Evaluation of the incidence of alveolar osteitis following tooth extraction

Alveolar osteitis (AO) is the most common postoperative complication following tooth extraction and remains a significant clinical problem due to severe pain and delayed healing. This retrospective study aimed to evaluate the incidence of AO and analyze demographic, clinical, and procedural factors associated with its development in patients treated at a university-based oral and maxillofacial surgery clinic. Archival records of 35,266 tooth extractions performed between January 1, 2023, and July 11, 2025, were retrospectively reviewed. A total of 375 AO cases were identified and included in the analysis. Data regarding patient age, sex, systemic diseases, extraction region, number of extracted teeth, postoperative presentation time, smoking status, and seasonal distribution were recorded. AO cases were categorized into predefined groups, and statistical analyses were performed using chi-square tests, with the significance level set at p<0.05. The overall incidence of AO was 1.05%. AO occurred most frequently in patients aged 21–60 years (82.1%), with a significantly higher prevalence among female patients (58.84%) (p=0.002). Mandibular posterior teeth, particularly third molars, showed a significantly higher association with AO (p<0.001). Most patients presented ≥7 days postoperatively (66.96%). AO developed predominantly after single-tooth extractions (85.1%). Smoking was significantly associated with AO, with 65.4% of affected patients being smokers (p<0.001). No statistically significant seasonal variation was observed. AO was most frequently associated with mandibular molar extractions, female sex, smoking, and delayed postoperative presentation. Although the overall incidence was relatively low, AO remains a distressing complication because of its clinical burden. Identification of high-risk patients and reinforcement of postoperative instructions may contribute to early diagnosis and improved management outcomes.