Further evidence confirms the association between smoking and dry socket: a motivational opportunity for tobacco cessation.

DESIGN: A systematic review and meta-analysis of observational studies. DATA SOURCES: Electronic search included PubMed, Scopus, and Web of Science databases up to March 2022 using appropriate keywords. SELECTION CRITERIA: The review included all observational studies (case-control, cohort and cross-sectional studies) published in English after 2000, comparing the prevalence of dry socket between smokers and non-smokers after simple or surgical tooth extraction. Exclusion criteria included patients with other post-extraction complications, prevalence of different risk factors, and unrelated study designs (literature reviews, case reports, expert opinion, and conference reports). DATA EXTRACTION AND SYNTHESIS: Two independent investigators screened the records (by title, abstract, and full text), and selected the eligible studies according to the predefined criteria. Collected data from each study included author name and country, year of publication, gender and age of patients, smoking status, inclusion and exclusion criteria, medical history and oral hygiene, prevalence of dry socket, type of tooth and extraction technique, symptoms and treatment. Risk of bias was assessed according to the (NHLBI, NIH) Quality Assessment Tool For Observational Cohort and Cross-Sectional Studies, while the level of evidence was assessed using the classification of the Oxford Centre for Evidence-Based Medicine levels for diagnosis. Two independent reviewers conducted the assessments, and any disagreements were addressed through discussion. RESULTS: Eleven studies from ten different countries representing a total of 10,195 patients (3007 smokers and 7188 non-smokers) were included in the final analysis. Nine studies were classified as having "good" quality and two as "intermediate," while all of the studies have the third or fourth level of evidence (through 5-graded scale). The prevalence of dry socket in smokers was about 13.2% (95% CI: 5.8-23.1%) and in non-smokers about 3.8% (95% CI: 2.1-6.0%). Meta-analysis showed that regular tobacco smoking was associated a more than 3-fold increase in the odds of dry socket after tooth extraction. CONCLUSION: Despite heterogeneity among the included studies (different age groups and types of teeth extracted), there was a consistent association between cigarette smoking and an elevated risk of developing dry socket post tooth extraction.

Clinical management of alveolar osteitis. A systematic review.

BACKGROUND: Alveolar Osteitis (AO) is one of the most common complications of tooth extraction. Several therapeutic interventions have been described for the treatment of AO, however, there are no treatment standardized protocols. The aim of this study was to conduct a systematic review on the efficacy in pain control of the different treatments for AO. The feasibility of the application of these interventions is also discussed. MATERIAL AND METHODS: A structured electronic and hand search strategy was applied to PubMed, Scopus, Cochrane Library, OpenGrey, and Google Scholar between January 2010 and July 2020 to identify studies according to PRISMA guidelines. The inclusion criteria were original English and Spanish clinical trials that analyzed pain-control parameters according to visual analog scale (VAS, 0-10 scale), or pain relief patients' percentages. Those treatments that reach VAS ≤ 4 on day 2 or before; or ≥ 85% of patients with absence of pain symptoms at day 7 or before were considered acceptable for their recommendation. RESULTS: The final review included 17 clinical trials. Among them, there were analyzed a total of 39 different AO treatments. 53,8% of the treatments fulfill the proposed parameters for pain control. CONCLUSIONS: Treatment alternatives are multiple, heterogeneous, and difficult to compare. The management of AO is summarized in basic (intra-alveolar irrigation) and specific procedures (Alveogyl®, Neocones®, SaliCept Patch®, Low-Level Laser, Platelet-Rich Fibrin) that reach pain control success. They could be selected according to their availability and advantages or disadvantages.

Retrieval of foreign body from maxillary sinus through extraction socket.

Dry socket or alveolar osteitis is one of the most common complication following tooth extraction. Patients usually reports of pain, which typically starts on third or fourth postoperative day and responds to simple irrigation and placement of zinc oxide eugenol (ZOE) pack, which provides an obtundent effect. The pack should be loosely kept in the extraction socket and should be changed periodically to allow healing. This report presents a case of retrieval of foreign body, which actually was a ZOE pack from maxillary sinus, 6 months after the patient underwent extraction of upper left maxillary first molar.

