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Literature review

Non-healing extraction socket: a diagnostic challenge for general dental practitioners

British Dental Journal volume 237, pages 911–916 (2024)Cite this article

Abstract

Introduction In the UK, more than 18 million extractions are performed annually. Healing after extraction is often uneventful, but there are rare cases where weeks or months pass and an extraction socket does not heal.

Aim The aim of this study is to provide a review of cases in which a non-healing extraction socket is attributed to a serious systemic disease or malignancy, or an adverse consequence of systemic therapy.

Methods PubMed, Embase, Scopus, ProQuest and Google Scholar databases were searched using the term ‘non-healing extraction socket'. Results were subsequently restricted to humans and English language.

Results A total of 50 cases of non-healing extraction socket (28 women and 22 men with an average age of 55.2 years) were identified. The total number of extracted teeth was 71. Malignancy (primary and metastatic) was the most common definitive diagnosis, followed by medication-related osteonecrosis of the jaw.

Discussion There are cases in which an extraction socket does not show any sign of proper healing, even after a lengthy period. Some of these cases are caused by primary or metastatic cancer, or other serious disorders.

Conclusion Dentists should be vigilant when encountering a non-healing extraction socket, as this may herald an undiagnosed serious disease or malignancy.

Key points

  • Dental extraction is one of the most common surgical procedures and healing is often uncomplicated following it.

  • If healing is delayed, this is most commonly due to local causes, such as infection or a foreign body.

  • Prolonged delay in healing after extraction should prompt the patient to seek advice from their dentist as this may occasionally be caused by a serious disease or condition.

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Data availability

The research data associated with our paper are available within the reference list and can be accessed through online databases.

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Authors and Affiliations

  1. UCL Eastman Dental Institute, University College London, United Kingdom

    Abdouldaim Ukwas, Colin Hopper & Rachel Leeson

  2. Faculty of Dentistry, The Libyan International Medical University, Libya

    Ahmed Elbego & Mahmoud Albego

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  1. Abdouldaim Ukwas
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  2. Ahmed Elbego
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  3. Mahmoud Albego
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  4. Colin Hopper
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  5. Rachel Leeson
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Contributions

Abdouldaim Ukwas initiated the conception, designed the article, performed the search and wrote the manuscript. Ahmed Elbego and Mahmoud Albego were responsible for data extraction and analysis. Colin Hopper and Rachel Leeson reviewed the results, critically appraised the manuscript and updated to its final version

Corresponding author

Correspondence to Abdouldaim Ukwas.

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The authors declare no conflicts of interest.

Consent to publish was not required for Box 1 as details are from an already published case which is publicly available.

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Ukwas, A., Elbego, A., Albego, M. et al. Non-healing extraction socket: a diagnostic challenge for general dental practitioners. Br Dent J 237, 911–916 (2024). https://doi.org/10.1038/s41415-024-7895-5

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