Wound healing

Question 1

Inflammation Creates & stabilizes the

Answer 1

blood clot signals for cells to clean up the wound

Question 2

Vasodilation allows for

Answer 2

inflammatory mediators to rush in to start healing.

Question 3

4-5 day mark, —- happens

Answer 3

proliferation

Question 4

Tissues laid down on blood clot to form provisional matrix upon which bone will be laid

Answer 4

proliferation.

Question 5

Collagen and capillaries form on

Answer 5

fibrin of hemostasis

Question 6

Epithelialization

Answer 6

not a stage of wound healing - tooth extraction site should look healed around 3-4 weeks max. Younger pts will heal quicker.

Question 7

Remodeling

Answer 7

1st year to fill up socket - ongoing process. Replacement of collagen matrix with woven bone, then mature bone.

Question 8

Proliferation

Answer 8

setting up matrix in socket.

Question 9

Lamina dura, radioluscency after

Answer 9

extraction

Question 10

lamina dura resorbed at

Answer 10

4-6 months

Question 11

Week 3 - socket should look

Answer 11

healed over.

Question 12

1 pack a day

Answer 12

vasoconstriction all day long.

Question 13

Radiation therapy

Answer 13

> 5000cGy (a TON)
You will see radiation induced fibrosis
Turnover rate of surviving bone is slowed and can be ineffective in self-repair

Question 14

Radiation effects are

Answer 14

lifelong - never gets better.

Question 15

Anti-resorptive drugs

Answer 15

treagtment of bony metastasis of solid tumors and osteolytic lesions of MM. Potent osteoclastic inhibition.

Question 16

Anti-resorptive drugs of concern - High dose, potent

Answer 16

Nitrogen containing bisphosphonates, RANKL inhibitors.

Question 17

Suppression of host defenses

Answer 17

Uncontrolled diabetes, alcoholism (protein priorities elsewhere in body), malnutrition, chronic systemic steroid use (autoimmune issue patients), myeloproliferative disease (not turning out adequate numbers of WBC/mature WBCs)

Question 18

Dry socket

Answer 18

localized alveolar osteitis

Loss, lysis, or breakdown of the blood clot prior to its maturation into granulation tissue
• Not an infection!

Question 19

Dry socket signs

Answer 19

3-5 days post-op
• Increase in quantity and/or change in quality of pain
• Recommended pain medication ineffective
• Malodor, foul taste

Question 20

Granulation tissue is —– in color, and is made up with

Answer 20

Reddish pink

Blood vessels, tiny capilaries, collagen

Question 21

Dry socket color

Answer 21

gray/brown clot or complete absence of clot.
• +/- food debris
• +/- adjacent soft tissue inflammation

Question 22

Maxilla

Answer 22

more trabecular, spongy, incredibly unlikely to get dry socket.

Question 23

Oral contraceptives can increase likelihood of

Answer 23

dry socket.

Question 24

Surgical time (longer procedure)

Answer 24

increases likelihood of dry socket.

Question 25

Copious irrigation of surgical site with saline will

Answer 25

decrease risk of dry socket.

Question 26

Dry socket treatment is to

Answer 26

make things feel better during healing (it’ll happen naturally). Irrigate and place palliative dressing, use iodoform gauze, eugenol (woo). Packing changed QD or QOD until pain has resolved.

Question 27

Dry socket resolved in

Answer 27

3-5 days most times.

Question 28

If patients do not respond to dry socket treatment

Answer 28

osteomyelitis - acute infection of marrow space in bone.

Question 29

Osteomyelitis

Answer 29

bone infection, medical and surgical tissue, can lead to significant morbidity.

Question 30

Iodoform gauze does

Answer 30

NOT dissolve - has radiographic strip to confirm that it is there. Needs to be removed.