Alveolar osteitis (alveolitis, fibrinolytic alveolitis, osteomyelitis, dry alveolus, thrombus infection, etc.) is an inflammation of the open area of the alveolar bone (alveolar process of the upper or lower jaw). It is a classic complication after surgery to remove a tooth(s). It usually occurs when, after surgery, a cavity or defect remains in the gum. This leads to the fact that the acidic environment of the oral cavity begins to affect bone tissue, causing alveolar osteitis.
A fragment remains after tooth extraction: why does this happen?
A tooth is an integral organ that consists of a crown and root parts. If a root or splinter remains after tooth extraction, it means the tooth has lost its integrity. This occurs due to mechanical stress during removal. Tooth destruction during extraction occurs for a number of reasons.
- Doctor's mistake.
Lack of doctor qualifications is a fairly common cause of complications. Incorrect tooth extraction technique can lead to the destruction of even a relatively strong tooth. - Poor condition of the tooth root.
If the root of the tooth remains in the gum, this is often due to the fact that the root part was in poor condition, so when you try to remove it, the tooth literally breaks into two parts. - When removing a tooth,
the neighboring one was hit, and a fragment from it fell into the socket. This happens quite rarely, but it still happens. This situation is also a consequence of incorrect extraction technique.
Treatment of alveolar osteitis
Prophylactic antibiotics reduce the risk of alveolar osteitis, as well as relieve pain and reduce the risk of soft tissue infections.
If we are talking about treatment, it is usually symptomatic (for example, taking painkillers), and the dentist also removes debris from the nest by irrigation with saline solution or local anesthesia. Medicinal solutions can be placed in the exposed socket, but their use is limited due to severe pain.
People who experience alveolar osteitis often seek help from a doctor several times after surgery.
Moscow metro station Zvezdnaya, Danube Avenue, 23
Symptoms
This complication has very pronounced symptoms.
- Pain.
Many people perceive pain as a standard consequence of tooth extraction. This is partly logical, but over time the pain does not stop and only gets stronger. This is a clear sign of a complication. - Swelling and inflammatory process.
A tooth fragment injures soft tissues, causing swelling and inflammation. The longer you delay treatment, the stronger the inflammation. - A characteristic coating in the area of the hole.
Appears at a later stage, when the body tries to fight the inflammatory process. - Pus and bad breath.
A late stage complication that requires immediate intervention.
Restoration of bone tissue in periodontitis and periodontal disease
Almost every adult faces the problem of losing molars. The most common reason leading to tooth extraction is periodontitis (progressive destruction of the structure of the alveolar process of the jaw). This disease is very common; its initial signs (bleeding gums, exposure of the neck of the tooth) can be found in everyone after 40–50 years. Less common is periodontal disease, which develops in the absence of normal blood supply to the periodontal tissues. For example, with diabetes and atherosclerosis. Restoration of bone tissue during periodontitis or periodontal disease is required when atrophy of the bone tissue of the alveolar processes of the jaws occurs.
Complicating factors
The extraction procedure itself is ordinary and highly predictable, given the level of modern dentistry and the technological equipment of clinics. Nevertheless, even such manipulation has complications, especially if you take it lightly. It is worth taking into account that each clinical case is individual: if in one case tooth extraction is not very difficult, then in another the dental surgeon has to apply all his skills and use advanced technologies and equipment in treatment. It is no coincidence that the price lists of clinics include the item “Complicated tooth extraction”: you have to pay more for this service. Experts identify several factors that can lead to complications, including fragments in the socket.
- Wisdom teeth.
Because of their remoteness, default eights are quite difficult to remove. They often grow incorrectly or do not fully erupt, which increases the risk of complications during removal. - Retention.
A tooth that has not fully erupted, when only part of the crown is visible above the gum or is completely hidden in the soft tissues. - Dystopia.
The tooth erupts at the wrong degree and abuts its neighbors. - The tooth is severely damaged due to trauma.
In such a situation, when removed, it may crumble, and some of the fragments will remain in the hole.
Peptides for bone tissue restoration in dentistry
There are peptide bioregulators that specifically stimulate the regeneration of jaw bone tissue and promote bone formation. They are also called odontotropic regulatory peptides. Peptides for bone tissue restoration in dentistry are used both for treatment and for preventive purposes. First, you must definitely visit a dentist and, on his advice, choose a drug - balm, capsules or toothpaste. For example, Revidont toothpaste contains three types of peptide complexes (A-3, A-4, A-6) and superoxide dismutase. The therapeutic effect of the paste includes strengthening the structure of teeth, normalizing microcirculation in the oral cavity, restoring bone tissue and having an anti-inflammatory effect.
What to do if the tooth is not completely removed?