Aplicación de una jalea de caléndula al 1% en pacientes con alveolitis / Application of a 1% calendula jelly in patients with alveolitis

Objetivo: demostrar los beneficios terapéuticos del uso de una jalea de caléndula al 1% en pacientes con alveolitis. Métodos: se realizó una intervención terapéutica en el Policlínico Julián Grimau, provincia Santiago de Cuba, Cuba, entre enero y junio de 2019. Por muestreo no probabilístico se reclutó una muestra de 24 pacientes con diagnóstico de alveolitis seca o húmeda, distribuyéndose en dos grupos: A (control) y B (estudio), los cuales recibieron tratamiento convencional y jalea de caléndula al 1%, respectivamente. Se analizaron las variables: edad, sexo, tipo de alveolitis, tiempo de remisión del dolor y de cicatrización, respuesta al tratamiento (mejorado y no mejorado) y beneficios terapéuticos. Se empleó el porcentaje como medida de resumen y el test estadístico Ji al cuadrado de Independencia con un nivel de significación (a) de 0,05. Resultados: se evidenció un predominio de la alveolitis en pacientes con 19-59 años de edad (50,0%), del sexo femenino (66,7%) y del tipo húmeda (75,0%). En ambos grupos de tratamiento, el mayor porcentaje de los pacientes (17) refirió alivio del dolor a las 48 horas. En el 83,3% de los pacientes, incluidos en el grupo B, se observó menor tiempo de cicatrización. El 100% de los pacientes se categorizó como mejorado. Conclusiones: la jalea de caléndula al 1% resulta beneficiosa, dada su capacidad analgésica y cicatrizante en el tratamiento de pacientes con alveolitis.

Objective: demonstrate the therapeutic benefits of a 1 % calendula jelly in patients with alveolitis. Methods: a therapeutic intervention was carried out at the Julián Grimau Polyclinic, Santiago de Cuba province, Cuba, between January and June 2019. By non-probabilistic sampling, a sample of 24 patients with a diagnosis of dry or wet alveolitis was recruited, distributed in two groups: A (control) and B (study), who received conventional treatment and 1% calendula jelly, respectively. The variables were analyzed: age, sex, type of alveolitis, time of remission of pain and healing, response to treatment (improved and not improved) and therapeutic benefits. The percentage was used as a summary measure and the Chi-square test of Independence with a significance level (a) of 0.05. Results: a predominance of alveolitis was evidenced in patients aged 19-59 years (50.0 %), female (66.7 %) and of the wet type (75.0 %). In both treatment groups, the highest percentage of patients (17) reported pain relief at 48 hours. In 83.3% of the patients included in group B, a shorter healing time was observed. 100 % of the patients categorized as improved. Conclusions: Calendula jelly 1 % is beneficial as an analgesic and healing in the treatment of patients with alveolitis.

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.

Potential effects of advanced platelet rich fibrin as a wound-healing accelerator in the management of alveolar osteitis: A randomized clinical trial.

AIM: The aim of the present study was to determine whether the use of advanced platelet rich fibrin based on the low speed+ centrifugation concept (A-PRF+) might improve the pain management and healing of delayed wound healing among cases of alveolar osteitis following mandibular third molar extraction. MATERIALS AND METHODS: The patients (N = 40) with a complaint of alveolar osteitis following third molar extractions were divided into two groups: Group I (control; saline only); and Group II (use of A-PRF+). Pain was evaluated using the visual analogue scale (VAS). Soft tissue healing was assessed by the modified Index of Landry, Turnbull and Howley and bone density was assessed with the i-Dixel 2.1.8.2 software. Inter-group comparisons were analyzed by means of a student t-test and the Mann Whitney U test to identify group samples. Analysis of variance and the Friedman test were applied for repeated measurements. The Wilcoxon test and Bonferroni's test for multiple comparisons were conducted at the time-factor level. Yates Correction was used to compare qualitative data. RESULTS: In regard to pain, A-PRF+ application demonstrated rapidly and continually reduced pain intensity at each respective time in comparison to the control. Statistically, the healing rates of epithelium and hard tissue were significantly faster in the A-PRF+ application group (p: 0.000, P < 0.05). CONCLUSIONS: The results show that A-PRF+ might represent an improved and accelerating therapeutic development for hard and soft tissue healing in management of alveolar osteitis that is also effective in reducing pain.

