Tuesday 24 June 2014

Extraction Socket Healing

Tissue taken from a socket 3 days after tooth extraction was comprised of a fibrin clot
partially infiltrated with inflammatory cells, which were loosely organized and very
fragile. In another sample, tissue taken from a 1-week-old extraction socket
was found to be composed of degenerating fibrin and early granulation tissue


fibrin clot----Granulation tissue----organize into----collagen plug[1 month]----plug increase in density---replaced from the apex and the periphery---by bone deposition



After the development of a fibrin clot, the tissue becomes granulation tissue, which
contains blood vessels, fibroblasts, and chronic inflammatory cells. The granulation
tissue eventually matures into a collagen plug. For example, the authors found that, after
1 month, tissue removed from the center of the extraction site was composed of fibrous
connective tissue and fibroblasts with some remaining inflammatory cells.The
buccal wall and alveolar crest was resorbing with associated gingival collapse and loss of
interdental papilla. The socket enlarged to the buccal, and bone on the buccal alveolar
surface, and alveolar crest resorbed in the area of the extraction site. In this
patient, tooth extraction precipitated a generalized resorptive response in the alveolar
bone.


In tissue samples of the periphery of the soft tissue removed from extraction sockets, new 
bone formation occurred on the old necrotic bone of the original socket wall. 
However, in the same socket, necrotic bone was set free from the underlying vital bone 
and was sloughed into the socket to be expelled as bone sequestra . The  bone of the original socket wall dies and is undermined by osteoclastic resorption. This necrotic bone can form a nidus for new bone growth, or the necrotic bone can be expelled from the socket as bone sequestra. A portion of the old socket wall will form new bone on its surfaces and will become incorporated into bone forming in the extraction socket. However, a significant portion of the old socket wall will be undermined, become 
necrotic, and be sloughed into the oral cavity through the extraction socket orifice.



If the first stage of extraction-socket healing is resorption and disposal of necrotic bone,
then this would explain why tooth extraction in patients on bisphosphonates occasionally
leads to osteonecrosis. The bisphosphonates prevent osteoclastic undermining and disposal of necrotic bone lining the socket wall. The inability of the alveolus to dispose of the necrotic bone lining the socket wall could then lead to progressive osteonecrosis

Even with modern antibiotics, osteomyelitis and osteonecrosis are major medical
challenges. To prevent osteomyelitis and osteonecrosis, bone mounts an inflammatory
response to protect the host.After extraction, a significant amount of bone is sacrificed
by the body, but the host survives.However, with proper treatment, our findings
indicate the resorptive, clotting, granulation, and collagen phases of healing can be
skipped, and the extraction socket can proceed directly from extraction to regeneration.


To skip the negative phases of extraction-socket healing, a biocompatible material must
be placed in the socket after extraction. However, to avoid the resorptive phase of
healing, the graft material should not require resorption before bone formation. The graft
material should be biocompatible, inhibit bone resorption, and stimulate osteogenesis.
Also, to limit bone resorption on the buccal, lingual, and crestal bone surfaces, gingival
flaps that expose this bone should not be raised during placement of the graft material.

The drug component in Socket Graft stimulates osteoblasts and inhibits osteoclasts and
phagocytes. As the calcium phosphate based component of the bone graft is replaced by
bone, the drug component enters the osteoblasts, stimulating osteogenesis. The drug
component is retained by the osteoblast and continues to stimulate osteogenesis after the
calcium phosphate portion of the graft material has been converted into bone

12 comments:

Thanks for a wonderful share. Your article has proved your hard work and experience you have got in this field. Brilliant .i love it reading.
best dental clinic SE Calgary
SE Calgary dentist near me
SE Calgary dentist
dental clinic SE Calgary
same day dentist SE Calgary

Awesome – that’s what I was looking for ;) Keep up the great work! I’ve been waiting patiently for your next blog entry! ;)

Best Dental Clinic in Dubai

Best Dentist in Dubai

Dental Clinic in Dubai

Dental implant in Dubai

Dentist in Dubai

This comment has been removed by the author.

Informative article, Thank you for sharing the content with us. It was very useful. good luck. For any Dental queries kindly visit https://www.rajkumarsdentistry.in/

DENTX ACADEMY, the institution with a unique curriculum and fusion of the best practices in Dental and Medical Sciences in association with LINCOLN UNIVERSITY (Malaysia). It is our everlasting passion that has driven us towards training our students with unsurpassed skills in Clinical, Academic and Research domains.
We believe that our ultimate success would be to see our students become strong confident successful professionals who not only treat their patients with perfection but also have an endless passion and dedication towards the profession.
dental webinars in India

Thanks for sharing this useful information
lady gynacologist near me

Post a Comment

About Me

My photo
Welcome to my blog....I am Dr Pratibha Singh and I am trying to create awareness in people so that people can have healthy and beautiful smile.Smile improves our face value and giving that wonderful smile is our[dental] profession.So keep reading and updated.

Labels

endodontics RCT Root Canal Treatment necrosis tooth paste Anesthetized area BMP Criteria for obturation Dr Shotwell Endodontic treatment Extraction GIC Impacted upper premolar Inferior Alveolar Block Nerve anesthetized OPG Pain history Pulpal disease Removable partial denture Salman Khan Treatment options for dentin hypersensitivity Trigeminal Neuralgia abrasion access opening anaesthesia antibiotic antiinflammatory apex apical periodontitis apically displaced apico coronal filing balanced force bass bone brushing technique buccal walls canals case presentation causes cementodentinal junction charter chief complaint circular classification components of prescription crown debridement dental dental pain dental problem dentist diagnosis duration electrolysis erosion etiology exudate file x ray files flaps fones free gingival graft growth and development healing instrumentation irreversible pulpitis laterally displlaced ledges light cure local anaesthesia major connector medicament minor connector molar RCT mouthrinses movement of files in RCT multirooted teeth nature oral ulcers oral; surgery orthodontics osteoblast osteoclast pain pulpal pain patient's education periodontics primary teeth eruption principles of RCT procedural accidents pulp pulp vitality pulpal floor pulpitis purulent discharge reamers restoration retreatment reversible rolls root rubber dam scrub method. site spread stamp stem winding steps in root canal TREATMENT tibiotics stillman supporting structures surgery symptoms teeth brushing technique demontration thermal test tooth tooth brushing technique treatment treatment follow up treatment of oral ulcers treatments type of pain wound you tube

Site Search