Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Pathology > Healing of Oral Wounds > Flashcards

Healing of Oral Wounds Flashcards

1
Q

Wound Healing

Early vascular response to injury

A
  • Starts as inflammation through the following…
  • Initial transient vasoconstriction followed by vasodilation.
  • Vasodilation is caused by action of histamine, prostaglandins, and other vasodilatory substances.
  • Dilation causes intercellular gaps to occur, which allows egress of plasma and emigration of leukocytes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Wound Healing

Inflammatory stage of wound repair

A
  • Wound fills with clotted blood, inflammatory cells and plasma.
  • Adjacent epithelium begins to migrate into wound along edge of the wound.
  • Undifferentiated mesenchymal cells begin to transform into fibroblasts.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wound Healing

Migratory phase of fibroblastic stage of wound repair

A
  • Continued epithelial migration under the fibrinous exudate.
  • Leukocytes dispose of foreign and necrotic material.
  • Capillary ingrowth begins.
  • Fibroblasts migrate into wound along fibrin strands.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Wound Healing

Proliferative phase of fibroblastic stage of wound repair

A
  • Proliferation increases epithelial thickness.
  • Collagen fibers are haphazardly laid down by fibroblasts.
  • Budding capillaries begin to establish contact with their counterparts from other sites in the wound.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Wound Healing

Remodeling stage of wound repair

A
  • Epithelial stratification is restored.
  • Fibrinous exudate resorbs, often leaving a depressed scar.
  • Collagen is remodeled into more efficiently organized patterns.
  • Fibroblasts slowly reduce and vascular integrity is re-established.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Wound Healing

Wound contraction

A
  • Begins near the end of fibroplasia and continues during the early portion of remodeling.
  • Wound contraction diminishes the size of the wound.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for biopsy

A
  • Any persistent pathologic condition which cannot be diagnosed clinically
  • Any lesion thought to be malignant/premalignant
  • To confirm clinical diagnosis
  • Any condition not responding to routine management
  • To allay cancer fears
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Biopsy Types

A

- Excisional -

remove entire lesion (benign tumor)

- Incisional -

only take a small piece of lesion (only diagnostic)

- Punch -

- Needle -

ex. Fine Needle Aspiration (FNA)

- Aspiration -

Place Biopsy Specimen in 10% neutral, buffered formalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Incisional biopsy

A
  • If the lesion is larger than 1cm or in a hazardous location or whenever there is a great suspicion of malignancy.
  • Is used to establish diagnosis.
  • It is a diagnostic biopsy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Excisional biopsy

A
  • Is used to remove the lesion.
  • It is a diagnostic and therapeutic biopsy.
  • For lesions that are small and you are confident are benign
  • Do not excise a lesion suspected of being malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Primary healing

A
  • Healing by primary intention.
  • When the margins can be approximated.
  • Usually heals with minimal scar.
  • Most Ideal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Secondary healing

A
  • Healing by secondary intention.
  • An open wound “granulates in”.
  • Heals with scarring.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cytology/Exfolative Cytology

A

the removal of individual cells, usually in order to determine microscopically if they appear normal or abnormal. It usually does not provide a definitive diagnosis.

  • screening for cancer usually
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cytology Advantages and Disadvantages

A

Cytology Advantages

*Safe

*Bloodless

*Painless

*Quick

*Screening

Cytology Disadvantages

*Only for surface lesions affecting epithelium

*Cannot establish a definitive diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cytology Grades

A

Grade I Normal (No biopsy)

Grade II Atypical (Biopsy)

Grade III Borderline (Biopsy)

Grade IV Suggestive (Biopsy)

Grade V Positive (Biopsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is indicated for cytology?

A

*Premalignant/malignant lesions

*HSV

  • Cytopathic viral effect
  • “Multinucleation”

*Candidosis

17
Q

Oral CDX Brush “Biopsy”

A

NOT A BIOPSY - NOT A DEFINITIVE DIAGNOSIS

  1. Cytological evaluation for premalignant/malignant lesions
  2. Improved cell harvesting
    - All cell layers
  3. Improved computer-based screening of specimen
  4. Improved diagnostic accuracy
  5. Atypical and positive results must be biopsied
  6. Does not provide definitive diagnosis
18
Q

Immunofluorescence

A

Diagnostic technique to identify autoantibodies

  • Direct (DIF)
  • Autoantibodies in tissue
  • Indirect (IIF)
  • Circulating autoantibodies in blood

Immunofluorescent testing generally reserved for conditions that you suspect are autoimmune (pemphigus vulgaris, mucous membrane pemphigoid)

Most oral diseases are (+) on Direct but (-) on indirect IF.

DIF biopsies cannot be placed in traditional fixative, a transport media is required

19
Q

Healing of Extraction Wound

First Week

A
  • The blood clot begins to undergo organization by the ingrowth of fibroblasts and capillaries from the residual periodontal ligament and adjacent bone marrow.
20
Q

Healing of Extraction Wound

Second Week

A
  • The blood clot is becoming organized.
  • PDL begins degeneration and the socket wall appears frayed.
  • Epithelium proliferates over the wound surface.
21
Q

Healing of Extraction Wound

Third Week

A
  • The original clot is organized by granulation tissue.
  • Early bone (osteoid) is formed by osteoblasts arising in the PDL and adjacent bone.
  • The crest of the alveolar bone is rounded off by osteoclastic resorption.
  • Epithelium completely covers the surface
22
Q

Healing of Extraction Wound

Fourth Week

A
  • Continued deposition of bone.
  • Much of the early bone is poorly calcified and is not evident on radiographs.
  • Radiographic evidence of bone formation is seen after six or eight weeks.
  • Evidence of differences in new bone in the alveolar socket will persist for four to six months.
23
Q

Localized Acute Alveolar Osteomyelitis (Dry Socket)

A
  • Due to loss of the blood clot from extraction site.
  • The socket appears dry and the bone is exposed.
  • Produces a foul odor and severe pain but no suppuration.
24
Q

Fibrous Healing of an Extraction Wound

A
  • Results from a difficult surgical extraction accompanied by loss of lingual and labial or buccal plates of bone with accompanying loss of periosteum.

Radiographic - appears as a circumscribed radiolucent area at the site of previousextraction wound.

  • may be mistaken for a residual cyst or granuloma.
25
Q

Focal osteoporotic bone marrow defect

A

Radiolucency in bone from bone marrow expansion may not be pathologic

  • Aberrant healing – many are in extraction sockets
  • Hyperplasia due to chronic anemia
  • ↑ Females 75%
  • ↑↑ Md (posterior)

Asymptomatic, no expansion

Radiolucencies, often ill-defined but with faint internal trabeculation

26
Q

Localized Tissue Overgrowth

A
  • Often a fragment of bone will become lodged in the socket and induce tissue hyperplasia (pyogenic granuloma, peripheral giant cell granuloma, inflammatory fibrous hyperplasia - all covered later).
  • Tissue growing from an extraction site can also represent malignancy growing along the course of least resistance.

Oral Pathology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions