A Comparative Study on Alvogyl and a Mixture of Black Seed Oil and Powder for Alveolar Osteitis: A Randomized Double-Blind Controlled Clinical Trial.

Introduction: Alveolar osteitis (AO) is the most common complication faced by exodontia patients and is usually seen 24-74 hours after tooth extraction, heralded by severe throbbing pain. Nigella sativa is commonly known as black seed known to have anti-inflammatory and antibacterial properties along with other reparative properties that enhance bone formation. This study aimed to evaluate and compare the effects of Alvogyl and a mixture of Nigella sativa powder and oil in the treatment of dry sockets. Materials and Methods: Sixty patients above the age of 18 and below 70 years, from both genders, who underwent extraction of teeth and were clinically diagnosed with a dry socket at the clinic of the College of Dentistry, Jouf University, Saudi Arabia, were included in this study. Pain scores were assessed after placement of the dressing at the following intervals: 5 minutes, 30 minutes, 60 minutes, 2nd day, 4th day, and 7th day. Patients were randomly allocated to three groups, namely, Group 1 (Alvogyl), Group 2 (mixture of Nigella sativa's powder and oil), and Group 3 (control). Pain relief and healing of the socket were compared between the three groups. The collected data were subjected to statistical analysis through Spearman's correlation test, independent t-test, ANOVA, and post hoc test. Results: A mixture of Nigella sativa powder and oil showed a statistically significant difference in relieving pain compared to the Alvogyl group. A mixture of Nigella sativa's powder and oil required fewer dressings when compared to the Alvogyl group. Conclusion: A mixture of Nigella sativa powder and oil is the more efficacious dressing material for the management of dry sockets compared to Alvogyl. It provides immediate and complete pain relief and fewer numbers of repeated visits.

The preventive effect of medicinal herbal extract and gelatin sponge on alveolar osteitis: An in vivo micro-computed tomography and immunohistochemical analysis in rats.

OBJECTIVE: The purpose of this study was to evaluate the preventive effect of medicinal herbal extract (MHE) and gelatin sponge on alveolar osteitis (AO) in an experimental rat model. DESIGN: Twenty-one Sprague-Dawley male rats with a mean age of 12 weeks were used. After extraction of the maxillary right first molar, an AO model was created for each animal. The animals were randomly separated to three equal groups. Group I served as a control, Group II was subjected to an intra-alveolar MHE application, and gelatin sponge was left in the sockets of Group III. On the 7th post-extraction day, the animals were sacrificed. The specimens were analyzed by micro-computed tomography (micro-CT), histopathologically and immunohistochemically. RESULTS: Macroscopic evaluation revealed mild to intense signs of AO in all groups, but the difference was not significant (p < 0.05). Micro-CT analysis showed that bone formation was the highest in Group III (bone volume/total volume; 10.63 ± 4.9 %), whereas bone mineral density was the highest in Group I (2.05 ± 0.2 g/cm3). The difference was not significant (p > 0.05). In Group III, only 16.7 % of specimens showed no signal of inflammatory response (p < 0.01). The difference was not significant between the positive labeling for receptor activator of nuclear kappa-ß (RANK), receptor activator of nuclear kappa-ß ligand (RANKL), osteoprotegerin and osteopontin, but the intensity of Groups II and III was higher than the Group I for osteopontin (p < 0.01). CONCLUSIONS: MHE and gelatin sponge were not effective enough to prevent alveolar osteitis, but positive results were obtained in bone healing.

The effects of photobiomodulation therapy for treatment of alveolar osteitis (Dry Socket): Systematic review and meta-analysis.

INTRODUCTION: Dry socket (alveolar osteitis) is one of the most common complications that occur after the extraction of permanent teeth. The aim of this review was to evaluate and compare the effectiveness of photobiomodulation (PBT) with other treatment methods on alveolar osteitis. METHODS AND MATERIALS: MEDLINE, Web of Science, EMBASE, Scopus and Cochrane's CENTRAL online databases were searched based on the search strategy. Also, the prominent laser journals and the references of relevant studies were hand searched for eligible studies and then the data were extracted from the retrieved studies were extracted using piloted custom forms. The data were combined and analyzed using inverse-variance random-effect meta-analysis. RESULTS: For the treatment of dry socket, pain perception based on the VAS score, PBT on average has a 3.41 higher pain level reduction compared to alveogyl which seems to be both statistically and clinically significant. In addition, based on the GRADE score, the evidence seems to be of moderate quality. Also, in the individual studies which were included in this systematic review, PBT seems to be more effective than other methods (Salicept, zinc-oxide eugenol, ozone, and photodynamic therapy) in pain reduction of patients with alveolar osteitis. CONCLUSIONS: PBT, in general, has a higher ability in decreasing pain levels for patients with alveolar osteitis (dry socket) compared to alveogyl. Therefore, PBT could be used as an appropriate method for treatment and controlling the signs of dry socket.

