Healing Of Oral Wounds Oral Pathology Essay Question And Answers

Healing Of Oral Wounds Important Notes

1. Types of healing
   • Healing by first Intention
     • Hero edges of the wound are approximated
     • The healing process is fast
   • Healing by secondary intention
     • There is tissue loss, wound edges cannot be apposed
     • The wound contracts to reduce in size, granulation tissue fills the wound and epithelisation occurs
     • This is healing by secondary intention
2. Factors affecting healing
   • Physical factors
     • Location of wound – wound in area with good vascular bed heals more rapidly
     • Immobilization – constant movement causes disruption of new connective tissue formation
     • Severe trauma – arrest rapid healing
     • Local temperature
       • Hyperthermia – accelerates healing
       • Hypothermia – delays healing
     • X-ray radiations
       • Low doses – stimulates healing
       • Large doses – suppresses healing
     • Anaemia – delays healing
     • Age of patient
       • Young patient – heals rapidly
       • Elder patient – healing is retarded
   • Nutritional factors – protein, vitamin deficiency delays healing
   • Hormonal factors – ACTH and cortisone inhibit the growth of granulation tissue formation
     • Diabetes mellitus – retards repair of wound
3. Types of biopsy
   • Incisional – removal of small piece for examination
   • Excisional – total excision of small lesion
4. Methods of biopsy
   • Surgical excision by scalpel
   • Surgical removal by cautery
   • Laser
   • Removal by biopsy forceps
   • Aspiration
   • Exfoliative cytology technique
5. Result of cytology smear
   • Class 1 – Normal – only normal cells are observed
   • Class 2 – Atypical – Presence of minor atypia
   • Class 3 – Indeterminate – Wider atypia, represents precancerous lesion
   • Class 4 – Suggestive of cancer – few malignant cells, many cells with borderline characteristics
   • Class 5 – positive for cancer – malignant cells present
6. Complications of fracture wounds
   • Delayed union
   • Fibrous union
   • Nonunion
   • Lack of calcification
7. Storage media for the preservation of teeth
   • Milk
   • Saliva
   • Saline
   • HBSS
   • Propolis
   • Viaspan
   • Coconut water
8. Types of oral implants
   • Endodontic
   • Endosseous
   • Subperiosteal

Healing Of Oral Wounds Short Question And Answers

Question 1. Write about healing of extraction wound and mention about its complications
Answer:

Healing of Extraction Wound

1. Immediate reaction
   • Coagulation of blood
   • Entrapment of RBC into fibrin mesh
   • Vasodilation and engorgement of blood vessels
   • Mobilization of leukocytes
   • Presence of areas of contraction of clot
2. First week
   • Growth of fibroblast into wound
   • Formation of granulation tissue
   • The proliferation of epithelium at the periphery
   • The osteoblastic activity of alveolar bone
   • Organization of blood clot
3. Second week
   • Penetration of new capillaries into centre of clot
   • Degeneration of remnants of PDL
   • Fraying of bony socket
   • Epithelium proliferation at periphery
   • Fragments of necrotic bone
4. Third week
   • Complete formation of granulation tissue
   • Presence of young trabeculae
   • Early bone formation
   • Remodeling of cortical bone
5. Fourth week
   • Bonefilling
   • Healing of crest of the bone

Read And Learn More: Oral Pathology Question And Answers

Healing of Extraction Wound Complications:

1. Dry socket
   • It is focal osteomyelitis of the tooth socket in which the blood clot has disintegrated or been lost
   • Clinical Features:
     • Loss of blood clot
     • Radiating pain
     • Foul odour
     • Metallic taste
2. Fibrous healing of extraction wound
   • Occurs when extraction is accompanied by loss of lingual and labial or buccal cortical plates and periosteum
   • It is asymptomatic
   • Treatment
     • Excision of lesion
     • Bony repair

Question 2. Dry socket
Answer:

Dry socket

It is focal osteomyelitis of the tooth socket in which the blood clot has disintegrated or been lost

Dry socket Etiology:

1. Bim’s hypothesis

2. Nitzan’s theory

• Suggests a relationship between the fibrinolytic activity of anaerobic bacteria and dry socket

Dry socket Predisposing Factors:

• Infection
• Decreased blood supply
• Debilitating conditions

Dry socket Clinical Features:

• Loss of blood clot
• Radiating pain
• Foul odour
• Metallic taste

Dry socket Management:

• Irrigation of socket
• Smoothening of bony margins
• Packing with pompom
• Analgesics
• Hot saline mouth bath
• Chemical cauterization
• Regular follow up

Dry socket Prevention:

• Doing extraction gently
• Instruct the patient not to rinse for 24 hours
• Prescribe vitamin B complex and vitamin C

Question 3. Exfoliative cytology
Answer:

Exfoliative cytology

Exfoliaive cytology is introduced by Papanicolaou and Traunt

Exfoliative cytology Indications:

