Extraction

socket healing
Ø Secondary intention
Ø Intramembranous bone healing

1. Granulation stage (immediate-5 days)
Ø Hemostasis
Ø Inflammation
Ø Granulation tissue
o Start from the base of the socket, extending cretally along the
socket wall
o Blood clot occupy central portion
o Osteoclast accumulate along alveolar bone crest

2. Initial angiogenic stage (1st week)
Ø Angiogenesis
o Start at the base of socket + PDL at cribiform plate (lamina
dura)
§ Because of the thick and strong trabeculae and capillary
plexus
o New sinusoids fills up 2/3 of the socket
§ Sinusoids = irregular trabecular space for passage of
blood
Ø Active bone resorption
o Mainly at crestal bone and cortical margin of alveolar socket

3. New bone formation (2nd week)
Ø Osteoid trabeculae (from base and sides of socket) slowly extends into
clot
Ø Anastomosing sinusoids à new bone trabeculae (governed by
expansion and location of the sinusoids)
Ø Woven bone formation (incompletely ossified)

4. Bone growth stage (4th-5th week)
Ø Deposit additional trabeculae
Ø Thickened socket base and wall à fill up 2/3 of original socket volume

5. Bone reorganization stage (6th week)
Ø From primary spongiosa (spongy cancellous bone) à secondary
spongiosa (irregular and larger framework)

6. Remodelling (3rd week onwards)
Ø A series of bone deposition and resorption
Ø 6th-8th week: apparent radiographic evidence of bone formation
Ø 4th-6th month: complete healing on radiograph