牙髓血运重建术动物实验研究
发布时间：2018-10-10 15:32
【摘要】：目的:年轻恒牙牙髓坏死或根尖周炎的治疗存在难点,传统治疗方法是根尖诱导成形术,该方法治疗后可以让年轻恒牙获得一定牙根增长和根端封闭,但是无法增厚根管壁,髓腔内无法获得活性软组织。牙髓血运重建术(Pulp revascularization)是最近热门的治疗选择,其通过有效的根管封药,然后刺破根尖周组织使血液进入根管内形成血凝块,将盖髓剂矿物三氧化物凝聚体(mineral trioxide aggregate,MTA)覆盖于血凝块上方,最后严密封闭。达到根管壁增厚,根尖阴影缩小、牙根增长,部分牙电活力测试显示阳性。本研究拟通过对比格犬建立根尖周炎模型,对患有根尖周炎模型的患牙行组织牙髓血运重建术(Pulp revascularization)。利用X线影像学对实验后牙根发育进行评价,利用组织学观察探讨根管内生长组织的特征。材料与方法:选择6只4月龄比格犬,伺养到前牙开始替牙,选择上颌第一、二切牙为实验牙,共24颗。实验牙建立根尖周炎模型,经三联抗生素封药消除炎症,刺破根尖出血后用MTA严密封闭,所有牙齿树脂永久充填后进行观察。在术后1、3、6月拍X线片,6月后处死实验动物,制作切片,HE染色,镜下观察描述,结果进行记录,所得结果记录后进行分析。结果:X线结果:有24颗牙根尖周阴影缩小,20颗牙根管壁增厚、20颗牙根尖孔闭合,有2颗牙出现牙根内吸收。HE染色结果:MTA下见钙化桥。根管壁新生细胞牙骨质样组织以及骨样组织增厚根管,根尖孔由细胞牙骨质样组织闭合,根管内也可见细胞牙骨质样组织。髓腔内软组织似牙髓组织,有炎症细胞浸润。有2例发现成牙本质细胞。有1例根尖吸收严重,但在根尖部根管壁侧仍可见有细胞牙骨质样组织沉积。结论:1:牙髓血运重建术可以使得年轻恒牙根尖周炎炎症愈合,根管壁增厚、根尖孔闭合。2:牙髓血运重建术根管内生成组织为细胞牙骨质样组织,骨样组织和牙周样软组织。3:根管内残余的牙髓组织,在没有感染的情况下,这些残余的牙髓组织可以逐渐恢复活力,并增殖生长,分化为成牙本质细胞,并使牙根继续发育。
[Abstract]:Objective: there are difficulties in the treatment of pulp necrosis or periapical periodontitis in young permanent teeth. The traditional treatment method is apical induced angioplasty, which can make the young permanent teeth gain a certain root growth and seal the root end after treatment, but it can not thicken the wall of the root canal. Active soft tissue could not be obtained in medullary cavity. Dental pulp revascularization (Pulp revascularization) is one of the most popular treatment options in recent years. It uses effective root canals to seal and then prick periapical tissue to make blood enter the root canal to form blood clots. The pulp capping mineral trioxide condensate (mineral trioxide aggregate,MTA) was covered over the hemagglutination and finally sealed. At the same time, the root canal wall thickened, the shadow of root tip reduced, the root grew, and some teeth showed positive electrical activity test. The aim of this study was to establish a model of periapical periodontitis in Beagle dogs and to perform tissue pulpal blood revascularization (Pulp revascularization).) for teeth with apical periodontitis. The root development after experiment was evaluated by X-ray imaging, and the characteristics of root canal growth tissue were studied by histological observation. Materials and methods: six 4-month-old Beagle dogs were selected, and 24 maxillary first and second incisors were selected as experimental teeth. The model of periapical periodontitis was established, and the inflammation was eliminated by using triple antibiotics. MTA was used to close the root tip bleeding and the permanent filling of all teeth was observed. The animals were killed 6 months after the operation, then the animals were killed. The animals were sliced, stained with HE, observed and described under microscope. The results were recorded and analyzed after the results were recorded. Results: the results of X-ray showed that the periapical shadow of 24 teeth was reduced, the wall of 20 teeth was thickened, the apical foramen of 20 teeth was closed, and 2 teeth were absorbed in root. The results of HE staining: calcified bridge was found under MTA. The new cell cementoid tissue and bone-like tissue thickened the root canal, the apical foramen was closed by the cell-cement-like tissue, and the cellular cement-like tissue was also seen in the root canal. The soft tissue in pulp cavity resembles dental pulp tissue, and inflammatory cells infiltrate. Odontoblast was found in 2 cases. In one case, the apical resorption was severe, but there was still cellular cement-like tissue deposition on the wall of the apical root canal. Conclusion: 1: pulp revascularization can make the inflammation of periapical periodontitis of young permanent teeth heal, the wall of root canal is thickened, and the apical foramen is closed. Bone like tissue and periodontal soft tissue. 3: the residual pulp tissue in the root canals can gradually recover its vitality, proliferate and grow, differentiate into odontoblast cells, and make the root continue to develop without infection.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.05
