Inspirational journeys

Follow the stories of academics and their research expeditions

Hypotheses related to pathogenesis of dry socket (alveolar osteitis)

Shishir Gazi

Thu, 13 Feb 2025


Etiology and Pathogenesis

Related to cascade of events after tooth extraction—

  • Liberation of plasmin, which contributes to fibrinolysis and activation of kinins
  • Localized infection due to lack of blood clot (absence or clot lysis soon after formation)

Other contributing factors

  • Bacteria—possible role of treponemes in clot degradation;
  • AO significantly more common in the context of poor oral hygiene
  • Trauma—local trauma at the extraction site activating inflammatory mediators
  • Smoking—two theories postulated
    • Negative pressure from sucking on cigarettes postulated to mechanically dislodge blood clots
    • Vasoconstriction mediated by nicotine
  • Medications—oral contraceptive pill usage linked to increased occurrence of AO mediated by increased
    fibrinolysis from reduced levels of plasminogen activator inhibitor
  • Anatomic—AO incidence greater after mandibular tooth extractions (especially third molars); theorized
    to result from greater vascularity predisposing to clot breakdown

Chow et al. Review of Current Concepts of AO. J Oral Maxillofac Surg 2020.

0 Comments

Leave a comment