• Herpes simplex
• Herpes zoster
• Pemphigus vulgaris
• Pemphigoid
• Squamous cell carcinoma
• Aphthous ulcer
• Candidiasis

Exfoliative cytology Technique:

Exfoliative cytology Results:

Question 4. Factors affecting healing of oral wound
Answer:

Factors affecting healing of oral wound

1. Age
   • Faster healing occurs in younger individuals compared to older individuals
2. Type of tissue
   • Fast healing occurs in epithelial tissues
   • Delayed healing in neural tissues
3. Location of wound
   • Good vascular area- fast healing
4. Mobility of wound
   • Movement of the site of wound delays healing
5. Trauma
   • Mild trauma- fast healing
   • Severe trauma- retards healing
6. Local temperature
   • High temperature- Fast healing
   • Low temperature- delay healing
7. Radiation
   • Low dose- stimulates healing
   • High dose- Retards healing
8. Nutritional factors
   • Nutritional deficiency- delays healing
   • Vitamins and proteins- speeds up healing
9. Infections
   • Low-grade infection- stimulates healing
   • Severe infections- interfere with healing
10. Hormonal factors
    • Trephones- accelerate healing
    • ACTH, cortisone- delays healing

Question 5. Healing of fractured wound
Answer:

Healing of fractured wound

• Bleeding occurs immediately at the site of the fracture, hematoma is formed which is converted into blood clot
• Stages of healing
• Stage 1 – formation of fibrous callus
  • The proliferation of fibroblasts and endothelial cells in the bone marrow as periosteum
  • These cells enter the fracture site and organise the clot
  • Development of edema
  • Inflammatory cell infiltration
  • Removal of necrotic cells, connective tissue, and bone fragments from fracture site by phagocytosis, proteolysis and osteolysis
  • Replacement of clot by granulation tissue
  • Formation of fibrous callus at fracture site
• Stage 2 – Formation of primary bone callus
  • Replacement of fibrous callus by immature bone
  • Formation of primary bone callus
  • Fibrous and primary bone callus binds the fracture fragments of bone together
• Stage 3 – Formation of secondary bone callus
  • Replacement of primary bone callus by mature bone
  • Remodelling of secondary callus by resorption
  • Restoration of normal jaw outline

Question 6. Biopsy
(or)
Types of biopsy
Answer:

Biopsy

It is the removal of part of tissue for the purpose of histological examination and analysis

Types of biopsy

Question 7. Complications of wound healing
Answer:

Complications of wound healing

1. Infection
   • Wounds provide portal of entry to microorganisms and result in infection
2. Keloid and hypertrophic scar formation
   • Keloids are overgrown scar tissues
   • Hypertrophic scars are more cellular and vascular
3. Hypopigmented or hyperpigmented areas
4. Cicatrization
   • It refers to late reduction in the size of scar
5. Implantation cyst
   • Epithelial cells may get entrapped in the wound and proliferate to form cyst

Question 8. Reimplantation
Answer:

Reimplantation

Reimplantation Replantation refers to the insertion of a vital or nonvital tooth into the same alveolar socket from which it was removed

Reimplantation Indications:

• Broken instruments in canals
• Presence of foreign body In periapical tissue
• Tooth apex present in close proximity to nerve and vessels
• Nonaccessible areas
• Persistent chronic pain
• Accidental avulsion of tooth

Reimplantation Contraindications:

• Medically compromised
• Periodontal involvement
• Missing buccal/lingual plate
• Nonrestorable tooth

Reimplantation Technique:

Question 9. Complications of healing of extraction socket
Answer:

Complications of healing of extraction socket

1. Dry socket
   • It is focal osteomyelitis of the tooth socket In which the blood clot has disintegrated or been lost
   • Clinical features
     • Posh of blood dot
     • Radiating pain
     • Foul odour
     • Metallic taste
2. Fibrous healing of extraction socket
   • Occurs when extraction Is accompanied by loss of lingual or buccal cortical plates and periosteum
   • It is asymptomatic

 

Healing Of Oral Wounds Viva Voce

1. Healing refers to the replacement of damaged tissue by living tissue to restore function
2. Replacement of lost tissue by granulation tissue is called repair
3. Cicatrization refers to late reduction in the size of scar
4. Biopsy refers to removal of tissue from a living organism for the purpose of microscopic examination and diagnosis
5. Granulation tissue formation occurs in healing by secondary intention
6. Exfoliative cytology is the study of cells that exfoliate or abraded from body surfaces
7. Replantation refers to the insertion of a vital or nonvital tooth into same alveolar socket from which it was removed or lost
8. Dry socket is most common and painful complication in the healing of extraction wound
9. Implants are any foreign material fixed or inserted into body tissue
10. Osseointegration is a direct structural and functional connection between ordered living bone and the surface of a load-carrying implant