The non-healing extraction socket: a diagnostic dilemma – case report and discussion

Statement of the problem: Delayed healing, or failure of the alveolus to heal post exodontia, is not an uncommon finding in both primary care and hospital practice. Local factors dominate and the majority of cases are the result of clot dissolution, secondary infection, foreign bodies, etc. However, potentially life-threatening, malignant lesions complicating healing can be overlooked and underestimated due to their rare occurrence.

Purpose of the review: This article presents a contemporary review of the normal physiological process that directs healing within the extraction socket and a differential diagnosis for delayed healing or failure of healing following extraction, with guidance on appropriate management.

Method: A case report of a squamous cell carcinoma presenting in the clinical setting of a non-healing extraction socket, and a discussion of local and systemic factors that may interfere with healing, are presented.

Conclusion: The aetiologies of delayed healing and failure of the extraction site to heal are diverse, and the process can be affected by local and systemic factors alike. Given that neoplastic lesions are relatively rare, it is therefore all the more important for GDPs to remain cognisant of the diagnostic red flags that may raise suspicions of a mitotic lesion to ensure that appropriate referral pathways are instituted.

Journal of the Irish Dental Association 2016; 62 (4): 215-220

Dr Cían J. Henry
BA BDentSc (Hons) DipPCD(RCSI) MFD(RCSI)
Senior House Officer, NCHD Department, Dental University Hospital, Lincoln Place, Dublin 2

Prof. Leo F.A. Stassen
FRCSI FDS RCS MA FTCD FFSEM FFD RCSI FICD
Professor/Chair Oral and Maxillofacial Surgery, TCD

Corresponding author: Dr Cían J. Henry, Senior House Officer, NCHD Department, Dublin Dental University Hospital, Lincoln Place, Dublin 2