Effects of Altitude and Relative Hypoxia on Post-extraction Socket Wound Healing: A Clinical Pilot Study

Background: Prolonged hypoxia is known to delay wound healing and in places of high altitudes, hypoxia is a major physiologic challenge. It is however yet to be seen if relative hypoxia in high altitude areas influences intraoral wound healing.

Aim: A prospective study aimed to evaluate the clinical pattern of healing of post-extraction socket wound following simple extraction in an established high altitude location.

Methodology: Thirty-one patients referred to oral surgery clinic for simple (intra-alveolar) exodontia were included in this study. The patients’ bio data, indications for extraction and the tooth or teeth to be extracted were documented on the day of treatment. Simple extractions were performed and patients given post-operative instructions without antibiotics prescription. They were subsequently assessed on days 3 and 7 post-extraction for alveoli wound healing. Data recorded were: presence or absence of pain, day of pain onset, duration of pain, type of healing complication and body temperature.

Results: Fifty-one extraction sockets were evaluated for alveoli healing during the course of the study. The mean age of the patients was 42.84±12.8 years and caries was the commonest indications for extraction. Out of these, 39 (76%) healed uneventfully, whereas 12 (24%) developed healing complications. Alveolar osteitis (dry socket) accounted for 9 (18%) and acutely infected alveoli 3 (6%) of the complications. Posterior teeth have the highest incidence of complications (67%). Pain in patients with alveolar osteitis lasted for more than 5 days whereas acutely infected alveoli presented with only mild pain, which lasted for not more than 3 days.

Conclusion: Uneventful healing occurred in most of the alveoli assessed. However, this was lower than what has been previously reported in the literatures. In addition, the 18% incidence of dry socket recorded in our study far exceeded what other previous studies observed in lowland regions. We can therefore conclude from this study that more complications of alveolar healing are more likely from high altitude areas.