Dry Socket

Question 1

What is expected normal healing?

Answer 1

Immediate: blood clot

1st week: granulation tissue

2nd week: epithelialisation, mature granulation tissue, bone resorption

3rd week: rounding alveolar crest, resorption socket wall, new bone, epithelial coverage

4th –> 1 year: new bone formation

Question 2

Factors lead to poor healing?

Answer 2

Smoking
Immunosuppression
Poorly controlled diabetes
Bone pathology 
Poor hygiene 
Previous radiotherapy

Question 3

What is a dry socket?

Answer 3

Alveolar osteisis = localised osteitis?

Question 4

What see in dry socket?

Answer 4

Severe pain - resistant analgesic
Foul taste and smell
Localised inflammation and tenderness
Partial or total loss clot

Question 5

What isn’t a dry socket?

Answer 5

Septic socket
Osteomyelitis
Osteonecrosis

Question 6

What is osteomyelitis?

Answer 6

Infection of cancellous bone

Question 7

Aetiology of dry socket?

Answer 7

Failure clot to form - poor blood supply/ smoking
Clot degradation
Clot loss
Bacterial colonisation

Question 8

What are pt risk factors for poor healing?

Answer 8

Female - OCP
Smoker
Failure comply POI
Age

Question 9

What are technical influence for poor healing?

Answer 9

Posterior mandibular teeth
Pre-existing infection
Traumatic XLA
Inappropriate irrigation

Question 10

Management of dry socket?

Answer 10

Prevent:

• salty mouth rinse
• avoid smoking 4 days

Therapeutic

• irrigate
• dress
• analgesia

Question 11

Are ab indicated dry socket?

Answer 11

Not usually

Question 12

What dress dry socket with?

Answer 12

Alvogyl

- LA, antiseptic and analgesic (eugenol)

Question 13

When suspect septic socket?

Answer 13

Symptom and evidence infection - swelling lymphadenopathy, formation pus

Question 14

Manage septic socket?

Answer 14

Dry socket +- ab (metro)

Question 15

What is osteomyelitis?

Answer 15

Infection cancellous bone

Question 16

Is osteomyelitis common?

Answer 16

Rare

Question 17

Management of osteomyelitis?

Answer 17

Ab and debridement - refer oFMS

Question 18

What see if pt has osteomyelitis?

Answer 18

Pain, altered sensation, pus, sinus formation

Question 19

What is osteoradionecrosis?

Answer 19

Damage to bone - necrosis due to endarteritis obliterates and previous damage to bone cell due to radiotherapy

Question 20

Management of osteoradionecrosis?

Answer 20

Remove teeth doubtful prognosis prior radiotherapy 
Maintain good OHI
Hyperbaric oxygen
Ab if infected
Debridement