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INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
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"Opportunities are usually disguised by hard work, so most people don't recognize them." - Ann Landers www.indiandentalacademy.com
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“Inflame” – to set fire. Inflammation is “dynamic response of vascularised tissue to injury.” Is a protective response. Serves to bring defense & healing mechanisms to the site of injury. www.indiandentalacademy.com
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Flush: capillary dilatation. Flare: arteriolar dilatation. Weal: exudation, edema.
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(Flare, Flush & Weal – Lewis)
Triple response
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Rubor : Redness – Hyperaemia. Calor : Warm – Hyperaemia. Dolor : Pain – Nerve, Chemical med. Tumor: Swelling – Exudation Loss of Function: www.indiandentalacademy.com
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1. Vaso dilatation 2. Exudation - Edema 3. Emigration of cells 4. Chemotaxis
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Chemical substances synthesised or released which mediate the changes in inflammation. Histamine by mast cells - vasodilatation. Prostaglandins – Cause pain & fever. Bradykinin - Causes pain.
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Acute:
Exudative Inflammation: excess fluid. TB lung. Suppuration/Purulent – Bacterial - neutrophils Fibrinous – pneumonia – fibrin Serous – excess clear fluid – Heart, lung Haemorrhagic – b.v.damage - anthrax.
Chronic inflammation: with healing.
Grannulomatous – clusters of epitheloid* cells eg. TB, Fungus, Foreign body.
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“Never let the competition define you. Instead, you have to define yourself based on a point of view you care deeply about.” – Tom Chappel
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Fibrosis/Scar Resolution Injury
Acute Inflammation
Chronic Inflammation
Abscess
Fungus Virus Cancers T.B. etc.
Ulcer Fistula
Sinus
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Flush, Flare & Weal Acute inflammatory cells - Neutrophils Vascular damage More exudation Little or no fibrosis
Little signs Fibrosis, Chronic inflammatory cells – Lymphocytes Neovascularisation No/less exudation Shashi-Mar 2000
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"People who soar, are those who refuse to sit back and wish things would change." Charles R. Swindoll Author and Pastor www.indiandentalacademy.com
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Heat
Redness Swelling www.indiandentalacademy.com
Pain Loss Of Func. Shashi-Mar 2000
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Dr. Venkatesh M. Shashidhar. Associate Professor of Pathology Fiji School of Medicine www.indiandentalacademy.com
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Hemorrhage Inflammation Granulation tissue (soft callus) Scar – Fibrosis (hard callus) Remodeling & Wound strength
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Regeneration of injured tissue by parenchymal cells of the same type Replacement by connective tissue In other words
Regeneration Scar
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Labile cells - continuously dividing
Stable cells - low level of replication
Epidermis, mucosal epithelium, GI tract epithelium etc Hepatocytes, renal tubular epithelium, pancreatic acini
Permanent cells - never divide
Nerve cells, cardiac myocytes, skeletal mm
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Most Important Mediators affecting Cell Growth Present in serum or produced locally Exert pleiotropic effects; proliferation, cell migration, differentiation, tissue remodeling Regulate growth of cells by controlling expression of genes that regulate cell proliferation
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Occurs when repair by parenchymal regeneration alone cannot be accomplished Involves production of Granulation Tissue replacement of parenchymal cells with proliferating fibroblasts and vascular endothelial cells
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Angiogenesis - New vessels budding from old Fibrosis, consisting of emigration and proliferation of fibroblasts and deposition of ECM Scar remodeling, tightly regulated by proteases and protease inhibitors
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Induction of acute inflammatory response by an initial injury Parenchymal cell regeneration Migration and proliferation of parenchymal and connective tissue cells
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Synthesis of ECM proteins Remodeling of parenchymal elements to restore tissue function Remodeling of connective tissue to achieve wound strength
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After sutures are removed at one week, wound strength is only 10% of unwounded skin (Walker’ Law) By 3-4 months, wound strength is about 80% of unwounded skin (Walker’s Law)
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Systemic Age Nutrition Vitamin def. Immune status Other diseases
Local Infection Size or extent. apposition Blood supply Mobility Foreign body
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Healing – Proliferation & Differentiation. Labile, Stabe & Permanent cells Stages of Healing: 1-2-3-4…. Healing by First or Second intention. Skin wound healing - bone healing. Factors affecting healing – Local / Systemic
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"Each time you are honest and conduct yourself with honesty, a success force will drive you toward greater success. Each time you lie, even with a little white lie, there are strong forces pushing you toward failure." Joseph Sugarman Author and Marketing Specialist www.indiandentalacademy.com
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www.indiandentalacademy.com Leader in continuing dental education
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