Periodontal wound healing following reciprocal autologous root transplantation in class III furcation defects.
Periodontal wound healing following reciprocal autologous root transplantation in class III furcation defects.
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DOI：
10.5051/jpis.2017.47.6.352
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发表时间：
2017-12
影响因子：
1.9
通讯作者：
Noguchi K
中科院分区：
文献类型：
--
作者：
Takeuchi N;Shirakata Y;Shinohara Y;Sena K;Noguchi K
磨牙根分叉病变很难治疗，并且被认为是牙齿脱落的危险因素。虽然牙周再生疗法，包括引导组织再生和各种类型的骨移植，已被应用于根分叉缺损，这些治疗的效果是有限的，特别是在大型III类根分叉缺损。本研究的目的是探讨自体牙根相互移植对犬III类根分叉缺损牙周创面愈合和再生的影响。在4只狗的单侧第三和第四前磨牙的根部分离后，手术创建分叉缺损（7 mm宽和6 mm高）。8个根分叉缺损被随机分为两组，一组接受自体牙根移植（试验组），另一组不接受进一步治疗（对照组）。实验组分别将近中、远中牙根移植到远中、近中拔牙窝中。手术后10周处死动物进行组织学评价。对照组的愈合模式的特点是广泛的皮瓣塌陷和牙周再生有限。试验组的新骨形成（3.56±0.57 mm）显著大于对照组（0.62±0.21 mm）。实验组移植根面可见密集的胶原纤维嵌入残留牙骨质中。在试验组的4个样本中，有2个样本在近远中侧观察到轻微强直，其中牙根平面面向现有骨。在对照组和试验组中均检测到牙根吸收（RR）。在本研究的范围内，可以得出结论，相互自体牙根移植对犬III类根分叉缺损的骨再生有效。然而，需要进一步的研究来标准化该方法，以便在临床应用之前防止不必要的RR。
Furcation involvement in the molars is difficult to treat, and has been recognized as a risk factor for tooth loss. Although periodontal regenerative therapies, including guided tissue regeneration and various types of bone grafts, have been applied to furcation defects, the effects of these treatments are limited, especially in large class III furcation defects. The purpose of this pilot study was to investigate the effect of reciprocal autologous root transplantation on periodontal wound healing and regeneration in class III furcation defects in dogs. Furcation defects (7 mm wide and 6 mm high) were surgically created after root separation of the unilateral third and fourth premolars in 4 dogs. Eight furcation defects were randomized to receive either reciprocal autologous root transplantation (test) or no further treatment (control). In the test group, the mesial and distal roots were transplanted into the distal and mesial extraction sockets, respectively. The animals were sacrificed 10 weeks after surgery for histologic evaluation. The healing pattern in the control group was characterized by extensive collapse of the flap and limited periodontal regeneration. New bone formation in the test group (3.56±0.57 mm) was significantly greater than in the control group (0.62±0.21 mm). Dense collagen fibers inserting into the residual cementum on the transplanted root surfaces were observed in the test group. Slight ankylosis was observed in 2 of the 4 specimens in the test group on the mesiodistal sides where the root-planed surfaces faced the existing bone. Root resorption (RR) was detected in both the control and test groups. Within the limits of this study, it can be concluded that reciprocal autologous root transplantation was effective for bone regeneration in class III furcation defects in dogs. However, further studies are required to standardize the approach in order to prevent unwanted RR prior to clinical application.