Introduction. Alveolar osteitis it is by far the most frequent painful complication of extraction. It is frequently unpredictable and without any obvious predisposing causes, but numerous possible etiological factors exist. Aim of the study. The objective is to define the condition known as alveolar osteitis and to critically review and discuss the etiology and pathogenesis of alveolar osteitis. In addition, the incidences of alveolar osteitis following third molar surgery using two different bone cutting methods: physio-dispenser and slow speed hand piece. Also the need for elimination of risk factors as well as the preventive and symptomatic management of the condition is discussed. Materials and methods.. Literature was selected through a search of PubMed, Embase electronic databases. The appropriate criteria of this study included the following: the patients were clearly diagnosed as having impacted mandibular third molars, the patients underwent physio-dispenser and slow speed hand piece surgeries, and the main complication was alveolar osteitis. They were divided in 2 groups according to the used technique. Most patients were recorded and investigated in a double-blinded manner, on the third and on the seven day after surgery for assessment of alveolitis. Results. Out of 100 scientific publications that were searched, were found only 5 relevant studies that compare the rotary system with the physio-dispenser surgeries. Alveolar osteitis is considered as typical post-extraction state and 97–100% cases were reported within a week of extraction. The summary of these indicate post-operative sequelae were insignificant in slow speed hand piece group. Beside the mode of cutting the bone the flap design, bone depth, irrigation during procedure, and medication; also play a major role in causing AO. Conclusions. In the current prospective study, was concluded that alveolar osteitis was not observed in the slow speed hand piece group, and was more effective with no complications as compared with physio-dispenser.