Wound healing in the tissues of the periodontium following periradicular surgery. I. The incisional wound.

Periradicular surgical procedures were performed on rhesus monkeys and the wound healing responses of the tissues of the periodontium were evaluated by light microscopy. This article, Part I of the investigation, reports the mucoperiosteal tissue wound healing responses to incisional wounds of the triangular and submarginal rectangular flap designs. Little difference was found in the temporal and qualitative healing responses to incisional wounds of the two flap designs. However, the submarginal rectangular design showed less predictable results, with a greater intersample variation of wound healing responses in the earlier postsurgical evaluation periods. Vital connective tissue and epithelium, although not visible clinically, remain attached to the root surfaces following reflection of flaps which include an intrasulcular incision. Preservation of these root-attached tissues prevented apical epithelial down-growth along the root surfaces and loss of soft tissue attachment levels. Vitality of root-attached tissues was preserved by preventing dehydration, avoiding curettement of root surfaces, and using a flap reflection technique which eliminates reflective forces in the intrasulcular incisional wound site.