Efficacy of Post-Extraction Suturing on the Incidence of Dry Socket Occurrence in Erupted and Semi-Erupted Mandibular Third Molar: A Case-Control Study
DOI:
https://doi.org/10.17656/jzs.10878Keywords:
Figure-eight suture, Semi-erupted mandibular third molar, Alveolar osteitis, Cross-sectional studyAbstract
Objectives: The main aim of this study is to evaluate the incidence of dry sockets in patients in relation to their clinical parameters such as pain, the disintegration of the clot, and halitosis regardless of their oral hygiene status. Also, to find sex and age-related to the reported parameters during surgical technique (time and complication).
Methods: A prospective cross-sectional study was done on 60 patients (30 study group and 30 control group) aged 21 -50 years with semi-erupted and full-erupted lower 3rd molars, which were indicated for extraction. The mandibular 3rd molar was extracted without any suturing in the control group, while extraction of the 3rd molar for the study group using a figure-eight suture. All the patients were evaluated for pain, presence of clot and condition of the alveolar bone to diagnose dry socket.
Results: The incidence of dry sockets was only 3 cases (5%) (one in study group and another two in control group) who were male heavy smokers. Regarding the clinical signs after 3, 5, and 7 days of tooth extraction, pain was severe/very severe in 3.3% at extraction sites in the study group and 6.7% in the control group on the 3rd day. While, the pain was moderate in 3.3% and 6.7% at extraction sites in the study and control groups, respectively, on the 5th day. In both groups, the blood clot was found in 100% of extraction sites on the 5th and 7th days but it was not found in 3.3% and 6.7% of extraction sites in study and control groups on the 3rd postoperative day, respectively. Also, halitosis was found in only 1% of the control group on the 3rd day but it was absent in 100% of the study group on the 3rd, 5th, and 7th postoperative days and the control group on the 5th and 7th days.
Conclusions: We realized that the incidence of dry sockets was less without significant difference in patients with a figure-eight suturing of extraction site that might be the cause for reducing pain in a study group as well as the amount of blood clot on 3rd postoperative day.
References
Palareti G., Legnani C., Cosmi B., Antonucci E., Erba N., Poli D., Testa S., & Tosetto A. (2016). Comparison between different D-dimer cutoff values to assess the individual risk of recurrent venous thromboembolism: Analysis of results obtained in the DULCIS study. International Journal of Laboratory Hematology. 38(1), 42–49. DOI: https://doi.org/10.1111/ijlh.12426
Rakhshan V. (2015). Common risk factors for postoperative pain following the extraction of wisdom teeth. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 41(2), 59-65. DOI: https://doi.org/10.5125/jkaoms.2015.41.2.59
Blum I.R. (2002). Contemporary views on dry socket (alveolar osteitis): A clinical appraisal of standardization, aetiopathogenesis and management: A critical review. International Journal of Oral and Maxillofacial Surgery. 31(3), 309–317. DOI: https://doi.org/10.1054/ijom.2002.0263
Taberner-Vallverdú M., Sánchez-Garcés M.Á. & Gay-Escoda C. (2017). Efficacy of different methods used for dry socket prevention and risk factor analysis: A systematic review. Medicina Oral, Patologia Oraly Cirugia Bucal. 22(6), e750–e758. DOI: https://doi.org/10.4317/medoral.21705
Tarakji B., Saleh L.A., Umair, A., Azzeghaiby S.N., & Hanouneh S. (2015). Systemic Review of Dry Socket: Aetiology, Treatment, and Prevention. Journal of Clinical and Diagnostic Research. 9(4), ZE10–ZE13. DOI: https://doi.org/10.7860/JCDR/2015/12422.5840
