Histological evaluation of contaminated furcal perforation in dogs' teeth repaired by MTA with or without internal matrix
Histological evaluation of contaminated furcal perforation in dogs' teeth repaired by MTA with or without internal matrix
复制标题
DOI：
10.1016/j.tripleo.2006.09.007
复制
发表时间：
2007-03-01
期刊：
影响因子：
--
通讯作者：
Al-Nazhan, Saad
中科院分区：
文献类型：
--
作者：
Al-Daafas, Abdullah;Al-Nazhan, Saad
根管治疗是根管治疗的一个重要环节，也是根管治疗的一个重要环节。1，2它可能是由于髓室底部或邻近髓室底部的大龋损、内部或外部牙根吸收以及在牙髓治疗期间或间隙准备后发生的。穿孔牙齿的长期预后取决于穿孔的位置，穿孔暴露于口腔污染的时间以及密封穿孔的能力。1对猴子和狗牙齿穿孔后牙周组织反应的实验研究，以及对人类牙齿穿孔的一些临床研究表明，根颈三分之一或髓室底部穿孔治疗后预后最差。3、4这些类型的穿孔通常会增加上皮增生和牙周炎的可能性。1，5采用非手术的即刻修复，使用适当的充填材料，可防止穿孔部位与龈沟之间的沟通，从而获得良好的预后。6银汞合金多年来一直是修复分叉穿孔的标准材料。7，8最近，发现矿物三氧化物聚集体（MTA）材料上级大多数尝试修复分叉穿孔的牙科材料。9、10穿孔性缺损的修复通常是复杂的，因为缺损的尺寸可能允许材料挤出到牙周韧带间隙和周围结构中。无论使用何种材料，这都可能妨碍成功。建议使用内部生物相容性基质，如硫酸钙、羟基磷灰石或HAPSET（Lifecore Biomedical，查斯卡，MN，USA），以尝试控制填充材料的挤出并增加修复材料的密封能力。6，11-13硫酸钙也被用作填充缺损的骨替代物。根据Bahn的说法，14它作为空间填充物，其使用的最重要优点是其自然吸收率，与新骨生长到缺损中的速度密切相关。因此，它作为一种内部基质，在修复材料的缺陷污染穿孔可能会促进愈合的受损组织。虽然一项已发表的研究9涉及单独使用MTA修复受污染的分叉穿孔，但已进行了组织学研究，尚未进行使用内部基质作为MTA促进骨愈合的研究。因此，本研究的目的是研究实验诱导的狗牙齿分叉穿孔的组织学愈合反应，该牙齿被唾液污染并用含或不含内部基质（硫酸钙）的MTA修复。结果与汞合金进行了比较。
Perforation is a communication between the root canal system and the surrounding tissues through the floor of the pulp chamber or root canal wall of the tooth. 1, 2 It can occur as a result of a large carious lesion in or adjacent to the floor of the pulp chamber, internal or external root resorption, and during endodontic treatment or after space preparation. The long-term prognosis of a perforated tooth is dependent upon the location of the perforation, how long the perforation is exposed to oral contamination, and the ability to seal the perforation. 1 Experimental studies of periodontal tissue reaction after perforations in monkeys’ and in dogs’ teeth, together with some clinical investigation of perforations in human teeth, suggest that perforation in the cervical third of the root or in the floor of the pulp chamber have the least favorable prognosis after treatment. 3, 4 These types of perforation usually increase the possibility of epithelial proliferation and periodontitis. 1, 5 Nonsurgical immediate repair using proper filling material may prevent the resulting communication between perforation site and gingival sulcus and thus favorable prognosis could be achieved. 6 Amalgam has been the standard material for repairing furcal perforation for many years. 7, 8 Recently, mineral trioxide aggregate (MTA) material was found to be superior to most of the dental materials that have been tried to repair furcal perforation. 9, 10 Repair of the perforated defect is usually complicated by the fact that the size of the defect may allow extrusion of the material into the periodontal ligament space and surrounding structures. This may preclude success regardless of the material used. The concept of using internal biocompatible matrices such as calcium sulfate, hydroxyapatite, or HAPSET (Lifecore Biomedical, Chaska, MN, USA) was suggested in an attempt to control the extrusion of the filling materials as well as increase the sealing ability of the repaired materials. 6, 11-13 Calcium sulfate has also been used as a bone substitute for filling defects. According to Bahn, 14 it acts as a space filler, and the most important advantage of its use is its natural rate of resorption, which compared closely with the rate of new bone growing into a defect. Therefore, its use as an internal matrix under repaired material of defected contaminated perforation might enhance the healing of the damaged tissue. Although one published study 9 that deals with repairing contaminated furcation perforation using MTA alone has been investigated histologically, no such study has been performed for the use of internal matrices as a promoter of bone healing with MTA. Therefore, the purpose of this study was to investigate the histologic healing response of experimentally induced furcal perforations in dogs’ teeth contaminated with saliva and repaired with MTA with or without internal matrices (calcium sulfate). Results were compared to amalgam.