Healing of the socket of an extracted tooth under the conditions of the development of acute purulent alveolitis depending on local treatment

Abstract

The frequency of dry socket is approximately 3% for all routine extractions and can reach more than 30% during mandibular third molars. A wide range of factors of ecto- and endogenous origin influence the healing processes of the socket of the extracted tooth, and special attention should be paid to local treatment. The aim of the study was to compare the clinical course of the healing of the socket of the extracted tooth depending on the type of local treatment. 20 patients diagnosed with acute purulent dry socket were examined. Patients were divided into two groups of 10 people each. Patients of the first group (control) were injected with turundum with iodoform into the socket of the extracted tooth, and in the second group of patients, turundum moistened with a solution of dekasan was applied locally. A clinical examination of patients was carried out on the 1st, 3rd, 5th and 7th days after the start of treatment. Objectively, in 3 patients of the control group, at the beginning of the treatment, the presence of collateral edema in the submandibular and in the lower parts of the buccal areas was noted. Intraorally, swelling and hyperemia of the mucous membrane of the oral cavity in the area of the extracted tooth were noted in all patients, the holes were filled with grayish plaque, food residues and fragments of a destroyed blood clot, in 3 patients an empty hole with food residues was found. Among the objective clinical signs, no significant difference was noted with the patients of the research group, which is due to the fact that the treatment at this stage of observation has not yet been carried out. The use of turunda gauze moistened with dekasan for the local treatment of acute purulent dry socket, in contrast to the standard use of iodoform gauze drainage, contributed to the reduction of subjective symptoms, such as the presence of bad breath, a feeling of malaise, improved the dynamics of pain reduction and body temperature reduction to normal values compared to the control group. It should be noted that the dynamics of the presence of collateral edema of the soft tissues of the face did not differ significantly between the results of both clinical groups. However, the decrease in the limitation of mouth opening in the patients of the experimental group had more intensive dynamics.