口腔种植学精品教学（中山大学）002oral implantology.docVIP

 PAGE \* MERGEFORMAT 6 BASIS OF PRACTICAL IMPLANTOLOGY Anatomy, histology, physiology , diagnosis and pharmacologic aspect LIN WANG Tel Email wanglin7@mail.sysu.edu.cn Contents Histology healing of tooth socket Anatomy gingiva (physio) maxilla and mandible alveolar process maxilla sinus Diagnosis radiographic imaging Oral condition and pharmacologic aspects Healing of tooth socket Why learn again? When do implant? Normal healing Abnormal healing (delayed healing) What causes abnormal healing How to avoid abnormal healing Normal healing of tooth socket 90 days of continuous process 1. Bleeding from the socket and socket sealed with clot This usually takes 15-30mins. Protect the blood clot 2. Organization of the clot and clot forms granulation tissue This process takes 7 days Contract of gingiva tissue to reduce the size of socket Temporary scaffold 3. Granual tissue replaced by connective tissue and epithelium The clot continues to get organized Epithelium at the wound periphery grows over the surface over the clot This process may take 20-30 days Active osteoclastic resorption is more distinct 4. Connective tissue replaced by trabeculae of osteoid Trabeculae of osteoid slowly extend into the socket This process begins in one week after extraction and continues for 4 weeks 5. Functional remodeling of alveolar process Active bone remodeling by deposition and resorption continues for several weeks poor calcified bone replaced by matured bone Fails to form clot，Clot drops early，Tooth remnant — Delayed healing — wait — Inflammatory granual tissue in socket block bone remodeling — debridement Gingiva Free gingiva Attached gingiva (wear resistant) Interdental papilla Alveolar mucosa Tooth loss—Free gingiva disappearing, Papilla disappearing, Attached gingival t