Antimicrobial and bone repair effects of boric acid in a rat model of dry socket (alveolar osteitis) following dental extraction.

BACKGROUND: Alveolitis occurs after dental extraction without blood clot formation, leading to an inflammatory process and bacterial contamination. Boric acid (BA) demonstrates anti-inflammatory, antimicrobial, and osteogenic properties. This study aims to evaluate the possible antimicrobial effects and bone repair of BA in a rat model of alveolitis (dry socket). METHODS: 33 male Wistar rats were submitted to the extraction of the upper right incisor and dry socket induction. They were first divided into two groups: dry socket (n = 17) and dry socket + 0.75 % BA (n = 16). Samples for the microbiological analysis were collected immediately after dental extraction, at the detection of clinical alveolitis, 7, and 14 days after BA application. For microCT and histological analysis, samples from euthanized rats were used in 14 and 28 days after alveolitis detection. RESULTS: Higher bacterial counts were found in 4-5 days after alveolitis induction, compared to the baseline in both experimental groups, decreasing significantly after 7 and 14 days of treatment with BA (P < 0.05). The microCT evaluation displayed increased bone volume, bone volume fraction, trabecular thickness, and bone mineral density in a time-dependent manner, regardless of BA treatment. On the other hand, the number of trabeculae and total bone porosity decreased over the 28 days of the experiment in the dry-socket group and both groups, respectively (P < 0.05). Histological analysis did not differ on bone repair in both experimental groups. CONCLUSION: This was the first report investigating the effects of BA in a rat model of alveolitis regarding microbiological and bone repair aspects. The BA local application decreased the total aerobic and facultative bacteria counts and does not seem to benefit the bone repair after alveolitis development. This study paves the way for more studies involving alveolitis and different BA applications.

High-Throughput Sequencing Analysis of Microbial Profiles in the Dry Socket.

PURPOSE: The aim of this study was to explore and describe the microbial profiles of dry socket (DS) and identify the key microbial population as a possible disease-related factor. MATERIALS AND METHODS: Bacterial samples were collected from patients who underwent surgical mandibular third molar extraction and were divided in 3 groups: the disease (D) group composed of patients who were diagnosed with DS; the treated (T) group composed of patients from the D group who received treatment; and the control (C) group composed of patients who did not have adverse reactions after tooth extraction. Bacterial DNA was extracted and the V3 and V4 hypervariable regions of the bacterial 16S rRNA gene were amplified and subjected to sequencing. Sequence data were analyzed using alpha and beta diversity indices. RESULTS: In total, 772,169 high-quality sequences were detected from 31 samples. Using a 97% similarity level, 531 operational taxonomic units were detected. In addition, 10 phyla, 23 classes, 38 orders, 63 families, and 116 genera were found. Composition of the microbial community in the D group differed considerably from that of the T and C groups. Furthermore, a specific microbial pattern, which included Parvimonas, Peptostreptococcus, Prevotella, Fusobacterium, Slackia, Oribacterium, and Solobacterium species, appeared abundantly in the D group compared with the T and C groups. Moreover, Parvimonas, Peptostreptococcus, Prevotella, and Fusobacterium species had important roles in discriminating the D group from the other 2 groups. CONCLUSION: These results suggest differences in the microbial community composition among DSs, normal-healing sockets, and post-treated sockets. These results provide better insight into the development of DS and enhance the understanding of DS. Nonetheless, further studies are necessary to investigate and confirm how these differential bacteria contribute to the development of the disease.

Clinical-microbiological research of action ozone therapy and light-emetting diode radiation of red range (630 nanometers) on microflora of the hole extracted toothatalveolitis and limited osteomyelitis of jaws. / Kliniko-mikrobiologicheskoe issledovanie deistviya ozonoterapii i svetodiodnogo izlucheniya krasnogo diapazona (630 nm) na mikrofloru lunki udalennogo zuba pri al'veolite i ogranichennom osteomielite chelyustei.

As a result of cliniko-microbiological research the data testifying to substantial improvement of efficiency of antimicrobictherape at inclusion in a complex of medical actions at alveolitis and the limited osteomyelitis of a jow ozone therapy in a combination with a light-emettinf diode irradiation of the hole extracted teeth red ( 630 nanometers) are obtained by light.

Perialveolar bacterial microbiota and bacteraemia after dental alveolitis in adult rats that had been subjected to neonatal malnutrition.

