Wound healing of extraction sockets

Abstract

The extraction of a tooth initiates a series of reparative processes involving both hard tissue (i.e. alveolar bone) and soft tissues (periodontal ligament, gingiva). The biological events occurring during the healing of an extraction socket and their chronological sequence have been evaluated in different animal and human studies. In the present review, the healing process of a tooth extraction wound was described. Factors affecting the histological aspects of the healing phase as well as the post extraction alterations of the ridge dimensions were also considered. Additionally, the healing of an extraction socket where a dental implant has been placed immediately after tooth removal was described in details. Finally, the histological and clinical outcomes of the application of different reconstructive technologies to the post‐extraction socket was evaluated.

Molecular and Cellular Aspects of Socket Healing in the Absence and Presence of Graft Materials and Autologous Platelet Concentrates: a Focused Review

“…Immediately after tooth extraction, the socket is filled with blood resulting from the haemorrhagic process, followed by the formation of a stable blood clot embedded in a network of fibrin [6,10]. The clot initially fills the socket volume up to the margins of the soft tissue, being in direct contact with the injured periodontal ligament [11]. Clot formation aims twofold - it prevents blood loss, and provides a structured scaffold for the adhesion of recruited cells that will orchestrate healing in the subsequent phases of the process [12].…”

“…Histological data reveals that, during the first week of healing, extraction socket is suffused with loosely organized cell-rich granulation tissue with an intense infiltration of inflammatory cells, vascular sprouts and fibroblasts - replacing the initial blood clot that undergoes coagulative necrosis, in a centrifugal process [11,27].…”

Indicação de biomateriais em alvéolos pós extração previamente à instalação de implantes

“…No quinto estágio observa-se osso lamelar e medular, ou seja, lamelas de osso maduro, osso mineralizado abrigando osteócitos por espaços medulares ricos em vasos, adipócitos, células mesenquimais e células inflamatórias. 12,19,20 O fechamento epitelial do alvéolo completa-se no 24° ao 35° dia. Preenchimento ósseo considerável ocorre entre a 5ª e 10ª semana.…”

Plasma rich in growth factors had limited effect on early bone formation in extraction sockets

“…In line with our protocol, previous studies evaluating PRGF treatment in extraction sockets included patients with teeth extracted for “severe periodontal disease” (Anitua ). To the best of our knowledge, there is no evidence supporting the hypothesis that the individual susceptibility to periodontitis may exert an effect on the healing of extraction sockets (Farina & Trombelli ). Consistently, a recent study failed to find significant differences in the tissue composition of fully healed extraction sites of periodontitis and non‐periodontitis subjects (Lindhe et al.…”