Analysis of pathological root resorption of deciduous teeth and establishment for the treatment

对乳牙根面进行了病理观察。用PCR检测方法分析根管分泌物。通过培养牙周韧带细胞，研究与破骨细胞分化有关的分子。对严重牙周炎的乳根进行扫描电镜观察，发现根管内或根表面有大量细菌。根尖区牙本质小管中未见细菌。大范围可见病理性牙根吸收，未见破牙细胞。病理性牙根吸收进展不规则，可见大量的吸收腔隙，呈虫食状。因此，认为细菌及其产物对病理性根吸收的影响很大。用消毒纸点吸收管内渗出液，观察乳牙根尖牙周炎的细菌结局。用PCR方法对含有渗出物的悬浮液进行分析。结果，在16例检测中，有12例检测到细菌16s rDNA。PCR细菌分析是明确牙周炎细菌种类和治疗的有效方法。牙周韧带（PDL）细胞产生的骨保护素（OPG）是成骨细胞和牙龈细胞的10倍。提示OPG可抑制PDL细胞的破骨细胞分化。PDL不仅是牙齿和牙槽骨之间的结缔组织，而且还可以保护骨和牙齿免受破骨细胞的吸收。我们认为用含OPG的根管拖拽抑制病理性根吸是可能的。提示根管完全冲洗和消毒是治疗病理性根吸收的有效方法。需要检测细菌种类并进行治疗。此外，骨蛋白素的诱导被认为是治疗根尖炎症的新方法。少

SEM observation of root surface of deciduous teeth surface pathologically resorted was done. Exudates from root cannal were analyzed by PCR detection. Moreover, periodontal ligament cells were cultured to study the moleculars concerned with osteoclast differentiation.1. By SEM observation of deciduous root with severe periodontitis, numerous bacteriums were observed in the root canals or on the root surfaces. However, no bacterium was there in the dentin tubules of apical region. Pathological root resorption was observed in wide region, but there was no odontoclasts. The pathological root resorption was advanced irregularly in the resion and a lot of resorbed lacunae were observed just like a worm-eaten shape. Therefore, it was thought that the pathological root resorption was greatly affected with bacteriums and their products.2. To determine the bacterial outcome of apical periodontitis in deciduous teeth, Intra-canal exudates were absorbed with sterilized paper points. The suspensio … More ns with exudates were analyzed by PCR. The result was that bacterial 16s rDNA was detected in 12 cases out of 16cases tested. Bacterial analysis by PCR is effective to clarify the bacterial species and treatment for periodontitis.3. Periodontal ligament (PDL) cells produce ten-fold osteoprotegerin (OPG) compared with osteoblasts and gingival cells. It suggests that osteoclast differentiation is depressed by OPG from PDL cells. It appears that PDL is not only connective tissue between a tooth and alveolar bone but also protection of bone and teeth resorption from osteoclast. We think that it is possible to depress for pathological root pesorption with canal root drag containing OPG.These results suggested that complete root canal rinsing and disinfection of root canal are an effective treatment of pathological root resorption. Detection of bacteria species and for the treatment is needed. Moreover, induction of osteoprotegrin was suggested for the new treatment in the apical root inflammation. Less