The aim of the present study was to analyse the bacteriological factors during the process of dental alveolitis, relating it to a higher incidence of bacteraemia in adult rats subjected to neonatal malnutrition. We used forty male Wistar rats, suckled by mothers fed a diet during lactation containing 17 % protein in the nourished group (N) or 8 % protein in the undernourished group (UN). After weaning, the animals were given the Labina standard diet. After 90 d, these animals underwent upper right incisor extraction and induction of alveolitis. The oral microbiota was obtained using a swab and blood culture through venous blood. These procedures were performed before the extraction, 5 min after extraction, on the 21st day after alveolitis for groups N-21 and UN-21 and on the 28th day after alveolitis for groups N-28 and UN-28. Data were expressed as means and standard deviations for parametric data, and as medians and interquartile intervals for non-parametric data. Statistical significance was considered by assuming a critical level of 5 %. Before and after extraction, lower bacterial growth was observed per colony-forming unit (CFU) in the perialveolar region of the upper right incisors of undernourished animals, while the opposite was true after alveolitis, when a larger number of CFU was observed in these animals. The percentage of positive blood cultures obtained after alveolitis was greater in the undernourished animals. The present study thus demonstrated the influence of neonatal malnutrition in the perialveolar microbiota and in the development of bacteraemia after dental alveolitis.

Alveolar osteitis and osteomyelitis of the jaws.

Postoperative bone healing after oral surgical procedures occurs uneventfully in most cases. However, in certain patients, the normal process of healing can be delayed and, in some cases, often because of multiple coexisting factors, the sites can become infected, with extension of the infection into medullary bone. This process is termed osteomyelitis. This article outlines the pathogenesis, microbiology, and surgical and medical therapies of this condition and specifically addresses osteomyelitis cases related to patients with no documented history of radiation or bisphosphonate exposure and in whom the principal factor in the development of the condition is infection by pyogenic microorganisms.

Experimental alveolitis in rats: microbiological, acute phase response and histometric characterization of delayed alveolar healing.

UNLABELLED: The pathogenesis of alveolitis is not well known and therefore experimental situations that mimic some features of this disease should be developed. OBJECTIVE: In this study, the evolution of the experimentally induced infection in rat sockets is characterized, which leads to clinical signs of suppurative alveolitis with remarkable wound healing disturbs. MATERIAL AND METHODS: Non-infected (Group I) and experimentally infected sockets in Rattus novergicus (Group II) were histometrically evaluated regarding the kinetics of alveolar healing. In addition, the characterization of the present bacteria in inoculation material and the serum levels of C-reactive protein (CRP) were performed. The detected species were Capnocytophaga ochracea, Fusobacterium nucleatum ss nucleatum, Prevotella melaninogenica, Streptococcus anginosus, Treponema socranskii and Streptococcus sanguis. RESULTS: All experimentally infected rats developed suppurative alveolitis, showing higher levels of CRP in comparison to those non-infected ones. Furthermore, infected rats presented a significant delayed wound healing as measured by the histometric analysis (higher persistent polymorphonuclear infiltrate and lower density of newly formed bone). CONCLUSION: These findings indicate that rat sockets with experimentally induced infection produced higher levels of serum CRP, showing the potential of disseminated infection and a disturb in the alveolar repair process in an interesting experimental model for alveolitis studies.

Experimental alveolitis in rats: microbiological, acute phase response and histometric characterization of delayed alveolar healing

The pathogenesis of alveolitis is not well known and therefore experimental situations that mimic some features of this disease should be developed. OBJECTIVE: In this study, the evolution of the experimentally induced infection in rat sockets is characterized, which leads to clinical signs of suppurative alveolitis with remarkable wound healing disturbs. MATERIAL AND METHODS: Non-infected (Group I) and experimentally infected sockets in Rattus novergicus (Group II) were histometrically evaluated regarding the kinetics of alveolar healing. In addition, the characterization of the present bacteria in inoculation material and the serum levels of C-reactive protein (CRP) were performed. The detected species were Capnocytophaga ochracea, Fusobacterium nucleatum ss nucleatum, Prevotella melaninogenica, Streptococcus anginosus, Treponema socranskii and Streptococcus sanguis. RESULTS: All experimentally infected rats developed suppurative alveolitis, showing higher levels of CRP in comparison to those non-infected ones. Furthermore, infected rats presented a significant delayed wound healing as measured by the histometric analysis (higher persistent polymorphonuclear infiltrate and lower density of newly formed bone). CONCLUSION: These findings indicate that rat sockets with experimentally induced infection produced higher levels of serum CRP, showing the potential of disseminated infection and a disturb in the alveolar repair process in an interesting experimental model for alveolitis studies.

Influence of local tetracycline on the microbiota of alveolar osteitis in rats.

