Management of Dry Socket: New regenerative techniques emerge while old treatment prevails

Abstract

Objective: Although dry socket has been recognized for more than a century, its etiology is still poorly understood, and treatment approach is diverse with varying outcome. The aim of this review is to investigate, classify, summarize, and discuss the treatment of dry socket. Method: Four databases (PubMed, Science Direct, Scopus and Medline) were searched from April 2000 till April 2020 for articles featuring the key words: ‘dry socket’, OR ‘alveolar osteitis’, OR ‘post-extraction complication’, OR ‘treatment of dry socket’, OR ‘treatment of alveolar osteitis’, OR ‘treatment of pain following tooth extraction’. The Standard Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were adopted for data gathering. Results: A total of 3,857 results were found and 17 articles were finally selected and reviewed thoroughly. Treatment initiatives were categorized into empirical approach, conventional approach and regenerative strategies. 19 treatment products were identified. Earlier therapeutic approaches focus on pain control, infection prevention and resolving inflammation while current strategies modulate angiogenesis and granulation tissue formation. These latter armamentariums use blood-based products such as Platelet-Rich Plasma; employing laser and ultrasound technology that initiate and propagate tissue regeneration. Conclusion: While evidence support a regenerative approach for dry socket healing, the old treatment modality controlling infection, inflammation and pain prevails.

Keywords

• Dry socket
• Alveolar osteitis
• Dry socket remedies
• Platelet rich plasma
• regenerative approach
• Low level laser