Extraction Wound Research Articles

Oral myiasis caused by sarcophagidae in an extraction wound

Oral myiasis (infestation by the larvae of Diptera flies) has only rarely been reported in the English-language literature. This article records a case of wound myiasis caused by flies of the family Sarcophagidae that affected a tooth-extraction site, and was a painful complication of the extraction.

Level of Clarithromycin in an effusion of tooth extraction wound

Level of Clarithromycin in an effusion of tooth extraction wound

Actinomycete infections in humans — a review

Diseases caused by pathogenic aerobic and facultatively anaerobic actinomycetes differ considerably with respect to their etiology, pathogenesis, clinical appearance and epidemiology. Facultatively anaerobic (fermentative) actinomycetes may not only be involved etiologically in the three classical forms of cervicofacial, thoracic and abdominal actinomycoses, but also in infections of the female genital organs, the eye, the tissue adjacent to dental implantation elements and tooth extraction wounds. The species distribution of the fermentative actinomycetes isolated from these conditions varied to a certain, but characteristic, extent, as did the concomitant actinomycotic flora. The sex ratio reported for human Actinomyces infections (male:female = 3:1) appeared to be restricted to actinomycotic abscesses and empyemas. The prevailing pathogenic, obligately aerobic actinomycete species in Germany was found to be Nocardia farcinica followed by Nocardia asteroides. The comparatively high incidence of N. farcinica infections was chiefly due to the occurrence of nonsocomial postoperative wound infections by this pathogen observed in two German hospitals. Besides surgical treatment, immunosuppressive treatment appeared to be the most common factor predisposing for nocardiosis. Recent observations strongly suggested that the spectrum of human nocardial infections in Germany has been changing, as regards the overall incidence, the prevalence of N. farcinica, the sex ratio, the mean age of patients, as well as the role of N. farcinica as a possibly important nosocomial pathogen.

Alveolar bone remodeling after tooth extraction in normal and osteopetrotic (ia) rats

One of the osteopetrotic mutations in the rat, incisors-absent (ia), exhibits generalized skeletal sclerosis and failure or delay of tooth eruption, characteristics of other osteopetrotic mutations. Osteopetrosis in ia rats is known to be due to a reduction in bone resorption, the result of the inability of ia osteoclasts to elaborate a ruffled border. During healing of extraction wounds, especially the initial period, osteoclastic resorption of alveolar bone is considered to be a significant feature, followed by new bone formation. We have studied extraction wound healing in osteopetrotic (ia) rats histologically in order to determine if their systemic reduction in bone resorption changes the sequence or rate of alveolar bone healing within and outside the socket after tooth extraction, In ia rats, the healing process was delayed in comparison to that of normal rats. Many osteoclasts were observed on the surface of alveolar bone, but there was little evidence of resorption. Bone formation in the socket following bone resorption was reduced and the newly formed trabeculae were irregular. In contrast, the quantity of resorption-independent (periosteal) new bone formation outside the socket was exaggerated compared to normal animals. These data indicate that the disturbance of new bone formation in the socket is probably related to the reduction in osteoclastic bone resorption.

Effect of salivary gland hypofunction on the healing of extraction wounds: A histomorphometric study in rats

The effect of salivary gland hypofunction (SGH) on oral wound healing is not well established. The present study evaluates the healing of extraction wounds in a SGH rat model. Experimental rats underwent removal of the submandibular and sublingual glands and ligation of the parotid ducts. Maxillary left first molars were extracted and healing was determined at 0, 1, 3, 5, 7, 10, 14, and 21 days after extraction. Salivary gland hypofunction caused a significant delay in socket healing. The inflammatory process was more intense and of longer duration. The formation of fibrous connective tissue and bone was relatively slow among the experimental rats. The results suggest that SGH patients undergoing oral surgery may have prolonged wound healing.