Edema em lábio superior associado à alveólise de dente decíduo / Edema em lábio superior associado à alveólise de dente decíduo

Introdução: As úlceras traumáticas são caracterizadas por episódios breves e dolorosos, mas podem se tornar crônicas se o agente causador não for eliminado. A alveólise é uma alteração que pode ocorrer durante o processo de reabsorção da raiz do dente decíduo, caracterizada por sua exposição à cavidade bucal, sem reabsorção. Objetivo: Descrever o caso de uma paciente com edema no lábio superior devido à úlcera traumática causada pela exposição do ápice da raiz de um incisivo decíduo. Relato do caso: Paciente do sexo feminino, 5 anos de idade. Após exame clínico, deduziu-se que o edema labial associado com uma úlcera causada pelo contato constante com o ápice do dente que sofreu alveólise. O tratamento consistiu na extração do dente e proservação da úlcera na mucosa labial. A extração favoreceu a erupção do incisivo permanente, permitiu a cicatrização completa da lesão traumática e a remissão do edema no lábio superior. Conclusão: Embora simples, o caso ressalta a necessidade de o profissional reconhecer a alveolise, possíveis complicações associadas e a maneira adequada de tratá-las. Um caso aparentemente complexo foi resolvido simplesmente devido ao diagnóstico e tratamento adequados(AU)

Introducción: Las úlceras traumáticas se caracterizan por episodios breves y dolorosos, pero pueden llegar a ser crónicas si no se elimina el agente causal. La alveólisis es una alteración que puede ocurrir durante el proceso de reabsorción de la raíz del diente primario, caracterizada por su exposición a la cavidad bucal, sin reabsorción. Objetivo: Describir el caso de una paciente con edema en el labio superior debido a la úlcera traumática causada por la exposición del ápice de la raíz de un incisivo primario. Presentación del caso: Paciente del sexo femenino, de 5 años de edad. Después del examen clínico, se dedujo que el edema del labio estaba relacionado con la úlcera causada por el contacto constante con el ápice del diente que ha sufrido alveólisis. El tratamiento consistió en la extracción del diente y preservación de la úlcera en mucosa labial. La extracción favoreció la erupción del incisivo permanente, permitió la curación completa de la lesión traumática y la remisión del edema en el labio superior. Conclusiones: Aunque simple, el caso destaca la necesidad de que el profesional reconozca la alveólisis, posibles enfermedades asociadas y la forma adecuada de tratarlas. Un caso aparentemente complejo se resolvió simplemente debido a un diagnóstico y tratamiento adecuados(AU)

Introduction: Traumatic ulcers are characterized by short and painful episodes, but can become chronic if the causative agent is not removed. Alveolisis is an alteration that may occur during the primary tooth root resorption process, characterized by its exposure to the oral cavity, without resorption. Objective: To describe the case of a patient with an important edema and associated pain in the upper lip due to traumatic ulcer caused by exposure of the root apex of a primary incisor. Case presentation: Female patient aged 5 years old. After clinical examination, it was deduced that the lip swelling was related to the ulcer that was caused by the constant contact with the apex of the central incisor that has undergone alveolisis. The treatment consisted in the extraction of the tooth and the preservation of the labial mucosa ulcer. The extraction favored the eruption of the permanent incisor, allowed the complete healing of the traumatic lesion and the remission of the upper lip edema. Conclusions: Although simple, the case highlights the need for the professional to recognize the alveolisis and the possible associated complications as well as the appropriate way to manage them. A seemingly complex case was solved simply due to correct diagnosis and treatment(AU)

The Efficiency of Three Irrigating Solutions after Surgical Removal of Impacted Mandibular Third Molars: A Cross-sectional Study.

AIM: The present study was conducted to assess the effect of irrigation with three different irrigants, namely normal saline, chlorhexidine, and povidone iodine on pain, alveolar osteitis, swelling, trismus, infection, and food impaction during surgical removal of impacted mandibular third molar. MATERIALS AND METHODS: Forty-eight patients, including 26 males and 22 females, fulfilling criteria for inclusion in this study were divided into three groups: group I where irrigant used was normal saline, group II as chlorhexidine, and group III as povidone iodine group. RESULTS: The pain was significantly more in groups I and III in 24 hours and 7th day as well. Alveolar osteitis was noted in groups III and I, nil in group II. The facial swelling measured in millimeters on 24 hours and on 7th day was significantly higher in 24 hours in groups I and III than in group II. Trismus was significantly more in group I and group III than in group II (with p < 0.01) on 7th day. CONCLUSION: It is concluded that chlorhexidine is effective in reducing pain, alveolar osteitis, swelling, and trismus when used as an irrigant following surgical removal of impacted third molar. CLINICAL SIGNIFICANCE: Chlorhexidine as irrigating solution helps in reducing the postoperative consequences after third molar surgery. Further studies are required using large sample size.

