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perio 2 exam 2 > post-surgical wound healing > Flashcards

post-surgical wound healing Flashcards

1
Q

what are the 3 phases of post-surgical wound healing?

A

1) Inflammation
2) Fibroblastic granulation
3) Matrix formation and remodeling

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2
Q

what is the immediate response during healing by primary intention?

A
  • Formation of blood clot between margins of wound and between flap and tooth or bone
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3
Q

the immediate clot of primary healing is composed of what?

A

Clot includes:

fibrin,neutrophils,platelets, red cells, cell debris, and capillaries at the edge of the wound

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4
Q

during healing by primary intention, what occurs within the first 24 hours?

A
  • Neutrophils infiltrate the connective tissue

* Epithelium begins to migrate from the wound margins

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5
Q

during healing by primary intention, what occurs during the first 1-3 days?

A
  • Space between the flap and tooth or bone narrows

* Epithelial cells migrate over the border of the flap, contacting the tooth

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6
Q

what happens during the 3-7 days after surgery during PRIMARY healing?

A
  • Epithelial migration continues
  • Neutrophils replaced by macrophages
  • Blood clot is replaced by granulation tissue
  • Re-vascularization begins
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7
Q

during healing by PRIMARY intention, the site of surgery will show the following characteristics after ONE WEEK:

A
  • Epithelium attaches to the root

* Blood clot is replaced by granulation tissue

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8
Q

the granulation tissue that replaces a blood clot during PRIMARY healing is derived from what 3 sources?

A

derived from:

  • gingival connective tissue
  • bone marrow
  • periodontal ligament
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9
Q

what are the characteristics of a wound TWO WEEKS after healing by primary intention?

A
  • Collagen fibers are oriented parallel to tooth surface (nonfunctional)
  • Union of flap to tooth is weak
  • Collagen fibers are immature
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10
Q

during healing by primary intention, Inflammatory cells are mostly gone after what amount of time?

A

1 month

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11
Q

what changes occur after 1 month of primary healing?

A
  • Fibroblasts proliferate, synthesize collagen
  • Revascularization process regresses
  • Epithelial attachment is well defined
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12
Q

During primary healing, the _________ will be FULLY epithelialized after ONE MONTH

A

gingival crevice

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13
Q

around the 1 month mark, there will be a Functional arrangement of ________ fibers (in healing by primary intention)

A

supracrestal

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14
Q

at what time, following surgery, will a wound healing from primary intention regain most of its original tensile strength?

A

2 months

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15
Q

When the bone is exposed by a full thickness flap, superficial bone necrosis occurs after _________ days

A

1 to 3 days

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16
Q

after bone exposure, ________ resorption follows superficial necrosis, peaking at 4 to 6 days

A

Osteoclastic

17
Q

Typically, how much bone is lost when exposed to the oral environment?

A

1 mm

18
Q

what should be done to ensure the best outcomes of surgical therapy?

(theres 4 things)

A

1) Minimize trauma to tissue
2) Minimize wound desiccation (irrigate with saline, minimize length of procedure)
3) Suture meticulously
4) Address systemic health issues

19
Q

how does healing by SECONDARY intention differ from healing by primary intention?

(3 key differences)

A
  • A more vigorous inflammatory response
  • Formation of a larger volume of granulation tissue to fill the defect
  • More pronounced wound contraction during healing
20
Q

during wound healing, the ____________ is a major initial source of growth factors and cytokines

A

the blood clot

21
Q

what 3 growth factors are released from a blood clot?

A

1) PDGF
2) EGF
3) TGF-beta

22
Q

what is the effect of PDGF on wound healing?

A

induces:
1) fibroblast and macrophage migration

2) fibroblast proliferation
3) macrophage activation

23
Q

the growth factor _______ induces epithelial proliferation

A

EGF

24
Q

what does growth factor TGF-beta induce?

A

induces:
A) migration of inflammatory cells

AND

B) proliferation of fibroblasts

25
Q

what factors are released by fibroblasts and macrophages?

A

1) TNF

2) IL-1B

26
Q

what are the effects of TNF? what about IL-1B?

A
  • TNF: activates endothelium, induces neutrophil migration

* IL-1ß: activates endothelium, induces neutrophil migration

27
Q

what are the requirements for the best outcome of healing by secondary intention?

A
  • Minimize trauma
  • Preserve blood clot
  • Minimize bacterial colonization of site
  • Address systemic health issues
  • Be aware that smoking impairs healing
28
Q

what is the definition of tissue repair?

A

damaged tissues are replaced by tissues that don’t duplicate the function or architecture or the original tissues

29
Q

what is the definition of tissue regeneration?

A

damaged tissues are replaced by tissues that duplicate the structure and function of the original tissues.

perio 2 exam 2 (4 decks)

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