Wound healing in the tissues of the periodontium following periradicular surgery. 2. The dissectional wound.

Wound healing responses of the tissues of the periodontium following periradicular surgery in rhesus monkeys were evaluated by light microscopy. Part II of this investigation reports the responses of mucoperiosteal and osseous tissues to blunt dissectional wounding resulting from the reflection of triangular or submarginal rectangular flaps. Healing of the dissectional wound is rapid, although slower than the incisional wound. Granulation tissues replaces the fibrin clot in the wound site as early as 4 days after surgery, and is replaced by fibrous connective tissue by 14 days. Minimal differences were found in the temporal and qualitative dissectional wound-healing responses to the two types of flap designs. The periosteum does not survive the flap reflection procedure. The cells of the cambium layer are destroyed and the collagen of the fibrous layer undergoes depolymerization. It is postulated that the depolymerized periosteal collagen plays a role in rapid reattachment of flapped tissues to cortical bone.