The use of hyaluronic and aminocaproic acid in the treatment of alveolar osteitis

Abstract

Background/Aim. Alveolar osteitis (AO), also known as "dry socket", is relatively common post-extraction complication. It probably occurs due to excessive fibrinolytic activity in the coagulum and is characterized by intense pain sensations. The aim of this clinical study was to examine the role of hyaluronic acid and aminocaproic acid in the treatment of AO. Methods. The study included 60 patients with the clinical diagnosis of AO. All the patients were divided into two groups of 30 patients each according to the applied non-pharmacological measure: irrigation - irrigation of dry socket with sterile saline; curettage - careful curettage. Both of these groups were further divided into three subgroups regarding the applied treatment (hyaluronic acid; hyaluronic acid + aminocaproic acid; Alvogyl®, an anesthetic and antiseptic paste), each with 10 patients, according to the following protocol: 0.2 mL of hyaluronic acid in the form of a 0.8% gel; 2 mL of aminocaproic acid and hyaluronic acid; Alvogyl®. During each visit, scheduled for every two days until complete absence of painful sensations, the patients had the therapeutic method repeated as at the first examination. At each control visit the number of present symptoms and signs of AO was recorded, as well as the level of pain (measured with a visual analogue scale). Results. With the use of hyaluronic acid, with or without aminocaproic one, a statistically significantly faster reduction in pain sensations was achieved, along with the reduction in the number of symptoms and signs of AO compared to the use of Alvogyl®. Conclusion. Hyaluronic acid, applied alone or in combination with aminocaproic acid significantly reduces pain sensation, thus it can be successfully used in the treatment of AO.

Uvod/Cilj. Alveolitis je relativno česta postekstrakciona komplikacija. Nastaje, najverovatnije, usled izrazite fibrinolitičke aktivnosti u koagulumu, a karakteriše se pojavom intezivnog bola. Cilj ove kliničke studije bio je da se ispita mogućnost primene hijaluronske i aminokapronske kiseline u terapiji alveolitisa. Metode. Studija je uključila 60 pacijenata sa kliničkom dijagnozom alveolitisa. U odnosu na primenjenu nefarmakološku meru svi pacijenti su bili podeljeni u dve grupe sa po 30 pacijenata: ispiranje - ispiranje obolele alveole sterilnim fiziološkim rastvorom; kiretaža - pažljiva kiretaža. Obe ove grupe, u odnosu na primenjeni tretman [(hijaluronska kiselina, hijaluronska kiselina + aminokapronska kiselina, Alvogyl® (kombinacija anestetika i antiseptika u obliku paste)], bile su podeljene u tri podgrupe sa po 10 pacijenata po sledećem protokolu: 0,2 mL hijaluronske kiseline u obliku 0.8% gela; 2 mL aminokapronske kiseline i hijaluronske kiseline; Alvogyl®. Na kontrolnim pregledima, zakazanim na svaka dva dana do potpunog prestanka bolnih senzacija, pacijentima je ponavljana terapijska opcija sa prvog pregleda. Evidentiran je broj prisutnih simptoma i znakova alveolitisa kod pacijenata, kao i nivo bola (meren pomoću vizuelno-analogne skale). Rezultati. Primenom hijaluronske kiseline, sa ili bez aminokapronske kiseline, postignuto je statistički značajno brže sniženje bolnih senzacija kao i smanjenje broja prisutnih simptoma i znakova alveolitisa u odnosu na upotrebu Alvogyl®-a. Zaključak. Hijaluroska kiselina, samostalno ili u kombinaciji sa aminokapronskom kiselinom, značajno snižava bol, te se može uspešno primenjivati u terapiji alveolitisa.