RADICULAR CYST AFFECTING A ROOT-FILLED HUMAN TOOTH - A LONG-TERM POSTTREATMENT FOLLOW-UP
RADICULAR CYST AFFECTING A ROOT-FILLED HUMAN TOOTH - A LONG-TERM POSTTREATMENT FOLLOW-UP
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DOI：
10.1111/j.1365-2591.1993.tb00563.x
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发表时间：
1993-07-01
影响因子：
5
通讯作者：
SUNDQVIST, G
中科院分区：
文献类型：
--
作者：
NAIR, PNR;SJOGREN, U;SUNDQVIST, G
根尖牙周炎主要是由受影响牙齿的根管中的微生物引起的。然而，有令人信服的证据表明，其他独立因素对传统根管治疗的结果产生不利影响。在本文中，形态学证据支持的潜在作用的两个内源性因素，可能会干扰根管治疗后愈合的根尖周。样本包括一个无症状的根尖周病变的手术活检，持续了44个月的随访期。对活检组织进行相关的光学和电子显微镜检查。病变的特点是存在一个大的中央管腔内衬的复层鳞状上皮。病变最显著的特征是存在大量的胆固醇晶体，其聚集在囊腔周围的结缔组织中。对根管和病变的根尖部进行广泛的光镜和电镜检查未能发现微生物的存在。这些发现强烈表明，内在因素，如某些组织分解产物（如胆固醇晶体）的积累，以及病变本身的囊性状态，会对根管治疗后根尖周的愈合过程产生不利影响。因此，这样的根尖病变可以长期保持传统牙髓治疗的难治性。
Apical periodontitis is caused primarily by microorganisms residing in the root canals of affected teeth. Nevertheless, there is convincing evidence implicating other independent factors that adversely affect the outcome of conventional root canal therapy. In this paper, morphological evidence is presented in support of the potential role of two endogenous factors that may interfere with post-endodontic healing of the periapex. The specimens consisted of a surgical biopsy of an asymptomatic periapical lesion which persisted for a follow-up period of 44 months. The biopsy was processed for correlated light and electron microscopy. The lesion was characterized by the presence of a large central lumen lined by a stratified squamous epithelium. The most striking feature of the lesion was the presence of vast numbers of cholesterol crystals which congregated in the connective tissue surrounding the cyst cavity. Extensive light and electron microscopic investigation of the apical part of the root canal and the lesion failed to reveal the presence of microorganisms.These findings strongly suggest that intrinsic factors like the accumulation of certain tissue break-down products such as cholesterol crystals, and the cystic condition of the lesion itself, can adversely affect the healing process of the periapex following root canal therapy. Consequently, such apical lesions can remain refractory to conventional endodontic therapy for long periods of time.