If a piece of a tooth or part of a root remains after removal, and the doctor did not notice it, then sooner or later the symptoms described above will appear. What to do if a tooth is pulled out and a fragment remains? First of all, there is no need to panic. A regular x-ray can detect the presence of foreign bodies, including remaining fragments. In most cases, tooth removal does not take much time and is performed using standard surgical techniques. If the case is complex, an incision of the mucosa may be required. Today there are advanced surgical treatment techniques, such as laser surgery. Thanks to this, in difficult cases it is possible to reduce the invasiveness of the intervention. Be that as it may, for a qualified dentist, coping with the complication will not pose any great difficulties. The main thing is to contact him in time.
Many people are interested in whether the tooth root can come out on its own. If after removal part of the root remains in the gum, then you definitely shouldn’t count on it. Sometimes a tooth fragment may come out on its own, but there is no need to hope for this either. Moreover, you should not try to remove a tooth fragment from the socket yourself. You will most likely hurt yourself even more. If you notice remains of a tooth in the hole, go to the doctor immediately.
Bone regeneration before implantation
Dental implant placement has become a common practice in modern dentistry. But it is not uncommon for a doctor to puzzle a patient with an unexpected proposal to first go through the process of restoring jaw bone tissue. Do not be upset if you are one of those patients who cannot have an implant installed immediately without bone grafting. And in no case should you look for doctors who will agree to follow your impatience and not carry out restoration of the jaw bone tissue - in the end this will end in even bigger problems.
Other situations
Sometimes after tooth extraction a phenomenon called ecostosis occurs. After tooth extraction, the edge of the gum settles, causing part of the bone to protrude to the surface. Many patients may mistake a piece of bone for a tooth fragment. Ecostosis can be easily eliminated using the usual grinding procedure, so there is practically nothing to worry about in this case. Sometimes part of the bone material may come out of the hole, which is replanted with the patient before implantation if the height and volume of the native bone is not enough. Sometimes small pieces of bone material may come out through the sutures, but this is also not considered a serious complication.
How is bone volume restored?
To restore the volume of bone tissue in a very thin area at the site of the dental alveolus, bone is split and the cavity is filled with bone tissue (an auto-, allo-, or synthetic graft is used). Then, after bone regeneration is complete, the implant itself can be installed. When it is necessary to increase the height of the bone, simultaneously with the implantation, bone tissue is increased with a special preparation that replaces it. A membrane coating is applied on top. The alveolar bone with various extension designs should heal and strengthen within 4–6 months, after which an artificial tooth (ceramic or metal-ceramic crown) can be installed.
To restore jaw bone tissue, an autogenous graft is used (bone is taken from the patient himself from another part of the jaw); allograft (donor bone is taken from another person) or synthetic materials that mimic bone (they contain calcium and phosphorus).
Some more tips
If you have the opportunity to choose a clinic where you can have teeth removed, then it is best to give preference to the paid option, since the quality of the services provided there is higher than in free clinics. However, it is best to look for reviews of other people on the Internet about a particular clinic; if the clinic has experience in performing dental operations, then there should be reviews about it.
Regardless of how well your molars are removed, you run the risk that periosteum will appear days or months later. Most often, the removal of the periosteum occurs quickly and without particularly severe pain. If you do not want to remove the periosteum surgically, then talk to your doctor about the possibility of an alternative option. Most likely, your doctor will suggest that you buy a special dental cream, thanks to which the periosteum will come out on its own within a few days of use.
Is it possible to restore bone tissue in osteoporosis?
Reduced bone density, or osteoporosis, is more common in women, especially postmenopausal and postpartum women, and in people of both sexes with hormonal imbalances. In such cases, you need to consult a therapist and endocrinologist and take prescribed medications. Restoration of bone tissue in osteoporosis is complicated by systemic reasons for its decrease throughout the human skeleton. However, modern technologies and materials used to restore bone during implantation make it possible to successfully implant new artificial teeth, saving patients from wearing removable dentures.
What does it lead to?
Many patients believe that atrophy is a completely harmless consequence of tooth loss. After all, visually this problem almost does not manifest itself at all. But that's not true. As the bone subsides, aesthetic defects in appearance arise and disturbances in the functioning of internal organs occur.
The most common consequences of decreased jaw bone volume are:
- change in appearance - an asymmetrical oval of the face appears, lips and cheeks seem to fall inward;
- a large number of wrinkles form in a short period of time;
- diction changes - the person becomes “lisp”;
- diseases of the gastrointestinal tract occur (this is due to poor quality of chewing food, swallowing large pieces);
- changes in bite, displacement of teeth adjacent to the atrophied area;
- impossibility of implantation without prior bone grafting.