Incidence and treatment of complications in patients who had third molars or other teeth extracted.

The aim of this study was to compare the incidence of complications after extraction of third molars (M3) or other teeth, and to describe their management. We made a retrospective cohort study of patients having M3 or other teeth extracted, and recorded complications up to two years' follow-up. A total of 142 complications developed after 2355 procedures (6%) - 7% after extraction of M3 compared with 5% after extractions of other teeth (p=0.024). The three most common complications were wound infection (2%), pain without apparent cause (<1%), and oroantral communication (<1%). Patients who had M3 extracted were at increased risk of complications compared with those who had other teeth extracted (Odds ratio (OR) 1.5, p=0.024), particularly for infection (OR 5.9, p<0.001) and hypoaesthesia (OR 8.4, p=0.027). Half of all patients with a complication were treated with antibiotics orally. The incidence of postoperative bleeding was 0.6% as a result of suboptimal management of antithrombotic drugs in extractions of teeth other than M3. Finally, optimal treatment of the complications was compared with the available evidence. Prevention and treatment of these complications could reduce the incidence, particularly of bleeding.

Evaluation of the Effect of Platelet-Rich Fibrin on the Alveolar Osteitis Incidence and Periodontal Probing Depth after Extracting Partially Erupted Mandibular Third Molars Extraction.

AIMS: To evaluate whether the alveolar osteitis (AO) incidence after extracting partially erupted third molars differs when platelet-rich fibrin (PRF) is administered in the alveolar socket and to assess the influence of PRF on postoperative pain levels and periodontal probing depth. SETTINGS AND DESIGN: In this split-mouth randomized study, 50 patients (17 men/ 33 women; mean age, 23.96 years) with bilateral symmetric partially erupted mandibular third molars were enrolled. MATERIAL AND METHODS: PRF was randomly placed in one extraction socket, whereas the other socket was left empty. A verbal rating scale was used to evaluate postoperative pain levels. AO development was evaluated on the 7th postoperative day. At 3 months postoperatively, periodontal probing depth was measured on the distal surface of the second molars. RESULTS: In total, 8% of patients in the PRF group and 18% of the patients in the control group were diagnosed with AO. None of the smokers in the PRF group and 37.5% smokers in the control group were diagnosed with AO. Mean postoperative pain levels were lower in the PRF group than in the control group at all time points. At 3 months postoperatively, periodontal probing depths were found to be ≤3 mm in both groups. CONCLUSIONS: PRF significantly reduced the AO incidence among smokers and had a positive effect on postoperative pain levels but not on periodontal healing.

Aplicación del ozono en alveolitis dentaria / Application of ozone in dental alveolitis

Se realizó un estudio experimental, controlado, fase lll, aleatorizado, a doble ciegas, en dos ramas, con el objetivo de evaluar la eficacia del ozono en pacientes atendidos con alveolitis dentaria, en el periodo comprendido de abril 2015 a abril 2016, atendidos en la consulta de urgencias del policlínico René Vallejo del municipio Bayamo. Los individuos quedaron distribuidos aleatoriamente en dos grupos: grupo 1 o estudio, que fueron tratados con oleozón y grupo 2 o control, tratados con alvogil. Las variables de inflamación, cicatrización y respuesta al tratamiento se evaluaron en las consultas, luego de aplicados los dos tratamientos, a las 48 horas como primera consulta, 72 horas como segunda consulta, 96 horas como tercera consulta y a los 7 días. En la tercera consulta se hizo un corte final. Los resultados mostraron para el grupo estudio 40 pacientes (80 por ciento) alivio el dolor a los 5 minutos de aplicado el medicamento, 40 pacientes, (80 por ciento) no estaban inflamados en la tercera consulta, así como 46 pacientes (92 por ciento) tuvieron cicatrización y 43 pacientes (86 por ciento) respondieron favorablemente al tratamiento, en el grupo control, los resultados mostraron que 13 pacientes (26 por ciento) aliviaron el dolor a los 5 minutos de aplicado el medicamento, 35 pacientes (70 por ciento) no estaban inflamados, 44 pacientes (88 por ciento) tuvieron cicatrización total y 40 pacientes (80 por ciento) tuvieron una respuesta favorable al tratamiento. No existieron diferencias significativas en la aplicación del tratamiento con ozono con relación al tratamiento convencional(AU)

