8. Wound Healing Considerations

Question 1

Implant site development

Answer 1

surgeries performed before implant placement to prepare the implant site (usually bone grafting)

Question 2

wound healing stages

Answer 2

1. hemostasis
2. inflammation
3. proliferaiton
4. remodeling

Question 3

hemostasis

Answer 3

blood clot to stop the bleeding

Question 4

inflammation

Answer 4

“first responders”

macrophages and lymphocytes clean the area sot hat new tissue can be formed

Question 5

proliferation

Answer 5

new tissue formed

new tissue is not mature yet

Question 6

remodeling

Answer 6

maturation of new tissue

Question 7

extraction wound bone tranforamtion

Answer 7

woven bone –> lamellar bone

Question 8

how much bone is required to place an implant?

Answer 8

diameter of implant + 1.5mm of bone in every direction

Question 9

average bone loss with natural healing

Answer 9

width - 3.87 mm
height - 1.67mm

Question 10

average bone loss with alvoelar ridge preservation

Answer 10

width - 1.83mm
height - 1.47mm

Question 11

alveolar ridge preservation

Answer 11

-immediately after tooth extraction
-aiming at reducing post extraction alveolar ridge dimensional changes by placing bone graft, membrane, and / or biological factors into socket immediately after extraction

Question 12

socket preservation

Answer 12

placement of bone graft in a socket with intact bony walls immediately after extraction

Question 13

guided bone regeneration

Answer 13

placement of a barrier membrane with or without other material in order to exclude non-osteogenic tissues from interfereing with bone regeneration

can be done immediately after extraction or at a later time on healed ridge for vertical or horizontal bone augmentation

Question 14

sinus lift

Answer 14

vertical augmentation of posterior max bone by elevating the schneiderian membrane

direct or indirect

bone graft usually placed under the elevated schneiderian membrane

Question 15

formula for indirect sinus lift

Answer 15

2 x (residual bone height) - 2 = mm of implant length

Question 16

manaement of pain

Answer 16

analgesics

Question 17

management of swelling

Answer 17

ice for up to two hours after surgery

Question 18

management of bleeding

Answer 18

pressure with gauze

Question 19

management of bruising

Answer 19

patience

Question 20

management of tristmus

Answer 20

warm compressions

Question 21

management of infection

Answer 21

antibiotics

Question 22

mangement of abscess

Answer 22

drainage with / without antibiotics

Question 23

management of soft tissue inflammation

Answer 23

chlorhexidine 0.12% application by rinsing or with cotton tip

Question 24

management of loos graft particles

Answer 24

gentle removal if encapsulated in soft tissue and easily accessible

Question 25

management of membrane exposure

Answer 25

-chlorhxidine 0.12% application by rinsing or with cotton tip
-consider membrane removal at 8 weeks if membrane is not resorbable

Question 26

management of wound dehiscence

Answer 26

chlorhexidine 0.12% application by rinsing or with cotton tip

Question 27

management of oroantral communication

Answer 27

-chlorhexidine 0.12% application by rinsing or with cotton tip
-follow up clinically with CBCT
-surgical closure

Question 28

management of sinusitis

Answer 28

antibiotics

Question 29

management of sinus cyst or polyp formation

Answer 29

diagnosis and referral to ENT