Journal of Dental Medicine

Background and Aims: Dry socket is one of the most common post-tooth-extraction complications. The aim of this study was to investigate the relationship between some of the predisposing factors of dry socket and this complication in all maxillary and mandibular molars and evaluation of its incidence. Furthermore, the two jaws were compared.
Materials and Methods: In this descriptive-analytical cross-sectional study, 150 patients were examined in 2020 in the city of Zahedan. A questionnaire consisting of two sections was designed: In the first section age, gender, systemic disease, smoking status, contraceptive pill consumption, and antibiotic consumption were investigated. In the second section, data related to the difficulty of surgery based on the duration of surgery and the number of local anesthetic cartridges that were administered were collected. Then, the collected data were analyzed by Chi-square and Kruskal-Wallis tests.
Results: The incidence of dry socket was 25.3%. The frequency of dry socket was significantly relevant to smoking, oral contraceptive consumption, difficulty of the surgery, and the number of local anesthetic cartridges that were administered (P≤0.05). Age, gender, controlled systemic disorder, and systemic antibiotic usage for two weeks prior to surgery revealed no significant associations with dry socket (P>0.05). Furthermore, the frequency of dry socket in maxillary and mandibular jaws had a significant difference according to smoking status, difficulty of surgery, and number of local anesthetics carpules (P≤0.05).
Conclusion: It is recommended to identify high-risk groups when performing extraction to consider pre-operative and post-operative measures in order to reduce postoperative complications.

Background and Aims: Dry socket is one of the most common complications following dental surgery. Therefore, effective prevention of dry socket can significantly improve patient recovery after tooth extraction. The aim of this study was to evaluate the effect of tranexamic acid combined with a Gelfoam carrier on the prevention of dry socket following surgical removal of impacted mandibular third molars.
Materials and Methods: This parallel randomized clinical trial was conducted in 2023 on 72 patients (40 in the intervention group and 32 in the control group) at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Islamic Azad University, Tehran Unit. In the intervention group, 250 mg of tranexamic acid powder was placed into the extraction socket and covered with Gelfoam, whereas the control group received sterile gauze only. The diagnosis of dry socket was made 2–3 days postoperatively by an independent surgeon. Statistical analysis was performed using the chi-square test, likelihood ratio, and Fisher’s exact test, with a significance level set at P<0.05.
Results: The incidence of dry socket was 7.5% in the intervention group and 34.4% in the control group. All statistical tests demonstrated a significant reduction in the occurrence of dry socket in the intervention group (P≤0.005). These findings are consistent with the physiological mechanism of tranexamic acid in inhibiting fibrinolysis and stabilizing the blood clot, resulting in a marked reduction compared with the control group.
Conclusion: Topical application of the tranexamic acid in combination with Gelfoam following extraction of impacted third molars is an effective, simple, and cost-effective method for the prevention of dry socket. For broader clinical recommendation, further studies with larger sample sizes, comparisons with existing standard preventive methods, and longer follow-up periods are suggested.