount of oxygen getting into the cells and tissues of the body, and also due to the reduced oxygen carrying capacity of hemoglobin in the blood. Anemia may be suspected from general findings on a complete medical history and physical examination, such as complaints of tiring easily, breathlessness, pale skin, and lips, or tachycardia. Anemia is usually discovered during a medical examination through blood tests that measure the concentration of hemoglobin and the number of red blood cells. Iron deficiency anemia is the most common type of anemia in the universe. Objective: This study was aimed to evaluate the knowledge and awareness regarding anemia among 1st year dental undergraduate students. Materials and Methods: A cross-sectional study was conducted during the academic year in December 2017 among the dental students of Saveetha Dental College, Saveetha University, Chennai. 100 1st year dental undergraduate students were involved in the study, including both males and females. All students in the study voluntarily completed a questionnaire consisting of 20 close-ended questions which were designed to assess their basic knowledge and awareness regarding anemia. Data were analyzed by descriptive and inferential statistics and results obtained. Results: Nearly 100% of students were aware about anemia and had the basic knowledge of anemia. However, regarding the diagnosis of anemia very few people answered correctly. Most of them were not aware about the management of anemia. Conclusion: 1st year dental undergraduate students are more adhesive to studies than practical work and they study about hemoglobin and anemia as it is there in their syllabus. Therefore, their basic knowledge about anemia and hemoglobin is good but lacking knowledge in clinical criteria including the diagnosis and treatment part of anemia. As a budding dentist, they should have more awareness regarding anemia. These students should participate in awareness programs to get more exposures about anemia.
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Objective: The aim of the study was to assess the perceived level of competency and knowledge among dental students in handling medical emergencies. Methods: A validated questionnaire of 15 questions, regarding the basic knowledge, attitude and perceived confidence in handling medical emergencies in dental clinics was distributed among 100 students randomly belonging to final year and intern students of Saveetha dental college, Saveetha university, Chennai. The data extracted were tabulated, statistically analyzed and results obtained. Results were calculated on the basis of frequency and percentages using SPSS Version 20.0. Results: 100% of them knew about the management of syncope. 80% of the students knew about the primary management of spontaneous bleeding after extraction. Also 80% had good knowledge about the drugs used for anaphylaxis, anginal pain and epilepsy. Only 40% of participants were actually very confident to handle any medical emergency in the dental office. Conclusion: Majority of dental students in the present study have a good knowledge regarding management of medical emergencies in dental clinics but were lacking confidence in handling some of the medical emergencies. Hence, in order to improve quality of patient care annual Basic life support courses should be made mandatory in dental teaching curriculum and further training is required.
Article
Objective: To assess the level of knowledge, attitudes, and practices regarding oral health among law students in Chennai. Methods: A validated questionnaire of 22 questions, regarding the basic knowledge, attitude and practices toward oral health was distributed among 100 students randomly belonging to first year, second year, third year and final year of Saveetha School of Law, Saveetha university, Chennai. The data extracted were tabulated, statistically analyzed and results obtained. Results were calculated on the basis of frequency and percentages using SPSS. Results: 64% agreed that oral health is important for overall health of the body. 55% of students were aware that calculus causes bleeding gums. 65% of them agreed that mouth washes contain medications that can prevent or reduce gum problem, but only 12% of students were using mouth wash. 66% of students brush their teeth only once daily. 68% of students were not taking any other measures apart from tooth brushing for oral hygiene maintenance. Majority (49%) change their toothbrush only when it gets spoilt. According to 58% participants, one should visit dentist only when there is a problem. Conclusion: Law students in the present study have a satisfactory level of knowledge about oral health care. However, the knowledge acquired must be transferred into daily practice. This can be achieved by a change in their attitude towards oral hygiene maintenance. Inclusion of oral health-oriented education programs in their curriculum would improve their knowledge and behaviour and they would be a good model to the community.
