Abstract
A wound is defined as any physical break in tissue continuity. Wounds differ depending on the type and severity, mechanism of wounding, location, and desired outcome. The act of wounding or injury disrupts anatomical continuity, tissue function, and cellular integrity 1. Alterations in wound healing may result in impaired or delayed healing. Impaired wound healing often occurs in the presence of concurrent injury or infection as in a patient who has diabetes or has received radiation therapy, and almost always leads to a poor wound outcome 2. A delayed or poorly healing wound may have decreased tensile strength or low collagen accumulation but may eventually heal to normal (3). Delayed wound healing, especially in the context of stress-induced immune suppression may result in increased infection, scarring, poor esthetic outcome, and poor regenerative potential (4). Tissues in the oral cavity are capable of remarkable regeneration and repair. Depending on the severity and location of tissue damage and whether the source of injury or infection is eliminated, oral tissue will typically completely heal within 2 wk (5). Healing results rapidly in the majority of instances because of the rich vascular nature of the oral cavity. Nutritional deficiencies and other factors such as smoking, chronic disease, and medications can make oral tissue more susceptible to injury and impact the healing process.
Preview
Unable to display preview. Download preview PDF.
References
Certosimo F, Nicoll B, Nelson R, Wolfgang M. Wound healing and repair: a review of the art and science. Gen Dent 1998; July/August:362–369.
Winkler M. Surgery and wound healing. In Skipper A, ed. Dietitian’s Handbook of Enteral and Parenteral Nutrition. Gaithersburg, MD: Aspen Publishers, 1998.
Albina JE. Nutrition and wound healing. J Parenter Enteral Nutr 1994; 18:367–376.
Rozlog LA, Kiecolt-Glaser JK, Marucha PT, Sheridan JF, Glaser R. Stress and immunity: implications for viral disease and wound healing. J Periodontol 1999; 70:786–792.
Fehrenbach MJ, Lemborn UE, Phelan JA. Inflammation and repair. In Ibsen O, Phelan J, eds. Oral Pathology for the Dental Hygienist. 3rd Ed. Philadelphia, PA: W.B. Saunders, 2000, 43–101.
Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan M, Genco RJ. Dietary vitamin C and the risk for periodontal disease. J Periodontol 2000; 71:1215–1223.
Esposito M, Hirsch J, Lekholm U, Thomsen P. Differential diagnosis and treatment strategies for biologic complications and failing oral implants: a review of the literature. Int J Oral Maxillofac Implants 1999; 14: 473–490.
Cranin AN. Implant surgery: the management of soft tissues. J Oral Implantol 2002; 28:230–237.
Winkler S, Mekayarajjananonth T, Garg AK, Tewari DS. Nutrition and the geriatric implant patient. Implant Dent 1997; 6:291–294.
Rees TD, Orth CF. Oral ulcerations with use of hydrogen peroxide. J Periodontal 1986; 57: 689–692.
Kornman KS, Loe H. The role of local factors in the etiology of periodontal diseases. Periodontol 2000 1993; 2:83–97.
O’Leary TJ. The impact of research on scaling and root planing. J Periodontol 1986; 57: 69–75.
Axelsson P, Lindhe J. The significance of maintenance care in the treatment of periodontal disease. J Clin Periodontol 1981; 8:281–294.
Badersten A, Nilveus R, Egelberg J. Four-year observations of basic periodontal therapy. J Clin Periodontol 1987; 14:438–444.
Heard RH, Mellonig JT. Regenerative materials: an overview. Alpha Omegan 2000 1993; 4: 51–58.
Eickholz P, Kim TS, Hausmann E, Holle R. Long-term results of guided tissue regeneration therapy with non-resorbable and bioabsorbable barriers. Infrabony defects. Abstract. IADR/AADR/CADR 80th General Session, March 6–9, 2002.
Alfano MC. Controversies, perspectives, and clinical implications of nutrition in periodontal disease. Dent Clin North Am 1976; 20:519–548.
