再生性牙髓治疗的研究进展  

Research progress on regenerative endodontic procedures

作　　者：戴杏竹 陈丽娟 梁悦娥 赵望泓[1] DAI Xingzhu;CHEN Lijuan;LIANG Yuee;ZHAO Wanghong(Department of Stomatology,Nanfang Hospital,Southern Medical University,School of Stomatology,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院口腔科南方医科大学口腔医学院,广东广州510515

出　　处：《口腔疾病防治》2023年第1期73-76,共4页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省自然科学基金⁃重点项目(2018B030311047);南方医科大学“临床研究启动计划”重点项目(LC2019ZD023);南方医科大学南方医院“临床研究专项”(2020CR029)。

摘　　要：再生性牙髓治疗以牙髓生物学为基础,运用组织工程的基本原则,促进牙髓⁃牙本质复合体功能性再生,在牙髓坏死或伴根尖周炎的年轻恒牙治疗中已取得良好疗效,近年来也逐渐尝试应用于根尖发育成熟的恒牙治疗。最大限度控制感染并促进组织修复再生是再生性牙髓治疗的关键所在。与年轻恒牙的治疗不同,在根尖发育成熟的恒牙中可适当行根管机械预备;根管冲洗和根管消毒剂的选择,需综合考量抗菌效果、生物安全性及可能引起的牙冠变色、根管钙化等并发症;生物陶瓷材料的发展为冠方封闭材料提供了更多选择,但需进一步临床评估。除传统的血凝块支架外,以富血小板血浆、富血小板纤维蛋白、浓缩生长因子等血小板浓缩制品为代表的新型组织支架不断涌现,其实际临床疗效及与血凝块联用疗效仍需长期、大样本的研究。Regenerative endodontic procedures,based on dental pulp biology,use the basic principles of tissue engineering to promote the functional regeneration of dental pulpdentin complexes.Good results have been achieved in the treatment of young permanent teeth with pulp necrosis or apical periodontitis.There have also been preliminary clinical explorations of the treatment of mature permanent teeth in recent years.The key to successful treatment is controlling infection as well as promoting tissue repair and regeneration.Moderate root canal mechanical preparation is allowed in the therapy of mature permanent teeth,while it is not recommended in the treatment of young permanent teeth.The choice of root canal irrigation and intracanal antisepsis requires a comprehensive consideration of the antibacterial effects,biological safety,and possible complications,such as crown discoloration and root canal calcification.The development of bioceramic materials provides more options for crown sealing materials,but further clinical evaluation is needed.In addition to traditional blood clot scaffolds,new types of tissue scaffolds represented by plateletrich plasma,plateletrich fibrin,concentrated growth factors and other platelet concentrates have been developed.Longterm and largescale studies are needed to evaluate the actual clinical efficacy of these new scaffolds and the efficacy of their combined application with blood clots.

关 键 词：再生性牙髓治疗 组织工程 适应证 感染控制 根管预备 生物陶瓷 组织支架 血小板浓缩制品 

分 类 号：R78[医药卫生—口腔医学]