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The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
Socket preservation or alveolar ridge preservation is a procedure to reduce bone loss after tooth extraction. [1] [2] After tooth extraction, the jaw bone has a natural tendency to become narrow, and lose its original shape because the bone quickly resorbs, resulting in 30–60% loss in bone volume in the first six months. [3]
Unlike acute OM in the long bones, acute OM in the jaws gives only a moderate systemic reaction and systemic inflammatory markers, such as blood tests, usually remain normal. Acute OM of the jaws may give a similar appearance to a typical odontogenic infection or dry socket, but cellulitis does not tend to spread from the periosteal envelope of ...
Disturbance of the blood clot can cause alveolar osteitis, commonly referred to as "dry socket". With the partial or total loss of teeth, the alveolar process undergoes resorption. The underlying basal bone of the body of the maxilla or mandible remains less affected, however, because it does not need the presence of teeth to remain viable.
Dry-socket typically causes a sharp and sudden increase in pain commencing 2–5 days following the extraction of a mandibular molar, most commonly the third molar. [51] This is often extremely unpleasant for the patient; the only symptom of dry-socket is pain, which often radiates up and down the head and neck.
Pre-disposing factors to dry socket include smoking, traumatic extraction, history of radiotherapy and bisphosphonate medication. A dry socket can be managed by irrigating the socket with chlorhexidine or warmed saline to remove debris followed by dressing of the socket with bismuth iodoform paraffin paste and lidocaine gel on ribbon gauze to ...
Time to event ranged from 23 to 39 months and 42–46 months with high dose intravenous and oral bisphosphonates. [17] A prospective, population based study by Mavrokokki et al. . estimated an incidence of osteonecrosis of the jaw of 1.15% for intravenous bisphosphonates and 0.04% for oral bisphosphonates.
This type of drug has a high affinity for hydroxyapatite [28] and stays in bone tissue for a long period of time, [29] with alendronate, it has a half-life of approximately ten years. [ 30 ] The risk of a patient having MRONJ after discontinuing this medication is unknown.