Healing of surgical wounds in oral mucoperiosteal tissues

By Harrison JW.

Date: 06/1992
Journal: JOE

Summary:

-Periodontal wound healing studies are not directly applicable to endodontic surgery (differs in type of tissues injured and type of surgical wound inflicted).

– Regeneration: healing  by primary intention (wound edges are closely approximated, separated by thin clot), normal anatomy restored

– Repair: healing by secondary intention (wound edges are not approximated, formation of granulation tissue to bridge the hiatus), slower, scar formation.

Wound healing mechanism into 4 phases:

Clotting and inflammation: thin fibrin clot forms the initial seal, fast primary intention healing. Coagulum delays healing (secondary). Between flab and cortical bone (hematoma)

Epithelial healing: epithelial barrier (inhibits the loss of tissue fluids and strengthens the wound to be more resistant to separation)

Connective tissue healing: the wound site can be distinguished from normal mucoperiosteal tissue

Maturation and remodeling: change in the architecture of fibers to organized pattern -In periradicular surgery there are 3 types of wounding:

  – incisional

  – exisional

  – dissectional