Article
Objective: To assess the knowledge, attitude and practices among dental students on needle stick injuries (NSIs). Methods: A validated questionnaire of 23 questions regarding the basic knowledge, attitude and practices about NSIs was distributed among 100 students randomly belonging to 3rd year, final year, and internship (5th year trainee) of undergraduate dental program in Saveetha Dental College and Hospital, Saveetha University, Chennai. The data extracted were tabulated, statistically analyzed and results obtained. Results were calculated on the basis of frequency and percentages using SPSS. Results: About 87% of students had received hepatitis B (HBs) vaccination of which only 47% had carried out anti-HBs antibody check-up. Although 35% had suffered NSI, 15% of them did not report the incident of NSIs. However, only 37% of students knew about Universal Precaution guidelines. 76% of students had the habit of recapping the needle after injection. Conclusion: This study revealed that knowledge of dental students about the risks associated with NSIs and use of preventive measures was inadequate. A standard protocol regarding the training as well as adapting preventive measures should be formulated in all dental institutions. The implementation of Universal Precautions, elimination of needle recapping, use of safer needle devices, and use of sharps containers for safe disposal will reduce NSIs. © 2016, Innovare Academics Sciences Pvt. Ltd. All rights reserved.
Article
Antiplatelet drugs are used in the prevention and management of arterial and venous thrombi. These drugs are associated with an increase in bleeding time and risk of post-operative hemorrhage. Because of this, dental surgeons recommend their patients to stop the therapy before surgical procedures which may in turn cause fatal thromboembolic complications. This article reviews the commonly used antiplatelet drugs, dental management of patients on these drugs when subjected to minor oral surgical procedures. The objective of this article is to review various literature, whether to discontinue or continue antiplatelet therapy during dental surgical procedures, and current consensus and recommendations have been established. It is concluded that antiplatelet monotherapy and even antiplatelet dual therapy can be safely continued on patients during dental surgical procedures, and there is no need for altering or discontinuing the drugs. Post-operative bleeding can be managed by local hemostatic measures. © 2016, Innovare Academics Sciences Pvt. Ltd. All rights reserved.
Article
Objective: To evaluate the knowledge, attitude and practices of dental students toward dental management of patients on antiplatelet therapy. Methods: A self-administered questionnaire of 17 questions was administered to 150 students, belonging to third, final year and internship trainee of undergraduate dental program. The questionnaire was designed to collect the data regarding the knowledge of dental students about antiplatelet drugs, their attitude and practices when treating patients on antiplatelet therapy. The data from the participants were collected, statistically analyzed, and results were obtained. Results: About 80.8% of students have stated that minor surgical procedures cannot be carried out safely, without stopping the antiplatelet medication. 46.7% of students have mentioned that local hemostatic measures can control bleeding in a patient on antiplatelet therapy during dental treatment. 70% of them preferred to refer the patient to physician/cardiologist while treating patients on antiplatelet medications. 78.3% were not aware of the UK medicines information regarding surgical management of the primary care dental patient on antiplatelet medication. 70% of dental students have thought that evidence-based guidelines will be helpful in the dental management of patients on antiplatelet therapy. Conclusion: Educational programs or workshops related to the subject can increase the awareness of students to update their knowledge and practice related to managing patients on antiplatelet therapy before dental treatment. The findings from this study suggest that there is a great need to educate dental students to use evidence-based guidelines in terms of dental treatment for patients on antiplatelet therapy. © 2016, Innovare Academics Sciences Pvt. Ltd. All rights reserved.
Article
Effective local anesthesia is arguably the single most important pillar upon which modern dentistry stands. Paradoxically, the injection of local anesthetic is also perhaps the greatest source of patient fear, and inability to obtain adequate pain control with minimal discomfort remains a significant concern of dental practitioners. Although the traditional aspirating syringe is the most common method by which local anesthetics are administered, newer technologies have been developed that can assist the dentist in providing enhanced pain relief with reduced injection pain and fewer adverse effects. This article will discuss the clinical uses of various newer delivery systems for local anesthesia in dental field.
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A double blind experiment was performed to test the possible prophylactic effect of the antifibrinolytically active tranexamic acid (Cyklokapron®) on alveolitis sicca dolorosa (“dry socket”). Tablets containing tranexamic acid and placebo were administered orally at random selection for 5 days to 71 consecutive patients who had had an impacted mandibular third molar removed. In this investigation tranexamic acid did not seem to prevent alveolitis sicca dolorosa. The possible reasons for this are discussed.
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Alveolar osteitis (AO) is the most common postoperative complication following a tooth extraction. This article focuses on its etiology and contributing factors. It is intended to assist the general practitioner in reducing the incidence of AO in his or her practice. The article includes summaries of current preventive and treatment measures.