Rakhshan V. (2018). Common risk factors of dry socket (alveolitis osteitis) following dental extraction: A brief narrative review. Journal of Stomatology, Oral and Maxillofacial Surgery. 119(5), 407–411. DOI: https://doi.org/10.1016/j.jormas.2018.04.011
Kamal A., Salman B., Ar N.H., & Samsudin A.R. (2021). Management of dry socket with low-level laser therapy. Clinical Oral Investigations. 25(3), 1029–1033. DOI: https://doi.org/10.1007/s00784-020-03393-3
Mamoun J. (2018). Dry socket etiology, diagnosis, and clinical treatment techniques. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 44(2), 52–58. DOI: https://doi.org/10.5125/jkaoms.2018.44.2.52
Sharif M.O., Dawoud B.E., Tsichlaki A., & Yates J.M. (2014). Interventions for the prevention of dry socket: An evidence-based update. Gene Therapy. 21(3), 27-30. DOI: https://doi.org/10.1038/sj.bdj.2014.550
Halabi D., Escobar J., Alvarado C., Martinez N., Muñoz C. (2018). Chlorhexidine for prevention of alveolar osteitis: A randomized clinical trial. Journal of Applied Oral Science. 26, 1-7. DOI: https://doi.org/10.1590/1678-7757-2017-0245
Freudenthal N., Sternudd M., Jansson L., & Wannfors K. (2015). A double-blind randomized study evaluating the effect of intra-alveolar chlorhexidine gel on alveolar osteitis after removal of mandibular third molars. Journal of Oral and Maxillofacial Surgery. 73(4), 600-605. DOI: https://doi.org/10.1016/j.joms.2014.08.035
Bailey E., Bailey E., Esposito M., Furness S., Renton T.F., & Worthington H.V. (2020). Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database of Systematic Reviews. 2020(7). DOI: https://doi.org/10.1002/14651858.CD004345.pub3
Daly B., Sharif M.O., Newton T., Jones K., & Worthington H.V. (2012). Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database of Systematic Reviews. (12), 1-75. DOI: https://doi.org/10.1002/14651858.CD006968.pub2
Haraji A., Rakhshan V., Khamverdi N., & Khanzadeh A.H. (2013). Effects of Intra-alveolar Placement of 0.2% Chlorhexidine Bioadhesive Gel on Dry Socket Incidence and Postsurgical Pain: A Double-Blind Split-Mouth Randomized Controlled Clinical Trial. Journal of Orofacial Pain. 27(3), 256-262. DOI: https://doi.org/10.11607/jop.1142
Rubio-Palau J., Garcia-Linares J., Hueto-Madrid J.A., González-Lagunas J., Raspall-Martin G., & Mareque-Bueno J., (2015). Effect of intra-alveolar placement of 0.2% chlorhexidine bioadhesive gel on the incidence of alveolar osteitis following the extraction of mandibular third molars. A double-blind randomized clinical trial. Medicina Oral Patologia Oral y Cirugia Bucal. 20(1), e117-e222. DOI: https://doi.org/10.4317/medoral.20009
Requena-Calla S. & Funes-Rumiche I. (2016). Effectiveness of intra-alveolar chlorhexidine gel in reducing dry socket following surgical extraction of lower third molars. A pilot study. Journal of Clinical and Experimental Dentistry. 8(2), e160-e163. DOI: https://doi.org/10.4317/jced.52444
Xue P., Wang J., Wu B., Ma Y., Wu F., & Hou R. (2015). Efficacy of antibiotic prophylaxis on postoperative inflammatory complications in Chinese patients having impacted mandibular third molars removed: A split-mouth, double-blind, self-controlled, clinical trial. British Journal of Oral and Maxillofacial Surgery. 53(5), 416-420. # DOI: https://doi.org/10.1016/j.bjoms.2015.02.001
Abu-Mostafa N.A., Alqahtani A, Abu-Hasna M., Alhokail A., & Aladsani, A. (2015). A randomized clinical trial compared the effect of intra-alveolar 0.2% Chlorohexidine bio-adhesive gel versus 0.12% Chlorohexidine rinse in reducing alveolar osteitis following molar teeth extractions. Medicina Oral, Patologia Oraly Cirugia Bucal. 20(1), e82. DOI: https://doi.org/10.4317/medoral.19932
