Alveolar osteitis (AO; syn. dry socket) is one of the most frequent complications following tooth removal and it is defined as presence of severe postoperative pain in and around the extraction site, which increases in severity at any time between one and three days after extraction, accompanied by a partially or completely disintegrated blood cloth within the alveolar socket, with or without halitosis, and at the same time excluding any other cause for the pain (Blum 2002). To enhance standard treatment of AO, which consists of curettage of the dry socket, rinsing with saline solution, and inducing bleeding from the exposed alveolar bone walls, numerous products have been tested. One of them is hyaluronic acid (HY). The aim of the present study is to investigate the potential effect of HY gel application in the treatment of AO. Specifically, the application of HY only (HY test group; n = 20) or the combination of HY and an absorbable collagen sponge (HY+C test group; n = 20) will be compared to standard treatment (blood clot; control group, n=20). Clinical and patient related outcome parameters will be recorded for up to 14 days after treatment. A more stable blood clot and thus improved wound healing with faster pain reduction is expected through the use of HY.

Inclusion Criteria:

1. > 18 years;

2. Untreated AO after extraction of a permanent tooth (excluding wisdom teeth);

3. Diagnosis of AO based on the criteria of Blum (Blum 2002)

   Exclusion Criteria:

4. Patients with chronic diseases and/or taking any medication, influencing hard and soft tissue healing;

5. Pregnancy;

6. History of hypersensitivity or allergy to HY;

7. Inability to attend follow-up appointments; Intake of preoperative antibiotics.