中国实用口腔科杂志

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三种倒充填材料的X线和病理组织切片对比研究

杜兴华1,申    静2   

  1. 1.天津医科大学,天津 300041;2.南开大学口腔医院·天津市口腔医院国际诊疗中心,天津  300041
  • 出版日期:2015-09-15 发布日期:2015-10-13
  • 基金资助:

    天津市2011年自然科学基金(11JCYBJC11900)

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

摘要:

目的    通过比较在动物模型上完成的显微根尖手术后X线表现和病理组织切片,探讨氧化锌、矿物三氧化物凝聚体(MTA)、生物陶瓷(iRoot BP)作为根尖倒充填材料的疗效。方法    本研究于2011年4月至2015年3月在天津市口腔医院实验室完成。对形成实验性根尖周炎的4只Beagle犬的第二、第三、第四前磨牙(共24颗,48个根管)行常规根管治疗,术后1周行显微根尖手术,48个根管随机分为3组,每组16个,分别用氧化锌、MTA和iRoot BP作为根尖倒充填材料。术后1年,拍摄根尖X线片后处死实验动物获得标本,观察比较根尖组织的X线片和组织病理学切片,评价iRoot BP和MTA的疗效。结果    根据根尖X线片分析评价术后疗效,术后1年的成功率,氧化锌组为81.2%、MTA组为93.8%、iRoot BP组为93.8%,3组间差异无统计学意义。组织病理切片结果显示:MTA组和iRoot BP组与氧化锌组相比,炎症程度较轻,差异有统计学意义(P<0.05);MTA与iRoot BP比较,差异无统计学意义(P>0.05)。氧化锌、MTA和iRoot BP组根尖切除区牙本质表面牙骨质样组织沉积率分别为(50.2 ± 16.5)%、(80.2 ± 26.4) %、(78.6 ± 30.4)%,MTA组和iRoot BP组的骨样组织沉积高于于氧化锌组,差异有统计学意义(P<0.05);MTA组和iRoot BP组之间差异无统计学意义(P>0.05)。3组中,仅MTA组材料表面有牙骨质样组织的直接沉积。结论    作为倒充填材料,氧化锌、MTA和iRoot BP的疗效差异无统计学意义;3种材料均可促进根尖周硬组织的再生,iRoot BP与MTA对根尖周组织的炎症刺激较轻,MTA有最佳的生物相容性。

关键词: 氧化锌, 矿物三氧化物凝聚体, iRoot BP, 根尖片, 组织切片, 比格犬

Abstract:

Objective    To evaluate the effect of zinc oxide, iRoot BP and mineral trioxide aggregate(MTA) as root-end filling materials during periapical microsurgery in animals by comparing X-ray and pathological biopsy after surgery. Methods    The study was completed in Tianjin Stomatological Hospital Laboratory between April 2011 and March 2015.The mandibular premolars of 4 Beagle dogs were selected for study. Periapical lesions in teeth of dogs were induced in the experiment; root canal therapy and micro-surgery were made. Totally 48 canals were divided into three groups,each group having 16 canals.Zinc oxide, MTA or iRoot BP was randomly used as root-end filling materials. After one year,periapical radiography was taken and the animals were sacrificed, then serial sections from the roots were prepared for histopathological observation. The success rates of 12 months post-operatively were statistically analyzed according to imageology and histopathology. Results    According to the X-ray film, the success rate of zinc oxide, MTA and iRoot BP 1 year after operation was 81.2%, 93.8% and 93.8%,respectively. There was no significant difference among the three kinds of materials. Pathological results of tissue showed that the degree of inflammation of MTA and iRoot BP was lower than zinc oxide, the difference being statistically significant. There was no significant difference between iRoot BP and MTA in the number of inflammatory cells. The bone deposition rate of MTA[(80.2±26.4) %] and iRoot BP[(78.6±30.4)%] was higher than that of zinc oxide[(50.2±16.5)%]. The MTA was the only one on which direct deposit of hard tissues could be observed directly on. Conclusion    As retrograde root-end filling materials, zinc oxide, iRoot BP and MTA produce similar healing effect,and hard tissue can be promoted to regenerate by all of them. BP and the MTA produce less severe inflammation on the periapical tissues. MTA has the best biological compatibility.

Key words: zinc oxide , MTA, iRoot BP, periapical radiography, tissue section, Beagle dog