Monaco G., De Santis G., Pulpito G., Gatto M.R., Vignudelli E., & Marchetti C. (2015). What Are the Types and Frequencies of Complications Associated With Mandibular Third Molar Coronectomy? A Follow-Up Study. Journal of Oral and Maxillofacial Surgery. 73(7), 1246-1253. DOI: https://doi.org/10.1016/j.joms.2015.01.016
Kilinc A. & Ataol M. (2017). How effective is collagen resorbable membrane placement after partially impacted mandibular third molar surgery on postoperative morbidity? A prospective randomized comparative study. BMC Oral Health. 17(1), 1-8. DOI: https://doi.org/10.1186/s12903-017-0416-z
King E. M., Cerajewska T.L., Locke M., Claydon N.C., Davies M., & West NX. (2018). The Efficacy of Plasma Rich in Growth Factors for the Treatment of Alveolar Osteitis: A Randomized Controlled Trial. Journal of Oral and Maxillofacial Surgery. 76(6), 1150-1159. DOI: https://doi.org/10.1016/j.joms.2017.12.025
Asutay F., Yolcu Ü.M., Geçör O., Acar A.H., Öztürk S.A., Malkoç S. (2017). An evaluation of effects of platelet‑rich‑fibrin on postoperative morbidities after lower third molar surgery. Nigerian Journal of Clinical Practice. 20(12),1531-1536. DOI: https://doi.org/10.4103/1119-3077.181400
Reiland M.D., Ettinger K.S., Lohse C.M., & Viozzi C.F. (2017). Does Administration of Oral Versus Intravenous Antibiotics for Third Molar Removal Have an Effect on the Incidence of Alveolar Osteitis or Postoperative Surgical Site Infections? Journal of Oral and Maxillofacial Surgery. 75(9), 1801-1808. DOI: https://doi.org/10.1016/j.joms.2017.03.038
Congiusta M.A. & Veitz-Keenan A. (2013). Study confirms certain risk factors for development of alveolar osteitis. Evidence-Based Dentistry. 14(3), 86. DOI: https://doi.org/10.1038/sj.ebd.6400954
Younis M.H. & Ra'ed, O. (2011). Dry socket: frequency, clinical picture, and risk factors in a palestinian dental teaching center. The Open Dentistry Journal. 5, 7-12.
Mohammed H.A.Y. (2011). Dry Socket: Frequency, Clinical Picture, and Risk Factors in a Palestinian Dental Teaching Center. The Open Dentistry Journal. 5(1), 7-12. DOI: https://doi.org/10.2174/1874210601105010007
Eshghpour M., Rezaei N. M. & Nejat A. (2013). Effect of menstrual cycle on frequency of alveolar osteitis in women undergoing surgical removal of mandibular third molar: A single-blind randomized clinical trial. Journal of Oral and Maxillofacial Surgery. 71(9), 1484-1489. DOI: https://doi.org/10.1016/j.joms.2013.05.004
Bortoluzzi M.C., Capella D.L., Barbieri T., Marchetti S., Dresch C.P., & Tirello C. (2012). Does smoking increase the incidence of postoperative complications in simple exodontia? International Dental Journal. 62(2), 106-108. DOI: https://doi.org/10.1111/j.1875-595X.2011.00098.x
Sweet J.B. & Butler D.P. (2011). Smoking and localized osteitis. Journal of Oral and Maxillofacial Surgery. 69(12), 2945. DOI: https://doi.org/10.1016/j.joms.2011.09.020
Rosalin H. & Yosvimol K.R. (2017). Effectiveness of platelet-rich fibrin in the management of pain and delayed wound healing. European Journal of Dentistry. 11(4), 192-195.
Isik B.K., Gürses G. & Menziletoglu, D. (2018). Acutely infected teeth: to extract or not to extract? Brazilian Oral Research. 32, 3-7. DOI: https://doi.org/10.1590/1807-3107bor-2018.vol32.0124
Eshghpour M., Dastmalchi P., Nekooei A.H., & Nejat A. (2014). Effect of platelet-rich fibrin on frequency of alveolar osteitis following mandibular third molar surgery: A double-blinded randomized clinical trial. Journal of Oral and Maxillofacial Surgery. 72(8), 1463-1467. DOI: https://doi.org/10.1016/j.joms.2014.03.029
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Aram Sabr Saeed & Zanyar Mustafa Amin
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This work is licensed under 