Brin's Hypothesis of Dry Socket

Brin's Hypothesis suggest that,"Alveolar ostitis occurs when fibrinolysis or other proteolytic activity in and around the alveolus is capable of destroying blood clot."

Partial or complete lysis and destruction of the blood clot was caused by tissue kinases liberated during inflammation by a direct or indirect activation of plasminogen in the blood.

There are multiple plasminogen activators;

  1. Direct Activators

          a. Intrinsic: Factor XIIa dependent activators, Urokinase
          b. Extrinsic: Tissue Plasminogen activators (TPA), Endothelial Plasminogen activators (EPA)

2. Indirect Activators(Produced by bacteria)
          - Streptokinase
          - Staphylokinase

Fibrinolytic pathway





Pain in Dry socket in and around the alveolus is a cardinal sign that is sharp, severe, excurciating, increases in intersity somewhere between 3-5 days and is usually associated with foul breath. Brin also explained the cause of pain in dry socket by kinin pathway.

Factor XXI -- XIIa --> prekallikrein activator --> activated prekallikrein to kallikrein --> which further changes kinninogen to bradykinin --> activates peripheral free nerve endings which were presensitized by other inflammatory mediators (nociceptors).



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Comments

  1. Renee YurovskyAugust 2, 2021 at 3:22 PM

    Thanks for taking the time to share this informative information with us. I enjoyed going over all the details that you provided in this article. Have a great day and keep up the wonderful work.
    Dentist Center City Philadelphia

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