Dry Socket Flashcards
(20 cards)
What is expected normal healing?
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
Factors lead to poor healing?
Smoking Immunosuppression Poorly controlled diabetes Bone pathology Poor hygiene Previous radiotherapy
What is a dry socket?
Alveolar osteisis = localised osteitis?
What see in dry socket?
Severe pain - resistant analgesic
Foul taste and smell
Localised inflammation and tenderness
Partial or total loss clot
What isn’t a dry socket?
Septic socket
Osteomyelitis
Osteonecrosis
What is osteomyelitis?
Infection of cancellous bone
Aetiology of dry socket?
Failure clot to form - poor blood supply/ smoking
Clot degradation
Clot loss
Bacterial colonisation
What are pt risk factors for poor healing?
Female - OCP
Smoker
Failure comply POI
Age
What are technical influence for poor healing?
Posterior mandibular teeth
Pre-existing infection
Traumatic XLA
Inappropriate irrigation
Management of dry socket?
Prevent:
- salty mouth rinse
- avoid smoking 4 days
Therapeutic
- irrigate
- dress
- analgesia
Are ab indicated dry socket?
Not usually
What dress dry socket with?
Alvogyl
- LA, antiseptic and analgesic (eugenol)
When suspect septic socket?
Symptom and evidence infection - swelling lymphadenopathy, formation pus
Manage septic socket?
Dry socket +- ab (metro)
What is osteomyelitis?
Infection cancellous bone
Is osteomyelitis common?
Rare
Management of osteomyelitis?
Ab and debridement - refer oFMS
What see if pt has osteomyelitis?
Pain, altered sensation, pus, sinus formation
What is osteoradionecrosis?
Damage to bone - necrosis due to endarteritis obliterates and previous damage to bone cell due to radiotherapy
Management of osteoradionecrosis?
Remove teeth doubtful prognosis prior radiotherapy Maintain good OHI Hyperbaric oxygen Ab if infected Debridement