抜歯創の初期治癒過程における血管内皮細胞の電顕的研究

The vascularization is an important factor along with the wound healing process, and there are some reports on extraction wounds. However, the ultrastructure of newly developed capillaries in the healing process is still argued. It is aimed of clearing the ultrastructural early healing process of endothelial cells in the experimental tooth extraction wound by electron microscopy.Immediately after the extraction, the diffused basal lamina intermittently surrounded endothelial cells. Three days after the extraction, the basal lamina was not continuous, but had no gap with endothelial cells. Four days after the extraction, the basal lamina almost reconstructed.On tannic acid injection into blood vessels, it was observed in the narrow lumen of cell masses which continued to capillaries. It is suggested that cell masses are derived from the endothelial cells, and are the precursor of capillaries.The cell masses were formed by two or three undifferentiated endothelial cells. The narrow lumen was observed in the cell mass and these cells project short folds into the lumen. These cells connected by tight junctions, but the basal lamina was not complete. On tannic acid injection, it does not perfuse into the stroma through the basal lamina. It is concluded that these types of connections between the endothelial cells, were one of the characteristic features of capillaries in the tooth extraction wound.

ワルファリンカリウム投与ラットの抜歯か治癒過程に関する研究

Warfarin which antagonizes vitamin K is clinically used as a anticoaagulant agent. However, the effect of warfarin on bone remodeling is still unclear.The present study was to investigate the effect of warfarin on the healing process of tooth extraction wounds. Sprague-Dawley male rats were injected with warfarin according to the maintenance protocol by Price as the experimental group. Rats without the injection were used as the control group. The upper first molars of rats were extracted in both groups. These rats were killed on days 1, 2, 4, 7, and 10 and on weeks 2, 3, 4, and 6 postoperatively. Serial histological sections were stained with hematoxylin and eosin for light microscopy. And the osseous healing process was observed on day 4 and on weeks 1, 2, 3, 4, and 6 after extraction by microradiography.The results obtained were as follows:1. Warfarin-treated rats demonstrated that the number of mesenchymal cells and new capillaries were less than that of the control in the early stage after extraction.2. New bone formation in the sockets of control rats initiated on day 4 after operation, however, new bone formation in experimental rats was delayed and the number of osteoblasts were less than that of the control. In both groups, the new bone occupied the middle 2/3 of the socket on week 1, lower 4/5 on day 10, and whole socket on week 2, respectively. No significant difference was found in the location of new bone between the control and experimental groups. However, the thickness and volume of new bone were statistically different between the groups.3. The control group showed that osteoclasts appeared in the socket wall and fundus on day 1. They increased and reached a maximum number on day 2, and disappeared after day 4. In contrast, the experimental group demonstrated that osteoclasts appeared within on day 2, and reached a maximum number on day 4 and dispersed on day 10.4. 6 weeks after extraction, there were almost no remarkable differences between the experimental group and the control group.These results prove that warfarin delayed the healing process of soft tissue and the new bone formation in the early stage of wound healing, suggesting that warfarin affected the proliferation and the metabolism of mesenchymal cells, osteoblasts and osteoclasts.

抜歯創治癒への交感神経系の影響に関する研究 : 歯肉および抜歯窩内活性酸素動態の検討

The influence of the sympathetic nervous system activity on oxygen free radicals in tooth extraction wounds was studied in dogs. Cervical sympathetic trunks were stimulated continuously in seven healthy dogs by a portable pacemaker (group S). Postcervical ganglions were permanently blocked with pure ethanol in other seven dogs (group B). Bilateral gingival blood flow was measured in both groups by the hydrogen clearance method and the laser doppler method. Bilateral mandibular premolars and molars were extracted in all dogs of both groups. Activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and concentration of lipid peroxide (LPO) in gingivas and tooth extraction sockets of all dogs were measured on the fourth day after extraction. The results were as follows : 1. Gingival perfusion significantly decreased in group S and increased in group B in ipsilateral side compared with contralateral side without any remarkable cardiodynamic changes. 2. In group S, the average levels of SOD, GSH-Px activities and LPO concentration in ipsilateral gingivas seemed to be higher than those in contralateral gingivas. The level of CAT activity in ipsilateral gingivas seemed to be the same as that in contralateral gingivas. 3. The levels of SOD and CAT activities in ipsilateral extraction sockets seemed to be lower and the level of GSH-Px activity was significantly lower than those in contralateral extraction sockets in group S. Ipsilateral LPO concentration, however, seemed higher. 4. In group B, the level of ipsilateral gingival SOD activity seemed to be lower, moreover the levels of CAT, GSH-Px activities and LPO concentration were remarkably lower than those in contralateral gingivas. 5. The levels of SOD, CAT, GSH-Px activities and LPO concentration in ipsilateral extraction sockets showed no changes, the same as in contralateral side in group B. These results suggest that ischemia occurring by hyperactivity of sympathetic nervous system accelerates the production of oxygen free radicals in tooth extraction wounds. It seems that increase of perfusion by sympathetic nerve blocks suppresses those accelerations.

