Apical Cyst Theory: a Missing Link.
Apical Cyst Theory: a Missing Link.
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DOI：
10.5436/j.dehy.2010.1.00013
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发表时间：
2010-10-05
影响因子：
0.5
通讯作者：
Huang GT
中科院分区：
文献类型：
--
作者：
Huang GT
根尖囊肿的形成机制一直难以捉摸。长期以来，人们提出并讨论了几种理论，推测根尖囊肿是如何在牙髓感染引起的颌骨中发育和形成的。两种流行的理论是营养缺乏理论和脓肿理论。营养缺乏理论认为，过度增殖的上皮细胞会形成球团，使得球团中心的细胞失去营养。脓肿理论假设，当结缔组织中形成脓肿腔时，上皮细胞会增殖并排列在先前存在的腔内，因为它们固有地倾向于覆盖暴露的结缔组织表面。基于上皮细胞和上皮的性质，营养理论是一个童话，而脓肿理论充其量只是表明脓肿可能是导致复层上皮形成的因素之一，但并不能解释导致囊肿形成的机制。顶端囊肿的形成是静止上皮细胞由于炎症而增殖到足够数量的结果，使得它们能够针对死亡组织或异物形成极化和分层的上皮衬里。这些分层的上皮衬里沿着死亡组织或异物扩张，并最终以球形囊的形式包裹它们，即囊肿。囊中的空间被认为是分隔内部（组织）环境的外部环境——上皮的自然功能。该理论可以通过引入一种可生物降解的装置来测试，该装置能够在体内环境中缓慢释放上皮细胞有丝分裂原，该装置植入了靠近异物的上皮细胞。这将使细胞不断增殖，可能形成包裹异物的囊囊。
The mechanism of the formation of apical cyst has been elusive. Several theories have long been proposed and discussed speculating how an apical cyst is developed and formed in the jaw bone resulting from endododontic infection. Two popular theories are the nutritional deficiency theory and the abscess theory. The nutritional deficiency theory assumes that the over proliferated epithelial cells will form a ball mass such that the cells in the center of the mass will be deprived of nutrition. The abscess theory postulates that when an abscess cavity is formed in connective tissue, epithelial cells proliferate and line the preexisting cavity because of their inherent tendency to cover exposed connective tissue surfaces. Based on the nature of epithelial cells and the epithelium, nutritional theory is a fairy tale, while abscess theory at best just indicates that abscess may be one of the factors that allows the stratified epithelium to form but not to explain a mechanism that makes the cyst to form. Apical cyst formation is the result of proliferation of resting epithelial cells, due to inflammation, to a sufficient number such that they are able to form a polarized and stratified epithelial lining against dead tissues or foreign materials. These stratified epithelial lining expands along the dead tissue or foreign materials and eventually wrap around them as a spherical sac, i.e. a cyst. The space in the sac is considered the external environment separating the internal (tissue) environment – the natural function of epithelium. This theory may be tested by introducing a biodegradable device able to slowly release epithelial cell mitogens in an in vivo environment implanted with epithelial cells next to a foreign object. This will allow the cells to continuously proliferate which may form a cystic sac wrapping around the foreign object.