牙髓血運重建術(shù)動物實驗研究
發(fā)布時間：2018-10-10 15:32
【摘要】：目的:年輕恒牙牙髓壞死或根尖周炎的治療存在難點,傳統(tǒng)治療方法是根尖誘導(dǎo)成形術(shù),該方法治療后可以讓年輕恒牙獲得一定牙根增長和根端封閉,但是無法增厚根管壁,髓腔內(nèi)無法獲得活性軟組織。牙髓血運重建術(shù)(Pulp revascularization)是最近熱門的治療選擇,其通過有效的根管封藥,然后刺破根尖周組織使血液進入根管內(nèi)形成血凝塊,將蓋髓劑礦物三氧化物凝聚體(mineral trioxide aggregate,MTA)覆蓋于血凝塊上方,最后嚴密封閉。達到根管壁增厚,根尖陰影縮小、牙根增長,部分牙電活力測試顯示陽性。本研究擬通過對比格犬建立根尖周炎模型,對患有根尖周炎模型的患牙行組織牙髓血運重建術(shù)(Pulp revascularization)。利用X線影像學(xué)對實驗后牙根發(fā)育進行評價,利用組織學(xué)觀察探討根管內(nèi)生長組織的特征。材料與方法:選擇6只4月齡比格犬,伺養(yǎng)到前牙開始替牙,選擇上頜第一、二切牙為實驗牙,共24顆。實驗牙建立根尖周炎模型,經(jīng)三聯(lián)抗生素封藥消除炎癥,刺破根尖出血后用MTA嚴密封閉,所有牙齒樹脂永久充填后進行觀察。在術(shù)后1、3、6月拍X線片,6月后處死實驗動物,制作切片,HE染色,鏡下觀察描述,結(jié)果進行記錄,所得結(jié)果記錄后進行分析。結(jié)果:X線結(jié)果:有24顆牙根尖周陰影縮小,20顆牙根管壁增厚、20顆牙根尖孔閉合,有2顆牙出現(xiàn)牙根內(nèi)吸收。HE染色結(jié)果:MTA下見鈣化橋。根管壁新生細胞牙骨質(zhì)樣組織以及骨樣組織增厚根管,根尖孔由細胞牙骨質(zhì)樣組織閉合,根管內(nèi)也可見細胞牙骨質(zhì)樣組織。髓腔內(nèi)軟組織似牙髓組織,有炎癥細胞浸潤。有2例發(fā)現(xiàn)成牙本質(zhì)細胞。有1例根尖吸收嚴重,但在根尖部根管壁側(cè)仍可見有細胞牙骨質(zhì)樣組織沉積。結(jié)論:1:牙髓血運重建術(shù)可以使得年輕恒牙根尖周炎炎癥愈合,根管壁增厚、根尖孔閉合。2:牙髓血運重建術(shù)根管內(nèi)生成組織為細胞牙骨質(zhì)樣組織,骨樣組織和牙周樣軟組織。3:根管內(nèi)殘余的牙髓組織,在沒有感染的情況下,這些殘余的牙髓組織可以逐漸恢復(fù)活力,并增殖生長,分化為成牙本質(zhì)細胞,并使牙根繼續(xù)發(fā)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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R781.05
本文編號：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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R781.05
【引證文獻】
相關(guān)期刊論文 前1條
1 杜連美;高爾東;呂敏敏;王靜;陳萍;杜亞慧;;顯微鏡下牙髓血運重建術(shù)對年輕恒牙牙髓壞死治療的臨床療效研究[J];世界最新醫(yī)學(xué)信息文摘;2018年34期
，本文編號：2262309
本文鏈接：http://sikaile.net/yixuelunwen/kouq/2262309.html
最近更新
教材專著