本文编号：2262309
[Abstract]:Objective: there are difficulties in the treatment of pulp necrosis or periapical periodontitis in young permanent teeth. The traditional treatment method is apical induced angioplasty, which can make the young permanent teeth gain a certain root growth and seal the root end after treatment, but it can not thicken the wall of the root canal. Active soft tissue could not be obtained in medullary cavity. Dental pulp revascularization (Pulp revascularization) is one of the most popular treatment options in recent years. It uses effective root canals to seal and then prick periapical tissue to make blood enter the root canal to form blood clots. The pulp capping mineral trioxide condensate (mineral trioxide aggregate,MTA) was covered over the hemagglutination and finally sealed. At the same time, the root canal wall thickened, the shadow of root tip reduced, the root grew, and some teeth showed positive electrical activity test. The aim of this study was to establish a model of periapical periodontitis in Beagle dogs and to perform tissue pulpal blood revascularization (Pulp revascularization).) for teeth with apical periodontitis. The root development after experiment was evaluated by X-ray imaging, and the characteristics of root canal growth tissue were studied by histological observation. Materials and methods: six 4-month-old Beagle dogs were selected, and 24 maxillary first and second incisors were selected as experimental teeth. The model of periapical periodontitis was established, and the inflammation was eliminated by using triple antibiotics. MTA was used to close the root tip bleeding and the permanent filling of all teeth was observed. The animals were killed 6 months after the operation, then the animals were killed. The animals were sliced, stained with HE, observed and described under microscope. The results were recorded and analyzed after the results were recorded. Results: the results of X-ray showed that the periapical shadow of 24 teeth was reduced, the wall of 20 teeth was thickened, the apical foramen of 20 teeth was closed, and 2 teeth were absorbed in root. The results of HE staining: calcified bridge was found under MTA. The new cell cementoid tissue and bone-like tissue thickened the root canal, the apical foramen was closed by the cell-cement-like tissue, and the cellular cement-like tissue was also seen in the root canal. The soft tissue in pulp cavity resembles dental pulp tissue, and inflammatory cells infiltrate. Odontoblast was found in 2 cases. In one case, the apical resorption was severe, but there was still cellular cement-like tissue deposition on the wall of the apical root canal. Conclusion: 1: pulp revascularization can make the inflammation of periapical periodontitis of young permanent teeth heal, the wall of root canal is thickened, and the apical foramen is closed. Bone like tissue and periodontal soft tissue. 3: the residual pulp tissue in the root canals can gradually recover its vitality, proliferate and grow, differentiate into odontoblast cells, and make the root continue to develop without infection.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.05
【引证文献】
相关期刊论文 前1条
1 杜连美;高尔东;吕敏敏;王静;陈萍;杜亚慧;;显微镜下牙髓血运重建术对年轻恒牙牙髓坏死治疗的临床疗效研究[J];世界最新医学信息文摘;2018年34期
，本文编号：2262309
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