Histology of Periapical Lesions Obtained During Apical Surgery
Histology of Periapical Lesions Obtained During Apical Surgery
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DOI：
10.1016/j.joen.2009.01.024
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发表时间：
2009-05-01
影响因子：
4.2
通讯作者：
Bosshardt, Dieter
中科院分区：
文献类型：
--
作者：
Schulz, Malte;von Arx, Thomas;Bosshardt, Dieter
本研究的目的是评价根尖周手术治疗的牙齿根尖周病变的组织学。在根端切除后，将根尖连同根尖周病变组织一起去除。对包埋在甲基丙烯酸甲酯（MMA）中的钙化标本和包埋在LR白色（Fluka，布克斯，瑞士）中的脱矿标本进行组织切片。用光学显微镜和透射电子显微镜（TEM）对样品进行评价。组织学检查结果分为根尖周囊肿、肉芽肿或囊性病变（真囊肿或囊袋囊肿）。最终材料包括70%的肉芽肿、23%的囊肿和5%的脓肿、1%的瘢痕组织和1%的角化囊肿。125个样本中有6个无法使用。囊性病变不能细分为囊袋或真正的囊肿。所有的囊肿都有一个上皮衬里的腔，其中两个有纤毛衬里的上皮。这些结果表明，根尖肉芽肿的发生率高根尖手术中获得的根尖周病变。根尖周脓肿是一种罕见的情况。在根尖手术中获得的样本的组织学结果可能与拔牙获得的结果不同。通过根尖手术采集样本时，几乎不可能确定囊袋和真正的根尖囊肿。（J Endod 2009; 35：634 - 642）
The aim of this was to evaluate the histology of periapical lesions in teeth treated with periapical surgery. After root-end resection, the root tip was removed together with the periapical pathological tissue. Histologic sectioning was performed on calcified specimens embedded in methylmethacrylate (MMA) and on demineralized specimens embedded in LR White (Fluka, Buchs, Switzerland). The samples were evaluated with light and transmission electron microscopy (TEM). The histologic findings were classified into periapical abscesses, granulomas, or cystic lesions (true or pocket cysts). The final material comprised 70% granulomas, 23% cysts and 5% abscesses, 1% scar tissues, and 1% keratocysts. Six of 125 samples could not be used. The cystic lesions could not be subdivided into pocket or true cysts. All cysts had an epithelium-lined cavity, two of them with cilia-lined epithelium. These results show the high incidence of periapical granulomas among periapical lesions obtained during apical surgery. Periapical abscesses were a rare occasion. The histologic findings from samples obtained during apical surgery may differ from findings obtained by teeth extractions. A determination between pocket and true apical cysts is hardly possible when collecting samples by apical surgery. (J Endod 2009;35:634-642)