Effects of local anesthetics on healing process of extraction wound in rats with reference to effects of epinephrine

Effects of local anesthetics on the healing processes of the extraction wound were investigated in the rats. The study was performed on 5 experimental groups: control group (GA), 2% lidocaine without a vasoconstrictor (LEO) and 2% lidocaine with epinephrine 1/20,000 (LE2), 1/80,000 (LE8) and 1/200,000 (LE20). Under general anesthesia (GA) the mandibular 2nd molars were extracted after the injection of each local anesthetic. The control group (GA) had the teeth extracted without a local anesthetic. The wounds were examined histopathologically at timed sequence from 1 day to 14 days after the operation. Postextraction wounds of all the groups healed uncomplicatedly and these 5 groups could be classified into 2 types of healing process: epinephrine-free group (GA and LEO) and epinephrine group (LE2, LE8 and LE20). The 14-day postextraction sockets of the epinephrine-free group were filled with callus, whereas those of the epinephrine group had progressed to the final stage of bony healing unexpectedly. There was no difference in the healing process of each wound in the same group. These results suggest that a local anesthetic without a vasoconstrictor do not modify the postextraction wound healing process, and epinephrine does not prolong but will promote the wound healing.

ABO bloodgrouping on tooth material

The ABO bloodgroup was determined on the pulp, dentin and enamel of 35 teeth using the adsorption-elution technique. A bloodstained compress from the extraction wound was used as the reference sample. Twenty teeth were examined within 6 weeks after extraction and fifteen teeth were examined 6–10 months after extraction. It was found, that bloodgrouping on pulp gives fairly good results, whereas the possibilities for correct bloodgrouping seem to be limited for dentin and debatable for enamel. Similar results were found in both groups of teeth.

Extraction wound healing in desalivated rats

Wound licking has been shown to promote extraoral wound healing among animals. Although the oral mucosa is bathed in saliva. Little information about the role of saliva in oral wound healing is found. The present study evaluates the healing of extraction wounds in desalivated rats. Experimental rats underwent sialadenectomy of the submandibular and sublingual glands and ligation of the parotid ducts. Maxillary left first molars were extracted. Rats were killed at 0, 1, 3, 5, 7, 10, 14, and 21 days after surgery and maxillae were prepared for light microscopy examination. Generally, a delay in socket healing in the desalivated rats was found. No differences were observed in blood clot formation. Replacement of the clot by granulation tissue was relatively slow concomitant with a longer inflammatory process. Bone formation kinetics were slower among the experimental rats.

Primary herpes simplex virus (type 1) infection delays healing of oral excisional and extraction wounds in the rat

The effect of acute herpes simplex virus type 1 (HSV-1) infection on the healing process of intraoral wounds and tooth extraction sockets in the rat was studied. A standardized size of the buccal mucosa was excised and molars were extracted and a HSV-1 suspension was topically applied. The virus infected wounds were clinically characterized by erythema and swelling and histologically by heavy inflammation cell infiltrate and abscesses during the first week. The acute HSV-1 infection was found to significantly delay healing of both types of wounds by 3 days. Antiviral treatment with acyclovir (ACV) decreased the degree of inflammation and improved healing of the infected wounds. The present results indicate a delayed and disturbed healing of wounds in the oral cavity in the presence of HSV-1. The findings may have a clinical significance for primary or latent HSV-1 infections in conjunction with surgical intervention in the oral cavity.

Foreign body giant cell reaction related to placement of tetracycline-treated polylactic acid: Report of 18 cases

Presented are 18 cases of foreign body giant cell reaction in mandibular third molar extraction wounds previously treated with 40 mg of dry tetracycline powder carried into the wound with a biodegradable polymer dressing. The lesions vary in intensity from local, soft tissue granulomas to osteolytic, central bone pathologies. Several reports of foreign body giant cell reaction to insoluble tetracycline preparations are cited, along with a brief review of the relationship between myospherulosis and various formulations of tetracycline powder in petroleum-based carrier vehicles. The authors suggest that the foreign body giant cell lesions reported here were initiated by micron-sized particles of insoluble tetracycline powder and were further aggravated by certain hydrophobic characteristics of the associated biodegradeable polymer. The authors caution against use of dry, powdered forms of topical antibiotics in fresh dental extraction wounds.

