What is the pathophysiology and clinical management of “Alveolitis” (Dry Socket) after tooth extraction?

Alveolitis (dry socket) is a condition in which the blood clot that should fill the extraction socket (alveolar socket) and initiate healing fails to form, is dislodged, or is destroyed by bacterial enzymes, leaving the jawbone directly exposed to the oral cavity after tooth extraction. This condition, which begins on the 3rd or 4th day after extraction, manifests with severe, throbbing pain radiating to the ear, and is accompanied by gray-brown necrotic tissue and a foul odor within the socket. Clinical management involves rinsing the socket area with sterile saline under local anesthesia to remove all food particles. Special antiseptic pastes containing clove oil (eugenol), which instantly relieve pain and stimulate tissue healing, or clot-forming spongiodic agents are then placed inside to ensure patient comfort, and periodic dressings are applied until the tissue closes from below.