The Role of Epithelium in the Healing of Experimental Extraction Wounds

Fractured root tips during dental extractions and retained root fragments. A clinical dilemma?

“…[47][48][49][50][51][52] Animal [15][16][17][18][19][20]53 and human 8,14,54 studies on the histologic reaction to retaining root fragments showed that while the histological processes are often quicker in animals than in humans -due to the difference in socket size 47,48 -the actual events are similar. 55 When a portion of the root fractures and is left in situ there is a departure from normal healing, with the length, 47 pulpal status 16 and position 8,56 of the root along with adequate closure of the socket margins 16,17,19,20 dictating the outcome.…”

“…Most extraction sites healed well, but slower than empty extraction sockets due to inflammatory processes. It was seen that when bone or root fragments were close to the surface, the epithelium was not continuous and extended around the fragments similar to a periodontal pocket 18,19 (Fig. 3).…”

“…19,20 Fragments that are close to the surface of the socket are easily extruded. Fragments that are deeper within the socket are not externalised, as the epithelium is unable to extend under the root fragment completely.…”

“…8,14 Several histological studies have examined the healing of extraction sockets in the presence of fractured root fragments. 8,[15][16][17][18][19][20][21] The studies showed that, under certain circumstances, root fragments could successfully remain in situ with normal healing taking place together with the formation of a cementum layer on the dentine Root tip fracture can occur during the extraction of teeth. The clinician must then decide to either leave the root fragment in situ, or to attempt its removal.…”

The role of bone remodelling in the healing of extraction socket in rats

“…Studies were carried out in human [Ämter el at., I960, 1964;Ämter, 1969;Boyne. 1966), and laboratory animals [Huebuch et at., 1952;Smith, 1958;Simpson. 1958Simpson.…”