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Oral Surgery · single question

Which statement about alveolar osteitis is NOT true?

  1. It typically presents 3–5 days after extraction
  2. It involves increased fibrinolytic activity in the socket
  3. Oral contraceptive use increases the risk
  4. The precise etiology is well established and easily identified in each case
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Correct answer: D. The precise etiology is well established and easily identified in each case

  • A. This IS true. Pain characteristically begins 3–5 days after extraction, after an initial period of improvement, and radiates to the ear with a foul odor and empty-looking socket.
  • B. This IS true. Plasmin-mediated FIBRINOLYSIS dissolves the clot, exposing bare bone — this is the accepted core mechanism.
  • C. This IS true. Estrogens increase fibrinolytic activity; the risk is highest during the first three weeks of the pill cycle, and scheduling extractions in the last week of the cycle reduces risk.
  • D. CORRECT — this is NOT true. The exact cause in an individual patient is usually NOT identifiable. Dry socket is a multifactorial condition with recognized risk factors but no single demonstrable cause in most cases — which is why prevention focuses on modifying risk factors rather than eliminating a specific agent.

Note: Classic exam trap: dry socket pain is DELAYED and worsening — an infection would have been painful from day one.

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