Effect of enamel matrix proteins (Emdogain®) on healing after re-implantation of "periodontally compromised" roots -: An experimental study in the dog
Effect of enamel matrix proteins (Emdogain®) on healing after re-implantation of "periodontally compromised" roots -: An experimental study in the dog
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DOI：
10.1034/j.1600-051x.2003.00400.x
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发表时间：
2003-10-01
影响因子：
6.7
通讯作者：
Lindhe, J
中科院分区：
文献类型：
--
作者：
Araújo, M;Hayacibara, R;Lindhe, J
目的：本实验旨在评价Emdogain(R)在拔除的牙齿或暴露于根管计划的牙齿的根面上是否能保护再种植后的牙齿防止强直。材料和方法：实验包括两组狗，每组5只。对所有下颌第三前磨牙(P-3(3))的根管进行扩髓和牙胶充填。在第二至第四前磨牙区域放置一个尖端切口处。颊、舌侧全厚皮瓣隆起。用裂钻将P-3(3)的牙冠和分叉区在冠状切开中切断。远中牙段用升降机脱位，再用钳子拔除。A组：将P-3(3)近、远中节段在玻璃表面风干60min。对右侧的牙根进行条件化处理，并应用Emdogain(R)。除Emdogain(R)外，左侧牙根接受相同的处理，近中和远中牙段重新种植，牙冠部分水平切开并取出。将颊、舌侧皮瓣松动缝合，完全覆盖埋伏牙根。B组：在牙釉质-牙釉质结合部根尖4~5 mm处各开1个切迹。刻度和规划了位于缺口冠状位置的根部区域。用Emdogain(R)处理右侧下颌骨的牙根，左侧的牙根作为对照。愈合6个月后，处死狗，取含有一个牙根及其周围组织的块，进行组织学检查，包括形态计量学评估。结果与结论：拔除成牙骨质细胞后，再植牙根的愈合过程包括牙根吸收、牙根僵硬和新附着的形成。研究还表明，Emdogain(R)处理，即EDTA处理和在分离的牙根表面放置釉质基质蛋白，未能干扰愈合过程。
Objective: The present experiment was performed to assess whether Emdogain(R) applied on the root surface of extracted teeth or teeth previously exposed to root planning can protect the tooth from ankylosis following re-implantation.Material and Methods: The experiment included two groups of dogs, including five animals each. The root canals of all mandibular third premolars (P-3(3)) were reamed and filled with gutta-percha. A crestal incision was placed from the area of the second to the fourth premolar. Buccal and lingual full thickness flaps were elevated. With the use of a fissure bur, the crown and furcation area of P-3(3) were severed in an apicocoronal cut. The distal and mesial tooth segments were luxated with an elevator and extracted with forceps. Group A: The mesial and distal segments Of P-3(3) were air dried on a glass surface for 60 min. The roots from the right side were conditioned and exposed to Emdogain(R) application. The roots from the left side received the same treatment with the exception of Emdogain(R) application.The mesial and distal tooth segments were re-implanted and the crown portions were severed with a horizontal cut and removed. The buccal and lingual flaps were mobilized and sutured to obtain complete coverage of the submerged roots. Group B: A notch was prepared in each root, 4-5 mm apical of the cemento-enamel junction. The area of the root that was located coronal to the notch was scaled and planned. The roots in the right side of the mandible were treated with Emdogain(R), while the roots in the left side served as controls.After 6 months of healing, the dogs were killed and blocks containing one root with surrounding tissues were harvested, and prepared for histological examination, which also included morphometric assessments. Thus, the proportions of the roots that exhibited signs of (i) replacement (ii) inflammatory and (iii) surface resorption were calculated.Results and Conclusion: It was demonstrated that healing of a re-implanted root that had been extracted and deprived of vital cementoblasts was characterized by processes that included root resorption, ankylosis and new attachment formation. It was also demonstrated that Emdogain(R) treatment, i.e. conditioning with EDTA and placement of enamel matrix proteins on the detached root surface, failed to interfere with the healing process.