The aim of the present study was to evaluate the effects of local tetracycline on the occurrence of alveolar osteitis in rats, and on the microbiota associated to this infection. Forty Wistar rats were randomly assigned to 4 groups (n=10): I - the rats had the maxillary right incisor extracted and the alveolar wound did not receive any treatment; II - adrenaline and Ringer-PRAS were introduced into the alveolar wound; III - the alveolar wound was irrigated with sterile saline; and IV - the alveolar wound was irrigated with an aqueous solution of tetracycline. Microbial samples from the alveolar wounds were collected 2 days after surgery and inoculated on blood agar (with and without 8 microg/mL of tetracycline) and other selective media, and were incubated in either aerobiosis or anaerobiosis at 37 degrees C, for 2 to 14 days. It was verified that tetracycline reduced the occurrence of alveolar osteitis in the rats and caused significant changes in the microbiota of the surgical sites, decreasing the number of anaerobes and increasing the participation of tetracycline-resistant and multi-resistant microorganisms.

Influence of local tetracycline on the microbiota of alveolar osteitis in rats

The aim of the present study was to evaluate the effects of local tetracycline on the occurrence of alveolar osteitis in rats, and on the microbiota associated to this infection. Forty Wistar rats were randomly assigned to 4 groups (n=10): I - the rats had the maxillary right incisor extracted and the alveolar wound did not receive any treatment; II - adrenaline and Ringer-PRAS were introduced into the alveolar wound; III - the alveolar wound was irrigated with sterile saline; and IV - the alveolar wound was irrigated with an aqueous solution of tetracycline. Microbial samples from the alveolar wounds were collected 2 days after surgery and inoculated on blood agar (with and without 8 µg/mL of tetracycline) and other selective media, and were incubated in either aerobiosis or anaerobiosis at 37ºC, for 2 to 14 days. It was verified that tetracycline reduced the occurrence of alveolar osteitis in the rats and caused significant changes in the microbiota of the surgical sites, decreasing the number of anaerobes and increasing the participation of tetracycline-resistant and multi-resistant microorganisms.

O objetivo do presente estudo foi avaliar os efeitos do uso tópico de tetraciclina sobre a ocorrência de alveolite em ratos e sobre a microbiota a ela associada. Quarenta ratos foram divididos, ao acaso, em 4 grupos (n=10): grupo I, realizou-se somente a extração do incisivo superior direito e a ferida alveolar não recebeu nenhum tratamento; grupo II, além da extração dental, soluções de adrenalina e Ringer-PRAS foram introduzidas no interior do alvéolo; grupo III, a ferida alveolar foi irrigada com solução salina estéril; grupo IV, a ferida alveolar foi irrigada com solução aquosa de cloridrato de tetraciclina a 10 por cento. As amostras dos alvéolos para processamento microbiológico foram coletadas dois dias após a realização das cirurgias e foram inoculadas em ágar sangue com ou sem 8 µg/mL de tetraciclina e em outros meios de cultura seletivos, incubadas em aerobiose ou anaerobiose, a 37ºC, de 2 a 14 dias. Verificou-se que a tetraciclina reduziu a ocorrência de alveolite e provocou uma modificação significativa na microbiota do sítio cirúrgico, levando a uma redução nas proporções ocupadas pelos microrganismos anaeróbios e uma elevação da participação de microrganismos resistentes à tetraciclina e outros antimicrobianos.

Normal microbiota of the perialveolar region of incisors of rats / Microbiota normal da região perialveolar de incisivos em ratos

Identificou-se a microbiota normal da região peri-alveolar de incisivos em 72 ratos Wistar, com 70-90 dias de idade e 280-330g de peso. As bactérias foram coletadas com suabes embebidos em solução salina. Do material depositado em tubo contendo 460µl de Brain Heart Infusion e diluído em 1:10, retirou-se 1µl para semeadura em placas de Petri. O crescimento médio foi 1,4x10(6) ± 2,6x10(5)UFC/ml. Segundo a ordem das freqüências, as bactérias encontradas foram: Bacillus sp., Staphylococcus aureus, Streptococcus viridans, Corynebacterium sp., Staphylococcus coagulase negativa, Enterococcus sp., Staphylococcus saprophyticcus, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae e Serratia liquefaciens. De todas as bactérias isoladas, as Gram-positivas e as Gram-negativas compreenderam 91,2 por cento e 8,8 por cento, respectivamente. Dentre as Gram-positivas, a mais freqüente foi Bacillus sp.(31,2 por cento) e a menos, Staphylococcus saprophyticcus (3,0 por cento). Quanto às bactérias Gram-negativas, a mais encontrada foi Escherichia coli (50,1 por cento) e a menos, Serratia liquefaciens (6,2 por cento)

Alveolar osteitis: a review of its etiology, prevention, and treatment modalities.

