A Prospective Case Series on the Effect of Cross-Linked Hyaluronic Acid Combined With a Collagen Sponge in the Treatment of Alveolar Osteitis.

OBJECTIVES: This case series reports on alveolar osteitis (AO) treatment outcomes after standard AO therapy combined with cross-linked hyaluronic acid (xHyA) and a collagen sponge. MATERIAL AND METHODS: Nine patients fulfilling the AO criteria after permanent tooth extraction were included. After standard AO treatment, that is, irrigation and curettage, a xHyA gel combined with an absorbable collagen sponge was applied into the socket and stabilized with a suture. Pain perception (visual analogue scale [VAS], pain killer consumption), soft tissue healing index (STHI), alveolar bone exposure, necessity of re-treatment, occurrence of complications, and patients' opinion were assessed up to 14 days post-treatment. RESULTS: Eight patients completed the 14-day follow-up, while one patient dropped out after 1 day due to persisting pain. Initial mean pain perception (VAS) was 7.5 (1.4), which decreased after a single treatment to 4.4 (2.2) within 6 h and by 50% (3.8 [2.4]) within 24 h. In 5 out of 8 patients, complete pain resolution was achieved after 14 days, while 3 patients still experienced moderate pain. Pain reduction was accompanied by an improvement of STHI, reaching 4.0 (0.8) within 14 days; complete coverage of exposed alveolar bone walls was already observed within 3 days in all 8 patients. Only one patient required re-treatment; 5 out of 8 patients expressed willingness to pay on top between 50 and 300€ for the material costs (xHyA+collagen sponge). CONCLUSIONS: A single application of xHyA combined with a collagen sponge offered effective and fast pain relief combined with a favorable healing process in patients suffering from AO. Furthermore, the need for re-treatment was infrequent, and favorable patient feedback was observed. However, randomized controlled trials with a sufficient sample size and a control group are essential to validate these findings.