The Efficacy of Plasma Rich in Growth Factors for the Treatment of Alveolar Osteitis: A Randomized Controlled Trial.

PURPOSE: To investigate the efficacy of plasma rich in growth factors (PRGF; BTI Biotechnology Institute, San Antonio, Spain) for the treatment of alveolar osteitis compared with a positive control (Alvogyl; Septodont, Maidstone, Kent, UK). MATERIALS AND METHODS: This single-center, single-blinded, randomized, 2-treatment, parallel study was conducted in a UK dental hospital. All healthy adults who presented with alveolar osteitis after tooth extraction over a 3-month period were invited to participate. Each socket was randomized and treated with 1 of 2 treatment modalities, a test treatment (PRGF) or a positive control (Alvogyl). After treatment, patients were reviewed at 3 and 7 days by a second clinician blinded to the treatment given. Outcome measures included pain, exposed bone, inflammation, halitosis, dysgeusia, and quality-of-life assessment. RESULTS: Thirty-eight patients with data from 44 sockets (22 in the PRGF group and 22 in the Alvogyl group) were analyzed. The PRGF group showed significantly faster bone coverage and significantly decreased inflammation and halitosis (P < .05) compared with the control group receiving Alvogyl. There was no significant difference for pain, quality-of-life measures, or dysgeusia between groups. CONCLUSION: PRGF predictably treated alveolar osteitis after tooth extraction compared with the conventional standard treatment of Alvogyl, which has been used for many years. PRGF could be considered an alternative treatment for alveolar osteitis and indeed appears to have considerable advantages over Alvogyl.

Eficacia de la aplicación del propóleos al 8 por ciento en alveolitis dentaria / Effectiveness of propolis at 8 por ciento in patients suffering from alveolitis

Introducción: el propóleos, es una sustancia compleja, de origen vegetal, que preparan las abejas a partir de la recolección de resinas producidas en algunas plantas. Una de las actividades más importantes del propóleos es su actividad antimicrobiana, la cual se le atribuye básicamente a los flavonoides, ayuda en la cicatrización de las heridas, estimula el sistema inmunológico, antinflamatorio y antioxidante. Objetivo: determinar la eficacia del propóleos al 8 por ciento en pacientes atendidos en la alveolitis. Método: se realizó un estudio experimental, tipo ensayo clínico controlado, fase lll, aleatorizado, a doble ciegas, en dos ramas. En el periodo comprendido de abril 2014 a abril 2015, atendidos en la consulta de urgencias del Policlínico Jimmy Hirzel de Bayamo. Resultados: los resultados mostraron para el grupo estudio 25 pacientes (62,5 por ciento) alivio del dolor a los 5 minutos de aplicado el medicamento, 30 pacientes (75 por ciento) no estaban inflamados en la tercera consulta, así como 36 pacientes (90 por ciento) tuvieron cicatrización y 33 pacientes (82,5 por ciento) respondieron favorablemente al tratamiento, en el grupo control, los resultados mostraron que 19 pacientes (47,5 por ciento) aliviaron el dolor a los 5 minutos de aplicado el medicamento, 25 pacientes (62,5 por ciento) no estaban inflamados, 34 pacientes (87,5 por ciento) tuvieron cicatrización total y 30 pacientes (75 por ciento) tuvieron una respuesta favorable al tratamiento. Conclusiones: no existieron diferencias significativas en la aplicación del tratamiento con propóleos al 8 por ciento con relación al tratamiento convencional(AU)