An experimental, controlled, phase III, randomized, double blind study was conducted in two branches, with the aim of evaluating the effectiveness ofozone in patients treated with dental alveolitis, in the period from April 2015 to April 2016, attended the emergency department of the Rene Vallejo polyclinic in Bayamo municipality. Individuals were randomized into two groups: group 1 or study, which was treated with oleozon and group 2 or control, treated with alvogil. The variables of inflammation, healing and response to treatment were evaluated in the consultations, after the two treatments were applied, at 48 hours as first consultation, 72 hours as second consultation, 96 hours as third consultation and at 7 days. In the third consultation a final cut was made. The results showed 40 patients for the study group (80 percent) pain relief 5 minutes after the medication was applied, 40 patients (80 percent) were not inflamed in the third consultation, as well as 46 patients (92 percent) had scarring and 43 patients (86 percent) responded favorably to treatment, in the control group, the results showed that 13 patients (26 percent) relieved the pain 5 minutes after applying the medication, 35 patients (70 percent) were not inflamed, 44 patients (88 percent) had total healing and 40 (80 percent) patients had a favorable response to treatment. There were no significant differences in the application of ozone treatment in relation to conventional treatment(EU)

An unusual microscopic pattern of foreign body reaction as a complication of dry socket management.

Foreign body reactions in the oral cavity are relatively common, frequently resulting from iatrogenic causes. Depending on the nature of the foreign material, various microscopic patterns may be observed, causing diagnostic difficulties. Recognition of the ensuing unusual microscopic pattern, especially for cases in which the possibility of a foreign body reaction is not entertained in the clinical differential diagnosis, necessitates sufficient degree of suspicion, familiarization with the spectrum of microscopic appearances, and careful clinicopathologic correlation. Medicated dressings of various compositions are commonly placed for prevention or management of dry socket (or alveolar osteitis, a common postoperative complication of tooth extraction) and may be a cause of foreign body reaction. Here, we report a foreign body reaction to a medical dressing material in a postextraction socket, with an unusual microscopic pattern bearing resemblance to parasitic infestation.

Efectividad de la magnetoterapia en la terapéutica de las alveolitis / Effectiveness of magnet therapy in the treatment of alveolitis

Fundamento: la elevada incidencia de las alveolitis en los servicios estomatológicos precisa emplear técnicas de tratamiento eficaz e inofensivo que logren, en el menor tiempo posible, la curación del paciente. La magnetoterapia constituye una opción terapéutica.Objetivo: demostrar la efectividad de la magnetoterapia en la terapéutica de las alveolitis.Métodos: se realizó un estudio cuasi-experimental en la Clínica Estomatológica Ormani Arenado Llonch, de la provincia Pinar del Río, de septiembre de 2014 a agosto de 2015. El universo coincide con la muestra de estudio, que estuvo constituida por 100 pacientes con diagnóstico de alveolitis que cumplieron con los criterios de inclusión y exclusión. Se establecieron dos grupos de estudio comprendidos por 50 pacientes cada uno. En ellos se evaluaron las variables: grupo etario, sexo biológico, evolución y comparación del tratamiento en ambos grupos.Resultados: predominó el sexo femenino, entre 35 y 54 años de edad en ambos grupos. Prevaleció la variante de tratamiento curado en los grupos I y II con 80 por ciento y 42 por ciento. Se destacó la evolución satisfactoria con 96 por ciento de pacientes curados en el grupo I y 92 por ciento en el grupo II sin diferencias significativas.Conclusiones: se demostró la efectividad de la magnetoterapia en las alveolitis como alternativa de tratamiento seguro, técnico e inofensivo para los pacientes que acuden a consulta estomatológica(AU)

