自体移植牙术中不同根尖处理对牙髓及牙周愈合的影响  

Effect of Different Apical Treatments on Pulp and Periodontal Healing in Tooth Autotransplantation

作　　者：易守银 骆敬 冉娟 陈月 池峻舟 田鲲 Yi Shouyin;Luo Jin;Ran Juan;Chen Yue;Chi Junzhou;Tian Kun(Southwest Medical University,Luzhou 646000,China;Chengdu Seventh People's Hospital,Chengdu 610041,China;Sichuan Academy of Medical Sciences•Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]西南医科大学,泸州646000 [2]成都市第七人民医院,成都610041 [3]四川省医学科学院·四川省人民医院,成都610072

出　　处：《成都医学院学报》2023年第2期137-143,共7页Journal of Chengdu Medical College

基　　金：口腔移植工程四川省青年科技创新研究团队项目(No:2021JDTD0005);电子科技大学医工交叉基金项目(No:ZYGX2021YGLH220)。

摘　　要：目的 探索自体移植牙术中不同根尖处理对牙髓及牙周愈合的影响。方法 将比格犬下前牙6颗分为3组,每组2颗牙。A组扩大根尖孔使其直径> 1 mm;B组截根3 mm后倒充填;C组不处理。术后临床检查、X线片、micro-CT及HE染色观察移植牙牙髓及牙周组织再生情况。结果 仅C组脱落1颗牙,其余均愈合良好。A组牙根尖孔开放,组织学见类牙髓组织长入髓腔。B组根尖孔被高密度物密封,组织学见髓腔内少量残存坏死组织。C组见根尖周低密度透射影,组织学见根尖周炎性肉芽组织。结论 供牙扩大根尖孔或截根后倒充填可获得更好的牙周膜愈合,扩大根尖孔可获得一定程度牙髓再生。Objective To explore a more optimized operation to obtain a certain degree of dental pulp regeneration by evaluating the effect of different apical treatments during autotransplantation on the healing of dental pulp and periodontal tissue.Methods Six lower anterior teeth of beagle dogs were randomly divided into three groups.In group A,the apical foramen was enlarged to make the diameter larger than 1 mm;In group B,root tips was backfilled with iRootBP after 3 mm root cutting;And in group C,no special treatment was done.Clinical examination,X-ray examination,micro computed tomography(micro-CT)scanning and hematoxylin eosin(HE)staining were performed to observe the regeneration of dental pulp and periodontal tissue of the transplanted teeth.Results All teeth survived and achieved good clinical healing except one in group C.In group A,radiographs showed that the apical foramen were open,and histological observation showed pulp-like tissue grew into the pulp cavity from the apical foramen.In group B,radiographs showed the apical foramen was sealed by high-density material,and histological observation showed a small amount of residual necrotic tissue in the pulp cavity.In group C,radiographs showed low-density transmission shadow around the root apical,and histologically,inflammatory granulation tissue can be seen around the root tip.Conclusion Expanding the apical foramen or backfilling after root cutting of donor teeth can achieve better periodontal ligament healing.And expanding the apical foramen can obtain a certain degree of pulp regeneration.

关 键 词：自体移植牙 截根倒充填 扩大根尖孔 

分 类 号：R782.12[医药卫生—口腔医学]