It was carried out an experimental study, controlled clinical trial type, phase III, randomized, double-blind, into two branches, to determine the effectiveness of propolis at 8 percent in patients suffering from alveolitis treated in the emergency department of the polyclinic Jimmy Hirzel, from April 2014 to April 2015. The research involved 80 patients from 15 to 50 years without premedication and compensated chronic diseases, thus study group was composed of 40 patients who were treated with propolis at 8 percent and the same number in the control group treated with alvogyl. The information was collected through a data collection form where the variables of pain, inflammation, scarring, and response to treatment were studied. The following results showed for the study group: 25 patients (62.5 percent) had pain relief within 5 minutes of applying the medicine, 30 patients (75 percent) were not swollen in the third consultation, and 36 patients (90 percent) were healing and 33 patients (82.5 percent) responded favorably to treatment. In the control group, the results showed that 19 patients (47.5 percent) got pain relieved within 5 minutes of applying the medicine, 25 patients (62.5 percent) were not swollen, 34 patients (87.5 percent) had complete healing, and 30 patients (75 percent) had a favorable response to treatment. The statistical results showed no significant differences in the application of treatment with a P value of 0.58(EU)

The use of hyaluronic and aminocaproic acid in the treatment of alveolar osteitis.

Background/Aim: Alveolar osteitis (AO), also known as "dry socket", is relatively common post-extraction complication. It probably occurs due to excessive fibrinolytic activity in the coagulum and is characterized by intense pain sensations. The aim of this clinical study was to examine the role of hyaluronic acid and aminocaproic acid in the treatment of AO. Methods: The study included 60 patients with the clinical diagnosis of AO. All the patients were divided into two groups of 30 patients each according to the applied non-pharmacological measure: irrigation ­ irrigation of dry socket with sterile saline; curettage ­ careful curettage. Both of these groups were further divided into three subgroups regarding the applied treatment (hyaluronic acid; hyaluronic acid + aminocaproic acid; Alvogyl ®, an anesthetic and antiseptic paste), each with 10 patients, according to the following protocol: 0.2 mL of hyaluronic acid in the form of a 0.8% gel; 2 mL of aminocaproic acid and hyaluronic acid; Alvogyl®. During each visit, scheduled for every two days until complete absence of painful sensations, the patients had the therapeutic method repeated as at the first examination. At each control visit the number of present symptoms and signs of AO was recorded, as well as the level of pain (measured with a visual analogue scale). Results: With the use of hyaluronic acid, with or without aminocaproic one, a statistically significantly faster reduction in pain sensations was achieved, along with the reduction in the number of symptoms and signs of AO compared to the use of Alvogyl®. Conclusion: Hyaluronic acid, applied alone or in combination with aminocaproic acid significantly reduces pain sensation, thus it can be successfully used in the treatment of AO.

Eficacia de la aplicación del propóleos al 8 por ciento en alveolitis dentaria / Effectiveness of propolis at 8 percent in patients suffering from alveolitis

Introducción: el propóleos, es una sustancia compleja, de origen vegetal, que preparan las abejas a partir de la recolección de resinas producidas en algunas plantas. Una de las actividades más importantes del propóleos es su actividad antimicrobiana, la cual se le atribuye básicamente a los flavonoides, ayuda en la cicatrización de las heridas, estimula el sistema inmunológico, antinflamatorio y antioxidante. Objetivo: determinar la eficacia del propóleos al 8 por ciento en pacientes atendidos en la alveolitis. Método: se realizó un estudio experimental, tipo ensayo clínico controlado, fase lll, aleatorizado, a doble ciegas, en dos ramas. En el periodo comprendido de abril 2014 a abril 2015, atendidos en la consulta de urgencias del Policlínico Jimmy Hirzel de Bayamo. Resultados: los resultados mostraron para el grupo estudio 25 pacientes (62,5 por ciento)alivio el dolor a los 5 minutos de aplicado el medicamento, 30 pacientes(75 por ciento) no estaban inflamados en la tercera consulta, así como 36 pacientes (90 por ciento) tuvieron cicatrización y 33 pacientes (82,5 por ciento) respondieron favorablemente al tratamiento, en el grupo control, los resultados mostraron que 19 pacientes(47,5 por ciento) aliviaron el dolor a los 5 minutos de aplicado el medicamento, 25 pacientes (62,5 por ciento) no estaban inflamados, 34 pacientes (87,5 por ciento) tuvieron cicatrización total y 30 pacientes (75 por ciento)tuvieron una respuesta favorable al tratamiento. Conclusiones: no existieron diferencias significativas en la aplicación del tratamiento con propóleos al 8 por ciento con relación al tratamiento convencional(AU)