Background: the high impact of alveolitis in the dentistry service requires the use of effective and harmless treatment techniques that achieve in less possible time the recovery of the patient. Magnet therapy constitutes a therapeutic option.Objective: to demonstrate the effectiveness of magnet therapy in the treatment of alveolitis.Methods: a quasi-experimental study was carried out in Ormani Arenado Llonch clinic, Pinar del Río, from September 2014 to August 2015. The universe coincides with the sample of study. The latter was made up of 100 patients with diagnosis of alveolitis. They all met inclusion and exclusion criteria. Two groups of study composed of 50 patients were created. In them the following variables were assessed: age group, sex, evolution and comparison of the treatment followed by both groups.Results: female sex prevailed, between 35 and 54 years of age in both groups. Variant of cured treatment in groups I and II was predominant, with 80 percent and 42 percent. Satisfactory evolution with 96 percent of the cured patients in group I was highlighted as well as in group II, without significant differences.Conclusions: effectiveness of magnet therapy in alveolitis as a high save, technical and harmless alternative treatment for patients who attend the dentists(AU)

Efficacy of different methods used for dry socket management: A systematic review

BACKGROUND: Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but in spite of its high incidence there is not an established treatment for this condition. OBJECTIVES: Analyze the efficacy of different methods used in the management of dry socket regarding results of pain's relief and alveolar mucosa healing compared to conventional surgical treatment of curettage and saline irrigation. MATERIAL AND METHODS: A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "post-extraction complications", "alvogyl", "alveolar osteitis" and "fibrynolitic alveolitis", individually and next, using the Boolean operator "AND". The inclusion criteria were: clinical studies including at least 10 patients, articles published from 2004 to 2014 written in English. The exclusion criteria were case reports and nonhuman studies. RESULTS: 11 publications were selected from a total of 627. Three of the 11 were excluded after reading the full text. The final review included 8 articles: 3 prospective studies, 2 retrospective studies and 3 clinical trials. They were stratified according to their level of scientific evidence using the SORT criteria (Strenght of Recommendation Taxonomy). CONCLUSIONS: All treatments included in the review have the aim to relief patient's pain and promote alveolar mucosa healing in dry socket. Given the heterogeneity of interventions and the type of measurement scale, the results are difficult to compare. Curettage and irrigation should be carried out in dry socket, as well as another therapy such as LLLT, zinc oxide eugenol or plasma rich in growth factors, which are the ones that show better results in pain remission and alveolar mucosa healing. Assessment alveolar bone esposure must be a factor to consider in future research. Taking into account the scientific quality of the articles evaluated, a level B recommendation is given for therapeutic interventions proposed for the treatment of dry socket

Efficacy of different methods used for dry socket management: A systematic review.

BACKGROUND: Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but in spite of its high incidence there is not an established treatment for this condition. OBJECTIVES: Analyze the efficacy of different methods used in the management of dry socket regarding results of pain's relief and alveolar mucosa healing compared to conventional surgical treatment of curettage and saline irrigation. MATERIAL AND METHODS: A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "post-extraction complications", "alvogyl", "alveolar osteitis" and "fibrynolitic alveolitis", individually and next, using the Boolean operator "AND". The inclusion criteria were: clinical studies including at least 10 patients, articles published from 2004 to 2014 written in English. The exclusion criteria were case reports and nonhuman studies. RESULTS: 11 publications were selected from a total of 627. Three of the 11 were excluded after reading the full text. The final review included 8 articles: 3 prospective studies, 2 retrospective studies and 3 clinical trials. They were stratified according to their level of scientific evidence using the SORT criteria (Strenght of Recommendation Taxonomy). CONCLUSIONS: All treatments included in the review have the aim to relief patient's pain and promote alveolar mucosa healing in dry socket. Given the heterogeneity of interventions and the type of measurement scale, the results are difficult to compare. Curettage and irrigation should be carried out in dry socket, as well as another therapy such as LLLT, zinc oxide eugenol or plasma rich in growth factors, which are the ones that show better results in pain remission and alveolar mucosa healing. Assessment alveolar bone esposure must be a factor to consider in future research. Taking into account the scientific quality of the articles evaluated, a level B recommendation is given for therapeutic interventions proposed for the treatment of dry socket.

