Eugenol: A Definitive Solution for Dry Socket, Therapeutic Controversies Regarding the Iatrogenic Effects of Iodoform, and Implications for Implants

Due to the controversies arising from the heterogeneity of proposed treatments for dry socket and their dissent, there is no standard protocol, leading to confusion among dental professionals. We present a rare case of the introduction and compaction of iodine-based cement into a post-extraction dental alveolus with a dry socket refractory to iatrogenic treatment, followed by restoration with a dental implant. The formulations used for the treatment of dry sockets containing iodoform could impair tissue healing. Therefore, the cement inserted was excised and the alveolar cavity was cleaned. Basic therapy with eugenolated gauze, exchanged periodically for 40 days, was administered to an extreme case of alveolitis refractory to iodoform treatment, which delayed the healing of soft tissues and alveolar bone three times longer than usual. A dental implant was inserted three months later into this healed bone with very low density using a 15% reduced final surgical drill protocol. However, the success of bone healing and peri-implant tissue health was confirmed by clinical and radiographic follow-up of the dental crown on the implant subjected to masticatory loading for 18 months. The comprehensive treatment of DS to standardize a safe protocol remains a pending task for our scientific community. Nevertheless, we propose continuing specific lines of research on eugenolated gauze because it relieves pain in the first session and in less than two minutes, does not require complementary analgesic or anti-inflammatory medication, and does not interfere with or delay normal tissue healing, allowing for successful dental implant treatment, even in extremely refractory cases. Furthermore, because it is a classic medication, its availability, immediate availability, and affordability are guaranteed in all dental offices worldwide. However, clinical trials and comparative studies should be conducted in the future to validate this protocol.