Healing Of Oral Cavity Injuries

Healing Of Oral Cavity Injuries

Question. Write about healing of oral cavity injuries.

Answer.

Healing of oral cavity injuries

When the cut surfaces of the oral cavity injuries be approximated or closely sutured, the wound heals up by primary intention. The process occurs in the following way:

oral wound healing

Healing By Primary Intention

• In healing by primary intension, wound edges are approximated by surgical sutures.
• In the initial phase, there will be formation of blood clot, which helps to hold the parts of the wound together.
• The tissue becomes edematous and an inflammatory process starts, with the infiltration of polymorphonuclear neutrophils (PMN) and lymphocytes into the area.

“Remodeling phase of oral tissue repair”

• The tissue debris collected in the wound are cleared either by the process of phagocytosis or by their lysis with the help of proteolytic enzymes, liberated by the inflammatory cells.
• Once the tissue debris are cleared, granulation tissue forms that replaces the blood clot in the wound, and it usually consists of young blood capillaries, proliferating firoblasts, PMN and other leukocytes.
• The epithelium at the edge of the wound starts to proliferate and gradually it covers the entire wound surface.
• Finally, the healing process is complete with progressive increase in the amount of dense collagen bundles and decrease in the number of inflammatory cells in the area.

Healing By Secondary Intention

• When the opposing margins of the wound cannot be approximated together by suturing, the wound fills in from the base with the formation of a larger amount of granulation tissue, such type of healing of the open wound is known as healing by “secondary intention” or “secondary healing”.
• Secondary healing occurs essentially by the same process as seen in the primary healing, the only difference is that a more severe inflammatory reaction and an exuberant fibroblastic and endothelial cell proliferation occur in the later.

healing of oral cavity injuries

“Treatment options for oral cavity injuries”

• In secondary healing, once the blood clot is removed, the granulation tissue fils up the entire area and the epithelium begins to grow over it, until the wound surface is completely epithelized.
• Later on, the inflammatory exudates disappear slowly and the firoblasts produce large amounts of collagen.
• Most of the healing processes occurring due to secondary intention, result in scar formation at the healing site.
  However, in the oral cavity these are rare.