Enwonwu CO, Phillips RS, Falkler WA. Nutrition and oral infectious diseases: state of the science. Compend Contin Educ Dent 2002; 23:431–438.
Enwonwu CO. Interface of malnutrition and periodontal diseases. Am J Clin Nutr 1995; 61: 430S–436S.
Alfano MC, Miller SA, Drummond JF. Effect of ascorbic acid deficiency on the permeability and collagen biosynthesis of oral mucosal epithelium. Ann NY Acad Sci 1975; 258:253–363.
Leggott PJ, Robertson PB, Jacob RA, Zambon JJ, Walsh M, Armitage GC. Effects of ascorbic acid depletion and supplementation on periodontal health and subgingival microflora in humans. J Dent Res 1991; 70: 1531–1536.
Ismail AI, Burt BA, Eklund SA. Relation between ascorbic acid intake and periodontal disease in the United States. J Am Dent Assoc 1983; 107:927–931.
Ehrlichman RJ, Seckel BR, Bryan DJ, Moschella CJ. Common complications of wound healing. Surg Clin North Am 1991; 71:1323–1351.
Williamson CE, Yukna RA, Gandor DW. Zinc concentration in normal and healing gingival tissue in beagle dogs. J Periodontol 1984; 55:170–174.
Clarke DE. Clinical and microbiological effects of oral zinc ascorbate gel in cats. J Vet Dent 2001; 18: 177–183.
Markowitz K, Moynihan M, Liu M, Kim S. Biologic properties of eugenol and zinc oxide-eugenol: a clinically oriented review. Oral Surg Oral Med Oral Pathol 1992; 73:729–737.
Pitt Ford TR, Andreasen JO, Dorn SO, Kariyawasam SP. Effect of various zinc oxide materials as rootend fillings on healing after replantation. Int Endod J 1995; 28:273–278.
Anderson PM, Schroeder G, Skubitz KM. Oral glutamine reduces the duration and severity of stomatitis after cytotoxic cancer chemotherapy. Cancer 1998; 83:1433–1439.
Cockerham MB, Weinberger BB, Lerchie SB. Oral glutamine for the prevention of oral mucositis associated with high-dose paclitaxel and melphalan for autologous bone marrow transplantation. Ann Pharmacother 2002; 34: 300–303.
Waddington RJ, Moseley R, Embery G. Reactive oxygen species: a potential role in the pathogenesis of periodontal diseases. Oral Dis 2000; 6:138–151.
Diab-Ladki R, Pellat B, Chahine R. Decrease in the total antioxidant activity of saliva in patients with periodontal diseases. Clin Oral Investig 2003; 7:103–107.
Sculley DV, Langley-Evans SC. Periodontal disease is associated with lower antioxidant capacity in whole saliva and evidence of increased protein oxidation. Clin Sci 2003; 105:167–172.
Brock GR, Matthews J, Butterworth C, Chapple ILC. Plasma and crevicular fluid antioxidant defense in periodontitis and health. Abstract. IADR/AADR/CADR 80th General Session, March 6–9, 2002.
Battino M, Bullon P, Wilson M, Newman H. Oxidative injury and inflammatory periodontal diseases: the challenge of anti-oxidants to free radicals and reactive oxygen species. Crit Rev Oral Biol Med 1999; 10:458–476.
Sculley DV, Langley-Evans SC. Salivary antioxidants and periodontal disease status. Proc Nutr Soc 2002; 61:137–143.
Munoz CA, Kiger RD, Stephens JA, Kim J, Wilson AC. Effects of a nutritional supplement on periodontal status. Compend Contin Educ Dent 2001; 22: 425–432.
American Academy of Periodontology. The pathogenesis of periodontal diseases. J Periodontol 1999; 70: 457–470.
Persson L, Bergstrom J, Ito H, Gustafsson A. Tobacco smoking and neutrophil activity in periodontal disease. J Periodontol 2001; 72:90–95.
Rudolph DM. Why won’t this wound heal? Amer J Nurs 2002; 102:24DD–24HH.
Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: a two-way relationship. Ann Periodontol 1998; 3:51–61.
Grant-Theule DA. Periodontal disease, diabetes, and immune response: a review of current concepts. J West Soc Periodontol Periodontal Abstr 1996; 44:69–77.
Lin BP-J, Taylor GW, Allen DJ, Ship JA. Dental caries in older adults with diabetes mellitus. Spec Care Dent 1999; 19:8–14.
Taylor GW, Burt BA, Becker MP, Genco RJ, Shlossman M. Glycemic control and alveolar bone loss progression in type 2 diabetes. Ann Periodontol 1998; 3:30–39.
Dorocka-Bobkowska B, Budtz-Jorgensen E, Wloch S. Non-insulin-dependent diabetes mellitus as a risk factor for denture stomatitis. J Oral Pathol Med 1996; 25: 411–415.
Naugle K, Darby ML, Bauman DM, Lineberger LT, Powers R. The oral health status of individuals on renal dialysis. Ann Periodontol 1998; 3:197–205.
DeRossi SS, Glick M. Dental considerations for the patient with renal disease receiving hemodialysis. J Am Dent Assoc 1996; 127:211–219.
Ghezzi EM, Ship JA. Systemic disease and their treatments in the elderly: impact on oral health. J Pub Health Dent 200; 60:289–296.
Anstead GM. Steroids, retinoids, and wound healing. Adv Wound Care 1998; 11:277–285.
Levenson SM, Demetriou AA. Metabolic factors. In Cohen IK, Diegelmann RF, Lindblad WJ, eds. Wound Healing: Biochemical and Clinical Aspects. Philadelphia, PA: W.B. Saunders, 1992, 248–273.
Peterson DE, D’Ambrosio JA. Diagnosis and management of acute and chronic oral complications of nonsurgical cancer therapies. Dent Clin North Am 1992; 36:945–966.
Carl W. Oral complications of local and systemic cancer treatment. Curr Opin Oncol 1995; 7: 320–324.
Marciani RD. Critical systemic and psychosocial considerations in the management of trauma in the elderly. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87:272–280.
Position of the American Dietetic Association. Oral health and nutrition. J Am Diet Assoc 1996; 96: 184–189.
Dorsky R. Nutrition and oral health. Gen Dent 2001; November/December:576–582.
Selected Websites
A Comprehensive Color Photo Atlas of Dentistry: Wound Healing, Dental Images http://www.drdorfman.com/atlas/at204
American Academy of Periodontology http://www.perio.org
American Academy of Wound Management http://www.aawm.org
Association for the Advancement of Wound Care http://www.AAWC1.com
Center for Stress and Wound Healing http://www.med.ohio-state.edu/mindbody/
Comprehensive Training in Oral and Craniofacial Sciences (CTOC) http://www.ctoc.osu/edu/wound_healing.html
International Association for Dental Research and American Association for Dental Research http://www.iadr.com
Journal of Wound Care http://www.journalofwoundcare.com
National Institute of Dental and Craniofacial Research (NIDCR) http://www.nidr.nih.gov
The Wound Care Information Network http://www.medicaledu.com
The Wound Healing Society http://www.woundheal.org
UCLA Dental Research Unit: Wound Healing Research Center http://www.dent.ucla.edu/drl
Wound Healing Research Group, University of Wales College of Medicine, Wales, UK http://www.uwcm.ac.uk/study/dentistry/osmp/wound/wound.htm
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Winkler, M.F., Makowski, S. (2005). Wound Healing. In: Touger-Decker, R., Sirois, D.A., Mobley, C.C. (eds) Nutrition and Oral Medicine. Nutrition and Health. Humana Press. https://doi.org/10.1385/1-59259-831-5:273
Download citation
DOI: https://doi.org/10.1385/1-59259-831-5:273
Publisher Name: Humana Press
Print ISBN: 978-1-58829-192-9
Online ISBN: 978-1-59259-831-1
eBook Packages: MedicineMedicine (R0)