Inverted papilloma of the maxillary sinus: an unusual cause of a non‐healing extraction socket. Case report

Although the healing of extraction sites is generally a rapid and uncomplicated process, delayed healing or overt infection of recent extraction sockets may involve a variety of causes and the clinician must be aware pre-operatively of both local and systemic influences. Retarded or non-healing extraction sites always require investigation. This paper looks broadly at the subject of non-healing extraction sites and reports an unusual case involving an inverted papilloma of the maxillary antrum. To the authors' knowledge this is the first reported case of an antral papilloma causing delayed extraction wound healing.

Influence of different types of non-resorbable suture material on the healing of extraction wounds. A histological study in rats.

The influence of different non-resorbable suture materials on the healing of tooth extraction wounds was examined in 120 adult male albino rats. Nylon gave the best biological results for healing of the mucosa and dental socket. Silk and cotton produced considerable delay of socket healing. Healing was only mildly delayed by polyester suture, with a short moderate inflammatory reaction at the initial stage.

Histologic and Bone Morphometric Studies on Healing of Extraction Wounds in Rats Fed Diets Low in Calcium-deficient in Vitamin D and Low in Calcium

Histologic and Bone Morphometric Studies on Healing of Extraction Wounds in Rats Fed Diets Low in Calcium-deficient in Vitamin D and Low in Calcium

Compared concentrations of tooth extraction wound with blood concentrations of Enoxacin (ENX)

Compared concentrations of tooth extraction wound with blood concentrations of Enoxacin (ENX)

Primary wound closure in haemophiliacs undergoing dental extractions

215 teeth were extracted in 62 haemophiliacs following a single infusion of factor VIII supplemented with antifibrinolytics. Tooth sockets were packed with Sorbacel gauze soaked with an antifibrinolytic. 1 group was sutured and the other left open. Primary closure of the extraction wound did not show direct effect on haemostasis. However, the size of the clot showed a statistically significant difference between the primary closure and open wound groups. The authors conclude that primary closure of the extraction wound protects the blood clot, makes the postoperative period more comfortable for patients and may subsequently decrease the risk of postoperative bleeding.

脱歯創の骨性治癒における血管構築の変化について

Successive changes in the vascular pattern during the osseous healing of extraction wounds were investigated by studying microvascular casts under a scanning electron microscope. The casts were prepared utilizing the plastic injection method, after the extraction of the upper four incisors of the Japanese monkey (Macaca fuscata). Five days after extraction, vascular buds have sprouted from a pre-existing blood vessel on the alveolar wall into the blood clot, and leakage of the plastic injected was found from the tips of these buds. One week after extraction, newly-formed vessels have extended widely to the socket center, and dilated vessels have arborized towards the socket opening. Two weeks after extraction, the socket was filled with thick, newly-formed vessels. In the socket fundus, the woven bone was formed between irregular vascular networks, but was arranged different in the socket wall. Four weeks after extraction, the new bone forming on the socket wall became thickened and converted to a lamella-like bone. Inside it the woven bone was raised from the fundus, and blood vessels leaving it were decreased in their thickness and passed toward the socket center. Five weeks after extraction, the new bone structures came up to the level of the socket opening, the surface of which appeared as a shallow concavity (pivot), from which vascular bundles were directed to the socket opening. A beginning of the bone-remodeling was seen in osseous trabeculae in the socket fundus. Six weeks after extraction, almost all of the socket became filled with new trabeculae, between which, fine vascular networks were sorted out and communicated with the periosteal vascular network beyond the socket margin. The interalveolar septum between the extraction sockets was thickened by deposition of the lamella-like bone to be remodeled to a cancellous bone. It can be said that microvascular patterns formed through all stages of the osseous healing of the extraction wounds contributed to a woven bone formation and its development.

Irradiation effect of low-energy laser on alveolar bone after tooth extraction. Experimental study in rats

A histopathological study of the initial healing of extraction wounds following low-energy laser irradiation, using a gallium-arsenide semi-conductor laser, was carried out in rats. The results suggest that this mode of treatment has a beneficial effect on initial bony wound healing. It was found that proliferation of fibroblasts was more prominent in the irradiated group, and so was the formation of trabecular osteoid tissue. The deposition of lead in the newly formed bone suggests a more rapid ossification in the irradiated group.