The document summarizes the healing of biopsy wounds in the oral cavity. It describes that healing can occur through primary or secondary intention. Primary intention involves suturing the wound edges together, allowing rapid healing without scar tissue. Secondary intention occurs when wound edges cannot be approximated, requiring the wound to fill in slowly with granulation tissue before re-epithelialization. Both processes involve inflammation, fibroblast proliferation, new blood vessel formation, and collagen deposition to regenerate tissue.

2. GUIDED BY:
 DR.MOHSIN GHANCHI
 DR.DHAVAL JANI
 DR.KARTIKAY SAXENA
 DR.VIKAS BHAKHAR

3. PRESENTED BY
 THAKKAR SHIVANI .R.
 3RD YEAR BDS
 ROLL.NO:79

4. SEMINAR TOPIC
 HEALING OF BIOPSY WOUND

5. Healing of biopsy wound of the oral cavity is
identical with the healing of a similar wound in
any other part of the body & thus may be
classified as either primary healing or
secondary healing.
The nature of the healing process depends
upon whether the edges of the wound can be
brought into apposition, often by suturing, or
whether the lesion must fill in gradually with
granulation tissue.

6. PRIMARY HEALING
 It is healing that occurs after the excision of a piece of tissue
with the close apposition of the edges of the wound by suture.
 This is the from of healing one might expect after the excision of
the tissue is such that the wound may be drawn together &
suture.
 When the edges of the wound are brought into contact & held in
place by suture, the blood clots, & in a matter of hours
numerous leukocytes are mobilized to that area.

7. Connective tissue cells in the immediate vicinity
undergo transformation into fibroblasts, which in
turn undergo mitotic division, & the new
fibroblasts begin to migrate into & across the
line of incision.
In time, these cells from thin delicate collagen
fibrils, which intertwine & coalesce a general
direction parallel to the surface of the wound.

8.  At the same time, endothelial cells of the capillaries begin to
proliferate, & small capillary buds grow out & across the wound.
 These buds eventually from new capillaries which fill with blood,
& a rich network of young capillaries & capillary loops are
formed.
 When there is a close apposition of the edges of the wound, the
surface epithelium proliferates rapidly across the line of incision
& re-establishes the integrity of the surface.

9. The delicate connective tissue fibrils eventually
coalesce into denser bundles & usually contract,
so that in time all that is left to indicate the
biopsy wound area is a small linear scar which
may be depressed below the surface.
Because there is no defect which must be filled
with new tissue, this type of wound heals
rapidly.

11. SECONDARY HEALING
 It is healing by granulation or healing of an open
wound occurs when there is loss of tissue & the
edges of the wound cannot be approximated.
 Healing of this type is often spoken of as a process
in which the wound ‘granulates in’ since the
material, which fills the defect during the healing
process is called granulation tissue.

12. This type of wound is a result of biopsy of a
lesion in an area of the oral cavity in which the
edges cannot be approximated.
Example : Removal of a lesion of the palate or a
large lesion of the alveolar ridge is usually
followed by healing by second intention, since
the edges of the wound cannot be coapted.

13.  After the removal of the lesion, the blood fills the defect, clots &
the repair process begins
 It is basically identical with healing by primary intention expect
that the fibroblasts & capillaries have a greater distance to
migrate, more granulation tissue must form, & of necessity the
healing is slower.
 Cellular proliferation begins around the periphery of the wound,
& the fibroblasts & endothelial cells grow into the clot fibrin
strands.

14. In addition, polymorphonuclear leukocytes, &
later, lymphocytes, mononuclear phagocytes
migrate into the granulation tissue from the
adjacent vessels & tissues.
Large numbers of leukocytes also accumulate
on the surface of the wound.

15.  As the granulation tissue matures, it becomes more fibrous
through condensation of collagen bundles, & the surface of the
granulation tissue becomes epithelialized.
 As in primary healing, the collagen fibrils coalesce & the lesion
becomes somewhat less vascular, & eventually the only
evidence of the wound may be a small depressed area of the
mucosa.