富血小板纤维蛋白联合MTA用于兔牙直接盖髓术的组织学研究  

Histological study of platelet-rich fibrin combined with MTA for direct pulp capping of rabbit teeth

作　　者：杨雪 颜志豪 刘锦[2] 胡玉萍 黎淑芳[2] YANG Xue;YAN Zhihao;LIU Jin;HU Yuping;LI Shufang(Liuzhou People’s Hospital,Liuzhou 545006,China;Youjiang Medical University for Nationalities,Baise 533000,China)

机构地区：[1]柳州市人民医院,广西壮族自治区柳州545006 [2]右江民族医学院,广西壮族自治区百色533000

出　　处：《口腔疾病防治》2023年第3期171-178,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广西壮族自治区自然科学基金项目(2020JJA140030);广西壮族自治区研究生教育创新计划项目(YCSW2018217);百色市科学研究与技术开发计划项目(20171113)。

摘　　要：目的 探讨富血小板纤维蛋白(platelet-rich fibrin,PRF)联合三氧化矿物凝聚体(mineral trioxide aggregate,MTA)作为直接盖髓剂的可行性和疗效。方法 将32只新西兰兔随机分为4组,即PRF+MTA组(P+M组)、PRF组(P组)、MTA组(M组)、空白对照组(BC组),每组8只,对每只实验兔的2颗下颌中切牙进行开髓,分别用上述材料进行直接盖髓术,完成冠方封闭。分别在术后7 d、28 d从每组中随机选择4只实验兔并处死,实验牙进行HE染色,分析评价炎症细胞浸润程度、钙化桥形成程度及牙髓组织变性程度。结果 炎症细胞浸润程度:术后7 d和术后28 d,P+M组、M组均较BC组炎症细胞浸润程度轻,差异具有统计学意义(P<0.05);术后28 d,P+M组较P组轻(P<0.05);P+M组与M组比较差异无统计学意义(P>0.05)。钙化桥形成程度:术后7 d和术后28 d,P+M组钙化桥形成程度较P组、M组、BC组高,差异有统计学意义(P<0.05);术后28d,M组较BC组钙化桥形成程度高,差异有统计学意义(P<0.05);显微镜下观察,钙化桥内部含细胞成分,未出现牙本质小管样结构,周围牙本质样细胞包绕,其结构似骨样牙本质。牙髓组织变性程度:术后7 d,P+M组、M组均较BC组牙髓变性程度轻,差异具有统计学意义(P<0.05);术后28 d,P+M组较P组、BC组轻(P<0.05);P+M组与M组比较差异无统计学意义(P>0.05)。结论 PRF+MTA作为盖髓剂用于直接盖髓术时,牙髓炎症反应程度较轻,牙髓状态较稳定且具有较强的钙化桥形成能力,钙化桥结构似骨样牙本质。Objective To investigate the outcomes of a novel direct pulp capping agent containing platelet-rich fibrin(PRF) and mineral trioxide aggregate(MTA).Methods A total of 32 New Zealand rabbits were randomly divided into 4 groups, namely, the PRF+MTA group(P+M group), PRF group(P group), MTA group(M group) and blank control group(BC group), with 8 rabbits per group. Dental pulp exposure and direct pulp capping were performed, and complete crown square sealing was performed on 2 mandibular central incisor teeth of each rabbit. Four rabbits from each group were euthanized after each observation period(7 and 28 days). The experimental teeth were subjected to HE staining.Inflammatory cell infiltration, calcified bridge formation and pulp tissue disorganization were observed and graded.Results Inflammatory cell infiltration: on the 7^(th) day, group P+M and group M were lighter than group BC(P<0.05);on the 28^(th) day, group P+M was lighter than group P and group BC(P<0.05);group P+M and group M did not significantly differ(P>0.05). Calcified bridge formation: on the 7^(th) and 28^(th) days, group P+M was lighter than group P, group M and group BC(P<0.05);on the 28^(th) day, group M was higher than group BC(P<0.05). Under microscope, the calcified bridge contained cellular components and was surrounded by odontoblast-like cells, sharing a structure resembled osteodentin;dentin tubule-like structure could not be observed in calcified bridge, and the calcified bridge resembled certain points of osteodentin. Pulp tissue disorganization: on the 7^(th) day, group P+M and group M were lighter than group BC(P<0.05);on the 28^(th) day, group P+M was lighter than group P and group BC(P<0.05).group P+M and group M did not significantly differ(P>0.05).Conclusion The combination of PRF and MTA for direct pulp capping provided light inflammatory cell infiltration, stable pulp status and a strong ability of pulp tissue to form calcified bridge, and the calcified bridge resembled certain points of osteodentin.

关 键 词：富血小板纤维蛋白 三氧化矿物凝聚体 直接盖髓术 盖髓剂 炎症反应 钙化桥 牙髓变性 兔下颌中切牙 组织学分级 

分 类 号：R78[医药卫生—口腔医学]