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