alveolar osteitis or dry socket
TRANSCRIPT
DR.K.THANGAVELU
DRY SOCKET VIDEO
DRY SOCKET PICTURE
DRY SOCKET IS A COMPLICATION
OF TOOTH EXTRACTION
IT IS A PAINFUL CONDITION WHICH
OCCURS MOSTLY AFTER LOWER3RD MOLAR EXTRACTION DUE TO
TRAUMATIC EXTRACTION
IT IS CHARACTERISED BY SEVERE PAIN IN
AND AROUND THE EXTRACTION SITE USUALLY STARTS ON THE 2 – 4 POST-
OPERATIVE DAY AND CAN LAST FOR 10 – 40
DAYS.
THE PAIN IS USUALLY DESCRIBED AS A
THROBBING ACHE AND IS CAUSED BY CHEMICAL AND THERMAL IRRITATION OF
THE EXPOSED NERVE ENDINGS IN THE
PERIODONTAL LIGAMENT AND ALVEOLAR BONE.
PAIN RADIATES TO THE EAR AND TEMPORAL
REGION. POST-EXTRACTION
BLOOD CLOT IS ABSENT IN THE TOOTH SOCKET;
BONY WALLS OF THE SOCKET ARE BARE AND EXTREMELY SENSITIVE
BAD BREATH AND AN
UNPLEASANT TASTE IN THE MOUTH ARE
PRESENT.
INITIALLY THE CLOT HAS A DIRTY GRAY
APPEARANCE AND THEN IT DISINTEGRATES,
LEAVING A GRAY OR GRAYISH YELLOW BONY
SOCKET BARE OF GRANULATION TISSUE..
DRY SOCKET IS THE MOST COMMON CAUSE OF DELAYED POST EXTRACTION PAIN.
DRY SOCKET, ALSO KNOWN AS 1.DENTO-
ALVEOLAR OSTEITIS, 2.ALVEOLAR OSTEITIS,
3.ALVEOLITIS, 4.FOCAL OSTEOMYELITIS
WITHOUT SUPPURATION,
5.ALVEOLAGIA
6.ALVEOLITIS SICCA DOLOROSA AND
7.ALVEOLAR PERIOSTITIS,
CAUSES FOR DRY SOCKET
THE CONDITION ARISES AS A RESULT OF A
COMPLEX INTERACTION BETWEEN SURGICAL TRAUMA, LOCAL BACTERIAL
INFECTION AND VARIOUS SYSTEMIC
FACTORS
THEORIES OF DRY SOCKET
1.TRAUMATIC EXRACTION RELEASE TISSUE
ACTVATORS NEAR MARGINS OF SOCKET WHICH
CONVERTS PLASMINOGE TO PLASMIN WHICH IS RESPONSIBLE FOR
PRODUCTION OF DRY SOCKET AND PAIN
PATHOGENESIS
FOLLOWING TRAUMA AND INFECTION , INFLAMMATION OF BONE MARROW OCCURS –WHICH RESULTS IN RELEASE OF TISSUE ACTIVATORS WHICH CONVERTS PLASMINOGEN IN THE CLOT TO PLASMIN
PLASMIN CAUSES LYSIS OF BLOOD CLOT
PLASMIN RELEASES KININ FROM KININOGEN WHICH IS ALSO PRESENT IN THE CLOT
KININ IS RESPONSIBLE FOR SEVERE PAIN
2.TRAUMA TO ALVEOLAR BONE REDUCE
RESISTANCE TO INFECTION WHICH
CAUSE DRY SOCKET(Birn’S
theory)
3. PRIOR INFECTION,
4.FREQUENT WASH BY PATIENT,
5.ACTION OF ADRENALINE IN LA SOLUTION
6.INFECTION FOLLOWING EXTRACTION
THE DIAGNOSIS IS CONFIRMED BY GENTLY
PASSING A BLUNT INSTRUMENT INTO THE
SOCKET
INSTRUMENT FINDS NO RESISTANCE IN EMPTY
SOCKET
WHEN CLOT IS PRESENT PASSAGE OF INSTRUMENT IS PREVENTED BY CLOT.
TREATMENT
SOCKET SHOULD BE IRRIGATED WITH
SALINE
CURETTAGE SHOULD NOT BE DONE
STERILE GAUZE TO THE SIZE OF SOCKET
IS DIPPED IN EUGENOL AND PLACED INSIDE THE SOCKET
THE PACK ACTS AS AN OBTUDENT TO PROTECT THE EXPOSED BONE
THE PACK SHOULD BE REMOVED AFTER 3
DAYS
ANOTHER PACK SHOULD BE GIVEN FOLLOWING
REMOVAL FIRST DRESSING
THE DRESSING PREVENTS THE
ACCUMULATION OF FOOD DEBRIS IN THE
EXTRACTION SOCKET, PROTECTS THE EXPOSED
BONE FROM LOCAL IRRITATION AND
CALMS DOWN THE INFLAMMATION-
INFECTION WITHIN THE EXTRACTION SOCKET WALLS.
DRUGS TO BE PRESCRIBED METRANIDAZOLE 400MG TWICE DAILY FOR 3 DAYS
AMOXICILLIN 500MG TWICE DAILY FOR 3 DAYS
BRUFEN600MG TWICE DAILY FOR 3 DAYS
END