he Survey of the Knowledge of Dry Socket and Management Among Dental Practitioners; Still Controversy?

Abstract

xodontia is a common procedure in Dentistry. Dry Socket (DS) is one of the delayed post-extraction complication, reported usually 2-4 days postoperatively with moderate to severe pain with the incidence of 0.5-5% in routine extractions.1-2 The name dry socket is used because blood clot is lost and covered by a green-grayish membrane. This term was first used in 1896 by Crawford.3 Since then, other terms have been used to describe dry socket: localized osteitis, alveolar osteitis (AO), fibrinolytic alveolitis, alveolitis sicca dolorosa, and localized osteomyelitis.4 Dry socket is dislodgment of clot with exposed intrasocket bone (denuded bone) as acute painful complication arising 72 hours postoperatively.5,6 Most of published data states that the incidence of dry socket is 1-5% for all routine dental extractions and up to 40% for impacted mandibular third molars.7-11 The incidence of dry socket is higher in the mandible than maxillae12, occurring up to 10 times more often for mandibular molars compared with maxillary molars because of dense bone.13 Clinically dry socket is characterized by severe throbbing pain, marked halitosis, foul odor, and greyish look. Several theories have been documented on the etiology of dry socket including bacterial infection, trauma, and biochemical agents.9 According to one theory, there is increased fibrinolytic activity and activation of plasminogen to plasmin in the presence of tissue activators in dry sockets.14 This fibrinolytic activity is thought to affect the in tegr i ty of the pos t -ext rac t ion b lood c lo t . 2 Microscopically, dry socket is characterized by the presence of inflammatory cellular infiltrate, with numerous 1. Faculty, Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, KSU, Riyadh. Former Assistant Professor, HoD, Oral Path, Oral & Maxillofacial Surgery Department, Dental Section, NMC, Multan. 2. Lecturer, Dental Health Department, College of Applied Medical Sciences, College of Dentistry, King Saud University, Riyadh. 3. Intern; College of Dentistry, King Saud University, Riyadh. 4. Intern; College of Dentistry, King Saud University, Riyadh. Corresponding author: “Dr. Naveed A. Khawaja” < nakhawaja@yahoo.com >