The Effect of Terra-Cortril as Local Pain Medication on the Healing Process of a Fresh Extraction Socket: A Retrospective Cohort Study

Abstract

(1) Background: Use of Terra-Cortril may reduce pain and discomfort after tooth extraction. It is widely used among dentists, especially for third molar extraction and for treatment of dry socket. Only few case reports described unsuccessful healing with formation of myospherulosis. (2) Aim: The primary objective of this retrospective cohort study was to compare the occurrence of unsuccessful healing between extraction sockets locally treated with Terra-Cortril (TC) (exposure cohort) and extraction sockets subjected to unassisted healing (non-exposure cohort). The assessment of the three-dimensional morphology of the bone was a secondary objective. (3) Material and methods: The records of patients who had one or more extractions between 1 January 2020 and 1 July 2021 followed by implant placement in one private practice were retrieved and data were extracted. At the time of implant placement, practitioners established, both clinically and radiographically, if the healing was successful or unsuccessful. Explanatory demographic as well as clinical variables were extracted from patient files, checked and supplemented by contacting patients in cases of missing data. (4) Results: 69 patients were included who had, in total, 99 extractions. The exposure cohort included 55 sites, while the non-exposure cohort included 44 sites. A total of 56 sites demonstrated successful healing, and 53 showed unsuccessful healing. The regression model identified TC as a significant predictor (p = 0.014) for unsuccessful healing with an odds ratio of 2.86. Sites treated with Terra-Cortril had a significantly greater bone defect at level -1 mm, level -3 mm, and level -5 mm from the bone crest, and significantly greater maximal vertical and horizontal bone defects. At sites where Terra-Cortril was used, significantly more surgical consequences were reported (70.91% vs. 18.18%, p < 0.001). (5) Conclusions: fresh extraction sockets treated with Terra-Cortril increased the likelihood of unsuccessful healing with an odds ratio of 2.86. The greater defect size leads to significantly more limitations when planning implants at sites previously treated with TC.

Keywords: Terra-Cortril; extraction socket; implant; pain medication; socket healing; wound healing.

Figure 1

Flowchart of selection procedure.

Figure 2

Clinical view of 5 cases with incomplete healing with black, tar-like substance in the socket and corresponding CBCT cross-sectional image (see pictures below) after the use of Terra-Cortril.

Figure 3

The cross-sectional CBCT slide pertaining to the center of the extracted root(s) were selected for measurement. First, most coronal bone was identified with a line perpendicular to the long axis of the lingual bone (blue line). Then, 4 lines were constructed perpendicular to this axis at the following levels: −1 mm apical to the most coronal bone line (L1), −3 mm apical to the most coronal bone line (L3), −5 mm apical to the most coronal bone line (L5), and −7 mm apical to the most coronal bone line (L7). Vmax is the distance from L0 to the most apical part of the defect (green line).

Figure 4

Bar chart visualizing TC vs. healing outcome.