Non-healing extraction socket: a diagnostic challenge for general dental practitioners

Introduction In the UK, more than 18 million extractions are performed annually. Healing after extraction is often uneventful, but there are rare cases where weeks or months pass and an extraction socket does not heal.Aim The aim of this study is to provide a review of cases in which a non-healing extraction socket is attributed to a serious systemic disease or malignancy, or an adverse consequence of systemic therapy.Methods PubMed, Embase, Scopus, ProQuest and Google Scholar databases were searched using the term 'non-healing extraction socket'. Results were subsequently restricted to humans and English language.Results A total of 50 cases of non-healing extraction socket (28 women and 22 men with an average age of 55.2 years) were identified. The total number of extracted teeth was 71. Malignancy (primary and metastatic) was the most common definitive diagnosis, followed by medication-related osteonecrosis of the jaw.Discussion There are cases in which an extraction socket does not show any sign of proper healing, even after a lengthy period. Some of these cases are caused by primary or metastatic cancer, or other serious disorders.Conclusion Dentists should be vigilant when encountering a non-healing extraction socket, as this may herald an undiagnosed serious disease or malignancy.