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Surgical Wound Healing in the Oral Cavity: a Review

From Volume 47, Issue 2, February 2020 | Pages 135-143

Authors

Raunaq Shah

BDS(Birm), MFDS RCS(Edin), MJDF RCS(Eng)

Barnes Hill Dental Surgery, 267 Barnes Hill, Selly Oak, Birmingham, B29 5TX, UK

Articles by Raunaq Shah

Farya Domah

BA, BDentSc(TCD), MFDS RCS(Edin), MSc Oral Surgery (Distinction) (UCLan)

Department of Oral and Maxillofacial Surgery, University Hospitals of Birmingham, Edgbaston, Birmingham, B15 2TH

Articles by Farya Domah

Nirmal Shah

BDS, MFDS RCS(Edin), MSc Aesthetic Medicine (Distinction) (QMUL), PGCE

Barnes Hill Dental Surgery, 267 Barnes Hill, Selly Oak, Birmingham, B29 5TX, UK

Articles by Nirmal Shah

Javed Domah

BSc

University of Dublin, Trinity College, College Green, Dublin 2, Ireland

Articles by Javed Domah

Abstract

Wound healing is a fundamental survival mechanism, largely taken for granted. It consists of four intricately tuned phases: haemostasis, inflammation, proliferation and remodelling. Successful wound healing only occurs if each phase occurs in the correct sequence and timeframe. Moreover, the oral cavity serves as a unique and remarkable setting whereby wound healing takes place in a saliva-filled environment containing millions of micro-organisms. Many local and systemic factors can impair oral wound healing. This article provides an overview of the wound healing process, with a discussion of these respective local and systemic factors, along with the potential cellular and/or molecular mechanisms involved.

CPD/Clinical Relevance: On a daily basis, dentists perform procedures such as exodontia and implant placement that rely on adequate wound healing. An improved understanding of the local and systemic factors that can impair oral wound healing can help clinicians to control these factors more accurately, resulting in improved patient outcomes.

Article

Wound healing is an intricately tuned sequence of overlapping processes, serving to protect the body.1 This physiological process must adhere to a strict sequence, timeline and operate at an ideal intensity for a given duration.2 Multiple factors can interfere with one or more of the phases of wound healing, thereby resulting in impaired bone and soft tissue healing. Moreover, the oral cavity serves as a unique and remarkable setting whereby wound healing takes place in a saliva-filled environment containing a plethora of micro-organisms.

Oral surgery usually involves both bone and soft tissues. The modes of recovery of these respective tissues differ.

The dynamic process of wound healing constitutes four accurately programmed stages, each with specific biophysiological functions (Table 1).3

Table 3 summarizes cellular and physiological events across the healing process.

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