Eficacia de la tintura de propóleos al 5 por ciento en el tratamiento de la alveolitis / Effectiveness of 5 percent propolis tinction in treating alveolitis

Introducción: la alveolitis es una afección donde los síntomas álgicos son la principal razón por la que acuden los pacientes a consultas. Se decide evaluar la eficacia de la tintura de propóleos al 5 porciento para lograr una curación más rápida y la total restitución de los tejidos dañados, con menos molestias al enfermo. Método: se realizó un ensayo clínico controlado, con 68 pacientes de ambos sexos y mayores de 15 años, en el Policlínico Universitario Belkis Sotomayor Álvarez de Ciego de Ávila, desde enero 2010 a enero 2011, divididos en dos grupos (estudio y control), con el objetivo de determinar la eficacia del uso de la tintura de propóleos al 5 por ciento en el tratamiento de las alveolitis, en cuanto a: evolución del dolor de acuerdo al número de visitas, tipo, localización de la alveolitis y reacciones adversas presentes. El grupo de estudio recibió tratamiento con propóleos y el de control con alvogil. Las curas y visitas de evolución fueron diarias. Resultados: la eficacia del tratamiento de la alveolitis con la tintura de propóleos al 5 por ciento se observó en el 85,3 por ciento de los pacientes estudiados. Conclusiones: el propóleos resultó ser una terapia inocua y eficaz de elección en las alveolitis, independientemente de la intensidad del dolor, tipo y localización de la alveolitis. La intensidad del dolor disminuye a medida que aumenta el tiempo y las aplicaciones del propóleos(AU)

Introduction: alveolitis is a condition where pain symptoms are the main reason why patients attend consultations. It was decided to evaluate the effectiveness of propolis 5 percent to achieve a faster recovery and full restoration of damaged tissues, with less discomfort to the patient. Method: a controlled clinical trial was carried out with 68 patients of both sexes and over 15 years at Belkys Sotomayor Álvarez Universitary Polyclinic in Ciego de Ávila, from January 2010 to January 2011, divided into two groups (study and control), in order to determine the efficacy of propolis 5 percent in the alveolitis treatment, in terms of: pain evolution according to the number of visits, type, alveolitis location and present adverse reactions. The study group was treated with propolis and the control group with alvogil. The recovery and evolution visits were daily. Results: the alveolitis efficacy treatment with propolis 5 percent was observed in 85,3 percent of studied patients. Conclusions: the propolis proved to be an innocuous and effective therapy of choice in alveolitis, regardless of pain intensity, type and location. Pain intensity decreases with increasing time and applications of propolis(AU)

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

Uso de Oleozón en alveolitis en la Clínica Estomatológica Lidia Doce, Guantánamo / Using Oleozon in alveolitis at Stomatology clinic Lidia Doce, Guantánamo

Se realizó una investigación en la Clínica Estomatológica Lidia Doce del municipio Guantánamo en el año 2014, con el objetivo de analizar el comportamiento del uso de Oleozón®en alveolitis. El universo estuvo constituido por 63 pacientes que asistieron a la consulta padeciendo la enfermedad. Las variables estudiadas fueron: edad, sexo, tratamientos realizados y nivel de conocimiento de los prescriptores. Los principales resultados mostraron que fueron las mujeres las que más padecieron de esta enfermedad, aplicándole tratamientos de fitoterapia al 47,62 por ciento, terapia convencional al 33,34 por ciento y Oleozón® al 9,52 por ciento del total de pacientes. El nivel de conocimiento de los estomatólogos es adecuado en cuanto a la Medicina Natural y Tradicional a pesar que todavía es insuficiente el uso de Oleozón®. Se concluyó que es un problema gerencial en cuanto a la hora de trazar estrategias en los comités farmacoterapéuticos para la disminución de costo en tratamientos(AU)

An investigation was performed in the Stomatology clinic Lidia Doce the municipality Guantánamo in 2014, with the aim of analyzing the behavior of using Oleozón®in alveolitis. The universe consists of 63 patients who were attended at the consultation suffering this pathology. The variables were studied: age, sex, treatments performed and level of knowledge of prescribers. The main results show that most women who suffered from this disease, applying herbal treatments to 47.62 percent to 33.34 percent conventional therapy and Oleozón to 9.52 percent. The level of know ledge of dentists is suitable in terms of Natural and Traditional Medicine although it is still insufficient use Oleozón®. As a conclusion, that is a management problem when strategizing in therapeutic committees for cost reduction treatments(AU)