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DR.K.THANGAVELU
DRY SOCKET IS A COMPLICATION OF TOOTH EXTRACTION IT IS A PAINFUL CONDITION WHICH OCCURS RD MOLAR MOSTLY AFTER LOWER3
EXTRACTION DUE TO
TRAUMATIC EXTRACTION
IT IS CHARACTERISED BY SEVERE PAIN IN AND AROUND THE EXTRACTION SITE USUALLY STARTS ON THE 2 4 POSTOPERATIVE DAY AND CAN LAST FOR 10 40 DAYS.
THE PAIN IS USUALLY DESCRIBED AS A THROBBING ACHE AND IS CAUSED BY CHEMICAL AND THERMAL IRRITATION OF THE EXPOSED NERVE ENDINGS IN THE PERIODONTAL LIGAMENT AND ALVEOLAR BONE.
PAIN RADIATES TO THE EAR AND TEMPORAL REGION. POST-EXTRACTION BLOOD CLOT IS ABSENT IN THE TOOTH SOCKET;
INITIALLY THE CLOT HAS A DIRTY GRAY APPEARANCE AND THEN IT DISINTEGRATES,
DRY SOCKET IS THE MOST COMMON CAUSE OF DELAYED POST EXTRACTION PAIN.
DRY SOCKET, ALSO KNOWN AS 1.DENTO-ALVEOLAR OSTEITIS, 2.ALVEOLAR OSTEITIS, 3.ALVEOLITIS, 4.FOCAL OSTEOMYELITIS WITHOUT SUPPURATION,
7.ALVEOLAR PERIOSTITIS,
THE CONDITION ARISES AS A RESULT OF A COMPLEX INTERACTION BETWEEN SURGICAL TRAUMA, LOCAL BACTERIAL INFECTION AND VARIOUS SYSTEMIC FACTORS
1.TRAUMATIC EXRACTION RELEASE TISSUE ACTVATORS NEAR MARGINS OF SOCKET WHICH CONVERTS PLASMINOGE TO PLASMIN WHICH IS RESPONSIBLE FOR PRODUCTION OF DRY SOCKET AND PAIN
PATHOGENESIS
FOLLOWING TRAUMA AND INFECTION , INFLAMMATION OF BONE MARROW OCCURS WHICH RESULTS IN RELEASE OF TISSUE ACTIVATORS WHICH CONVERTS PLASMINOGEN IN THE CLOT TO PLASMIN
PLASMIN CAUSES LYSIS OF BLOOD CLOT PLASMIN RELEASES KININ FROM KININOGEN WHICH IS ALSO PRESENT IN THE CLOT KININ IS RESPONSIBLE FOR SEVERE PAIN
2.TRAUMA TO ALVEOLAR BONE REDUCE RESISTANCE TO INFECTION WHICH CAUSE DRY SOCKET(BirnS theory) 3. PRIOR INFECTION,
THE DIAGNOSIS IS CONFIRMED BY GENTLY PASSING A BLUNT INSTRUMENT INTO THE SOCKET
INSTRUMENT FINDS NO RESISTANCE IN EMPTY SOCKET WHEN CLOT IS PRESENT PASSAGE OF INSTRUMENT IS PREVENTED BY CLOT.
TREATMENT
SOCKET SHOULD BE
STERILE GAUZE TO THE SIZE OF SOCKET IS DIPPED IN EUGENOL AND PLACED INSIDE THE SOCKET
THE DRESSING PREVENTS THE ACCUMULATION OF FOOD DEBRIS IN THE EXTRACTION SOCKET, PROTECTS THE EXPOSED BONE FROM LOCAL IRRITATION AND CALMS DOWN THE INFLAMMATIONINFECTION WITHIN THE EXTRACTION SOCKET WALLS.
DRUGS TO BE PRESCRIBED
METRANIDAZOLE 400MG
FOR 3 DAYS
END