Alveolar osteitis (AO), commonly referred to as dry socket, is by far the most common complication following dental extraction. It represents a breakdown of healing after clot formation but before wound organization. This paper will review the literature associated with the etiology of AO, the risk factors which contribute to AO, and treatment regimens for AO once it is diagnosed. It will conclude with a summary of the current measures that hold the highest promise for the prevention of AO.

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.

Incidência de alveolites em exodontias realizadas por alunos da Faculdade de Odontologia da Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS / Incidence of alveolar osteitis after extraction tooh performed by graduation students a the Pontifícia Universidade Católica do Rio Grande do Sul

Neste estudo, foram analisados os resultados do pós-operatório de 511 exodontias, realizadas no ambulátorio de cirurgia da Faculdade de Odontologia da Pontifícia Universidade Católica do Rio Grande do Sul, no decorrer das disciplinas de Cirurgia I e II. Tais extraçöes foram efetuadas pelo alunos de 5§ e 6§ semestres do curso de Odontologia. Avaliou-se a incidência de alveolite de cada dentre, isoladamente, de cada grupo de dentes, por hemiarcadas, e no total. Os resultados sugerem que a menor experiência do profissional pode ser um dos fatores etiológicos da alveolite

[Alveolitis--current opinion]. / L'alvéolite, qu'en est-il aujourd'hui?

Following the removal of mandibular teeth, especially third molars nowadays, a post-operative complication may occur, namely alveolitis. This article reviews the pertinent literature concerning this condition and discusses its etiology, symptoms and treatment.

Prevention of dry socket with clindamycin. A retrospective study.

Clindamycin and other agents were compared for efficacy in preventing the entity "dry socket." A total 765 patients were treated with clindamycin, per os, and 408 patients were treated with other antibiotics or were non-treated controls. All patients underwent surgical removal of impacted mandibular third molars. The incidence of dry socket in untreated control and in non-clindamycin antibiotic-treated patients varied from 15 to 31 percent, while in those patients receiving clindamycin, the incidence was 0.65 percent. The results demonstrate a remarkable effectiveness of clindamycin in reducing the incidence of dry socket following surgical removal of impacted mandibular third molar.

[The microbial flora and humoral protective factors in odontogenic inflammations in the maxillofacial area]. / Mikrobnaia flora i gumoral'nye faktory zashchity pri odontogennykh vospaleniiakh v cheliustno-litsevoi oblasti.

Some features in the pathogenesis of various forms of an inflammatory process were demonstrated by immunologic and microbiologic methods in patients with odontogenic infections. A close relationship has been revealed between microflora of an inflammatory focus, immune response type, and inflammation course in the maxillofacial area.

Reactivated herpes simplex virus infection as a possible cause of dry socket after tooth extraction.

This study was designed to evaluate a possible association between reactivated herpes simplex virus type 1 (HSV-1) infection after lower third molar extraction and development of dry socket (DS). The HSV-1 antibody response was analyzed before and after tooth removal by enzyme-linked immunosorbent assay and immunoblotting in 208 patients. History of previous possible oral herpes reactivation was evaluated by a questionnaire that was based on self-rated frequency of oral cold sores. Tobacco users were identified. The anatomic proximity of the root apex to the mandibular nerve canal was classified radiographically before extraction. Fifteen patients (7%) developed DS after tooth extraction. Eleven of the 15 DS patients (73%) were HSV seropositive as compared with 7 of 15 (47%) in the matched control group. Seven of the 11 seropositive DS patients have shown HSV-1 reactivation by an increase of specific polypeptides, predominantly gB, gC, gD and ICP 4 and 6, in the immunoblot test. No change in HSV-1 reactivity was observed in control sera. DS patients reported a high frequency of oral cold sores (64%) compared with the controls (33%). Tobacco use was not found to influence the frequency of cold sores or the development of DS. A close radiographic proximity between the mandibular canal and root apex was more common (P < .05) in DS patients. The results indicate that extraction of a mandibular third molar could be a possible cause of reactivation and recurrence of an HSV-1 infection.(ABSTRACT TRUNCATED AT 250 WORDS)

A review of dry socket: a double-blind study on the effectiveness of clindamycin in reducing the incidence of dry socket.

This double blind clinical study was undertaken to evaluate the effectiveness of locally applied clindamycin in Gelfoam in reducing the incidence of dry socket formation after third molar surgery. A total of 1,021 third molar extractions were performed, and 520 mandibular third molar extractions of varied surgical difficulty were evaluated. The results indicated that this technique was effective. This study also demonstrates that the incidence of dry socket after third molar surgery is significantly higher in the mandible than the maxilla, in smokers than in non-smokers, and in females currently on oral contraceptives.