It was carried out an experimental study, controlled clinical trial type, phase III, randomized, double-blind, into two branches, to determine the effectiveness of propolis at 8 percent in patients suffering from alveolitis treated in the emergency department of the Polyclinic Jimmy Hirzel, from April 2014 to April 2015. The research involved 80 patients from 15 to 50 years without premedication and compensated chronic diseases, thus study group was composed of 40 patients who were treated with propolis at 8 por ciento and the same number in the control group treated with alvogyl. The information was collected through a data collection form where the variables of pain, inflammation, scarring, and response to treatment were studied. The following results showed for the study group: 25 patients (62.5 percent) had pain relief within 5 minutes of applying the medicine, 30 patients (75 percent) were not swollen in the third consultation, and 36 patients (90 percent) were healing and 33 patients (82.5 percent) responded favorably to treatment. In the control group, the results showed that 19 patients (47.5 percent) got pain relieved within 5 minutes of applying the medicine, 25 patients (62.5 percent) were not swollen, 34 patients (87.5 percent) had complete healing, and 30 patients (75 percent) had a favorable response to treatment. The statistical results showed no significant differences in the application of treatment with a P value of 0.58(EU)

Comparison of the effect of low level laser therapy with alvogyl on the management of alveolar osteitis.

BACKGROUND: This study investigated the efficacy of low level laser therapy (LLLT) for managing alveolar osteitis (AO). MATERIAL AND METHODS: Sixty patients with alveolar osteitis of mandibular third molars were randomly divided into three groups. In group 1, socket irrigation was followed by alvogyl placement, and the treatment was repeated 48 hours later. In group 2, socket was irradiated with a low power red laser for 3 consecutive days (200 mW, 30 seconds on each of the buccal and lingual surfaces and 30 seconds at the middle of the socket, 6 J per area). The subjects in group 3 underwent treatment with a low power infrared laser with the same parameters as group 2. A visual analogue scale (VAS) was used to record the degree of pain at the morning (T0, before intervention) and at 6 (T1) and 12 (T2) hours later for 3 days. RESULTS: Pain was significantly lower in the alvogyl group than the other groups at T1 and T2 points on day 1 and at T0 and T1 points on day 2 (p<0.05). At T2 point on day 2 and on day 3, VAS became significantly lower in the red laser group compared to the other groups (p<0.05). The infrared laser was not more efficacious than the other groups at any of the treatment intervals, but it reduced VAS to an acceptable level. CONCLUSIONS: LLLT displayed good results in this study for treatment of alveolar osteitis and should be further investigated as an alternative to alvogyl for AO management.

Clinical management and control of alveolalgia ("dry socket") with vitamin C.

PURPOSE: To monitor the incidence of dry socket in a sample of 696 consecutive tooth extraction patients and to test the possible therapeutic effects of vitamin C. MATERIALS AND METHODS: Following standardized extractions, 24 dry socket patients were provided 4,000 mg/day dosages of Vitamin C. Demographic and health history data were collected. RESULTS: The occurrence of dry socket (3.5% overall) was greater in females and individuals with lower overall health status, and supplemental Vitamin C was associated with rapid recovery.

Medicinal plants in the healing of dry socket in rats: microbiological and microscopic analysis.

The effectiveness of medicinal herbs as antimicrobial agents was tested on isolated microorganisms from an induced alveolitis and on alveolitis in rats. Sixteen ethanolic extracts from plants were prepared and tested. The plant materials were selected from ethnobotanic data and the best result was obtained with Schinus terebinthifolius Raddi. The activity on Enterococcus, Bacillus corineforme, Streptococcus viridans and S. beta-hemolytic was better than the one presented by the antibiotic currently used for the treatment of alveolitis. The extract of Schinus terebinthifolius Raddi has shown good wound-healing activity by histological analysis.

Treatment of fibrinolytic alveolitis with rifamycin B diethylamide associated with gelfoam: a histological study.

The most common complication in the healing of extraction wounds is fibrinolytic alveolitis, which may also be termed "dry socket". Reduction in the incidence of this condition after the application of topical antibiotics and the use of systemic antibiotics has been reported. A histological study of disturbed alveolar socket healing in rats was carried out to analyze the influence of application of rifamycin B diethylamide (Rifocin M) associated or not with Gelfoam. Sixty-four male rats (Rattus norvegicus albinus, Wistar), weighing 120-150 g, were divided into 4 groups of 16 animals each. In the second group of rats which received implants of Gelfoam, there was an intense resorption of bone walls in the initial stage. The rats that received implants of Gelfoam saturated with Rifocin M (fourth group) showed better results than the second group. The third group (only irrigation with rifamycin) showed better bone formation in the alveolar socket compared to the first, second and fourth groups. Thus, these results showed that rifamycin irrigation is useful in the control of alveolar infections.