中国实用口腔科杂志

中国实用口腔科杂志

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犬年轻恒牙根尖周炎和再生性牙髓治疗后组织学观察

陈    敏1，2，刘雪梅1，包志凡1，刘    尧1，姜力铭1，陈    旭1   

  1. 1. 中国医科大学口腔医学院儿童口腔科，辽宁省口腔疾病重点实验室，沈阳  110002；2. 江苏大学附属人民医院口腔科，江苏  镇江  212002
  • 出版日期:2015-09-15 发布日期:2015-10-13
  • 基金资助:

    辽宁省科学技术计划项目（2012225015；2013225090）

  • Online:2015-09-15 Published:2015-10-13

摘要：

目的    应用比格犬制造年轻恒牙根尖周炎动物模型，并进行再生性牙髓治疗（regenerative endodontic treatment， RET），组织学观察治疗后牙根发育情况，为进一步探寻炎症与损伤修复的关系以及RET后组织修复的机制奠定实验基础。方法    本研究于2013年12月至2014年7月在中国医科大学口腔医学院中心实验室完成。选择3只6月龄的比格犬，每只犬双根前磨牙4颗，共12颗牙，随机分为正常对照组、根尖周炎组、空根管组以及RET组，每组3颗牙。RET后3个月全麻下处死实验动物，颈静脉灌流固定，将上下颌骨取下后固定1周，pH 7.2的10%乙二胺四乙酸中脱钙3个月。常规脱水，石蜡包埋，切片，HE染色，镜下观察。结果    根尖周炎组根管内可见大量免疫细胞，无新组织修复；空根管组根管内仅有纤维性修复；RET组根管内、根管壁以及根尖部有新组织形成，使根管壁增厚，牙根增长，根尖孔闭合，牙根继续发育。结论    在有效根管消毒、控制年轻恒牙根尖周炎的基础上，机体即能发挥一定限度的组织修复能力；RET过程中刺破出血本身造成局部适度的损伤，可能进一步激发了干细胞的增殖和分化，利于新组织的形成，使牙根继续发育。

关键词: 年轻恒牙, 根尖周炎, 再生性牙髓治疗

Abstract:

Objective    In the present study， we performed RET on beagle dogs’ immature teeth with periapical periodontitis and observed the root development histologically. This animal study aimed to lay the basis for further exploring relationship between inflammation and tissue restoration as well as the mechanisms involved in RET. Methods    Totally twelve immature premolars from three 6-month-old Beagle dogs were randomly assigned to four groups normal control （NC）， apical periodontitis （AP）， RET， and empty root canal groups （3 teeth/group）. Three months after RET， the animals were sacrificed and perfused under general anesthesia. The tissue blocks were decalcified using 10%EDTA （pH7.2） and embedded in paraffin， stained with hematoxylin-eosin. Results    Histological results indicated that there were plenty of immune cells in periodontitis group without obvious repairment. After disinfection， only fibrous repairment could be observed in teeth without induction of blood clots in empty root canal groups. New soft and hard tissues contributing to thickened root wall increased root length and apical closure were formed after RET. Conclusion    After effective disinfection of the root canal and control of the periapical periodontitis of immature permanent teeth， repairment can take place to some extent. Induction of blood clot during RET can cause moderate impairment and irritate the proliferation and differentiation of stem cells， thus leading to further tissue regeneration and continual root development.

Key words: immature permanent tooth, periapical periodontitis, regenerative endodontic treatment