釉质龋牙髓损伤反应的观察  

Pulp response to enamel caries

作　　者：方碧松[1] 李玉晶[2] 葛丽华[2] 宿颖[2] 

机构地区：[1]首都医科大学口腔医学院牙体科,北京100050 [2]首都医科大学口腔医学院研究所,北京100050

出　　处：《北京口腔医学》2009年第5期252-255,共4页Beijing Journal of Stomatology

摘　　要：目的观察釉质龋阶段牙髓的组织病理学改变,并探讨牙髓损伤与龋损活动性的关系。方法选用拔出的患釉质龋的第三磨牙22颗(其中急性龋12颗,慢性龋10颗),无龋第三磨牙10颗作为对照,脱钙、切片、常规染色。光镜下观察釉质龋损下牙髓的组织病理改变。用多功能图象分析仪测量此区内成牙本质细胞的浆核面积之比(简称浆核比)、数目及前期牙本质的面积,血管数目与横截面积,炎症细胞数目。结果慢性的釉质龋未见明显的病理改变。急性釉质龋牙髓的病理变化有:前期牙本质变窄,成牙本质细胞排列紊乱,细胞体积缩小,胞核向前期牙本质区移位;少细胞层见少量成纤维细胞与炎症细胞侵入;多细胞层可见血管轻度扩张,成纤维细胞增殖。少量炎症细胞主要为淋巴细胞和单核细胞。结论釉质龋时牙髓可以出现成牙本质细胞的损伤性变化,而这种变化与龋损活动性相关。Objective To observe pulp reactions underlying enamel caries and its relation to caries activity. Methods A total of 22 teeth with enamel lesion were continuously sectioned, pulpal cellular reactions to the lesion were examined using computerized histomorphometry for the cytoplasm, nucleus ratio of the odontoblast cell, the adjacent predentine area and the number of odontoblast cells. Blood vessel and inflammtory cell reactions were also recorded. Results In active enamel caries, nucleus ratio of odontoblast and predentine area were markedly reduced, and the cellular proliferation into the cell-free zone, mild increase of chronic inflammatory cells and enlargement of blood vessel were also found. While in chronic enamel caries, no such changes were noted. Conclusion Dental pulp injury can take place in enamel caries and the degree of the injury is associated with caries activity.

关 键 词：釉质龋 成牙本质细胞 牙本质牙髓复合体 急性龋 慢性龋 

分 类 号：R781.1[医药卫生—口腔医学]