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Tissue response to a haemostatic alginate wound dressing in tooth extraction sockets.

Kaltostat is a new haemostatic wound dressing composed of non-woven sodium calcium alginate fibres, and was originally developed to cover exposed wounds of the skin. A histopathological study was undertaken to determine the tissue response to Kaltostat in healing tooth sockets, to obtain a comparison with oxidised regenerated cellulose (Surgicel). Tooth sockets filled with blood clot acted as controls. The results showed that both biomaterials delayed wound healing in the early phase (1-4 weeks), giving rise to foreign body reactions. At 12 weeks there was little difference between the control sockets and the sockets containing the test materials, although remnants of retained dressing materials were identified. Healing of the tooth sockets was complete at 24 weeks.

Alginates↗

[Changes in the microvascular patterns during the osseous healing of the tooth extraction wounds].

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.

Alveolar Process↗

[Radiodensitometric studies on bone structure following tooth extractions].

Radiographs of the human mandible, accurately showing the same location, are made at different times after extraction of lateral teeth and examined with regard to changes in the bone structure during wound healing. The radiograms are evaluated by densography and the photometric graphs thus obtained are evaluated by computer. Compared with histological findings known so far, these examinations furnish information on time and location of resorption and production of bone after dental extractions. The first findings are quantitatively presented.

Bone Regeneration↗