Acute alveolar osteitis: Difference between revisions
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==Background== | ==Background== | ||
*Also known as "Dry socket" | *Osteomyelitis of exposed bone. Also known as "Dry socket" | ||
*Caused by premature loss of healing clot in the alveolar socket after tooth extraction<ref>Kolokythas A, Olech E, Miloro M. Alveolar Osteitis: A Comprehensive Review of Concepts and Controversies. International Journal of Dentistry. 2010; 2010: 249073. doi:10.1155/2010/249073 </ref> | *Caused by premature loss of healing clot in the alveolar socket after tooth extraction<ref>Kolokythas A, Olech E, Miloro M. Alveolar Osteitis: A Comprehensive Review of Concepts and Controversies. International Journal of Dentistry. 2010; 2010: 249073. doi:10.1155/2010/249073 </ref> | ||
*Occurs 2-4d after tooth extraction | *Occurs 2-4d after tooth extraction | ||
*Initial post-extraction pain subsides followed by sudden/severe pain at extraction site | *Initial post-extraction pain subsides followed by sudden/severe pain at extraction site | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:DrySocket.jpg|thumb|Acute alveolar osteitis of a socket after tooth extraction of all maxillary teeth; note lack of blood clot in socket and exposed alveolar bone.]] | |||
[[File:Alveolar osteitis labeled dry socket.jpg|thumb|The most common location of acute alveolar osteitis: in the socket of an extracted mandibular third molar (wisdom tooth).]] | |||
[[File:drysocket.jpg|thumb|Dry socket]] | |||
*Postoperative pain at site of recent tooth extraction | *Postoperative pain at site of recent tooth extraction | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{ | {{Dental Problems DDX}} | ||
==Evaluation== | ==Evaluation== | ||
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==Management== | ==Management== | ||
*Analgesia (often requires dental block) | *[[Analgesia]] (often requires dental block) | ||
*Irrigate but socket should not be curetted and any residual clot should not be removed | *Irrigate but socket should not be curetted and any residual clot should not be removed | ||
*Pack with iodoform ribbon gauze soaked with eugenol (oil of cloves) or local anesthetic | *Pack with iodoform ribbon gauze soaked with eugenol (oil of cloves) or local anesthetic | ||
Latest revision as of 21:01, 2 December 2021
Background
- Osteomyelitis of exposed bone. Also known as "Dry socket"
- Caused by premature loss of healing clot in the alveolar socket after tooth extraction[1]
- Occurs 2-4d after tooth extraction
- Initial post-extraction pain subsides followed by sudden/severe pain at extraction site
Clinical Features
- Postoperative pain at site of recent tooth extraction
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Evaluation
- Clinical diagnosis
- Exposed bone with no clot in extraction site
Management
- Analgesia (often requires dental block)
- Irrigate but socket should not be curetted and any residual clot should not be removed
- Pack with iodoform ribbon gauze soaked with eugenol (oil of cloves) or local anesthetic
- If available, may use commercially available "dry socket paste"
- Penicillin VK 500mg PO QID OR clindamycin 300mg PO QID
Disposition
- Discharge with dental follow-up within 24 hours
See Also
References
- ↑ Kolokythas A, Olech E, Miloro M. Alveolar Osteitis: A Comprehensive Review of Concepts and Controversies. International Journal of Dentistry. 2010; 2010: 249073. doi:10.1155/2010/249073