Histologic Characterization of Regenerated Tissues in Canal Space after the Revitalization/Revascularization Procedure of Immature Dog Teeth with Apical Periodontitis
Histologic Characterization of Regenerated Tissues in Canal Space after the Revitalization/Revascularization Procedure of Immature Dog Teeth with Apical Periodontitis
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DOI：
10.1016/j.joen.2009.09.039
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发表时间：
2010-01-01
影响因子：
4.2
通讯作者：
Huang, George T-J.
中科院分区：
文献类型：
--
作者：
Wang, Xiaojing;Thibodeau, Blayne;Huang, George T-J.
简介：最近，已经表明，可以以愈合和促进新的重要组织向内生长到牙髓空间中的方式治疗具有受感染的牙髓空间和根尖牙周炎的未成熟牙齿。然而，新生长组织的类型尚不清楚。研究方法：基于先前报道的研究样本，我们进一步从组织学上研究了已生长到根管间隙中的组织类型。结果：根管内牙本质壁增厚，新生的牙骨质样组织附着于根管内，称为根管内牙骨质（IC）。“一个病例显示牙髓组织部分存活，并与在根管牙本质壁上形成IC的纤维结缔组织并列。IC也可以在根尖、根尖三分之一或根管中三分之一处形成桥。在许多情况下，根长随着牙骨质的生长而增加。尽管根尖或根管内存在炎性浸润，但仍可能发生根尖牙骨质或IC。这些牙骨质或牙骨质样组织类似于细胞牙骨质。骨或骨样组织在许多情况下观察到的椎管空间，并被称为根管内骨（IB）。在IC和/或IB周围的根管间隙中也存在类似于牙周韧带的结缔组织。结论：我们的研究结果部分解释了为什么许多临床病例的未成熟牙齿根尖牙周炎或脓肿可能会获得根厚度和根尖长度保守治疗后的振兴程序。（J Endod 2010;36：56-63）
Introduction: Recently, it has been shown that it is possible to treat an immature tooth with an infected pulp space and apical periodontitis in such a way as to heal and promote the ingrown of new vital tissue into the pulp space. However, the type of new-grown tissue is unclear. Methods: Based on the samples of a previously reported study, we further investigated histologically the types of tissues that had grown into the canal space. Results: The canal dentinal walls were thickened by the apposition of newly generated cementum-like tissue termed herein "intracanal cementum (IC)." One case showed partial survival of pulp tissue juxtaposed with fibrous connective tissue that formed IC on canal dentin walls. The IC may also form a bridge at the apex, in the apical third or midthird of the canal. The root length in many cases was increased by the growth of cementum. The generation of apical cementum or IC may occur despite the presence of inflammatory infiltration at the apex or in the canal. These cementum or cementum-like tissues were similar to cellular cementum. Bone or bone-like tissue was observed in the canal space in many cases and is termed intracanal bone (IB). Connective tissue similar to periodontal ligament was also present in the canal space surrounding the IC and/or IB. Conclusions: Our findings explained in part why many clinical cases of immature teeth with apical periodontitis or abscess may gain root thickness and apical length after conservative treatment with the revitalization procedure. (J Endod 2010;36:56-63)