Study of Arising Mechanism and Therapy for Endodontal Periodontal Lesion

我们给出了这项研究的大纲。1.根管牙周病变的临床情况分析：收集标本，根据病史、临床表现和影像学表现进行分类。然后将牙髓组织病理状态与临床状态进行比较。并检测龈沟液中弹性蛋白酶、组织蛋白酶B、H、L等蛋白酶与临床状态的关系。2.牙周与牙髓合并病变的研究：1、采用复制、扫描电镜、图像分析等方法对副根管的发生频率进行分析。我们研究了通过测量根管与牙周组织间的电阻值来诊断的方法。我们从追求组织液流动的方向来研究炎症的传播途径。因此，牙髓病变容易扩散到牙周组织，但只有严重牙周破裂的牙周病变才会扩散到牙髓和上颌窦。3.细菌区系研究：根管内微生物密度低，而牙周袋内微生物密度高。可培养菌群较根管内简单。对某些特定细菌的IgG抗体滴度较高，但细菌种类不同。然后我们检查了治疗与根管和牙周袋内细菌菌群（特别是厌氧菌）变化的关系。对于细菌总数，单次根管治疗均未检出根管内细菌，单次治疗也未发现牙周袋内细菌数量有任何变化。4.治疗方面的研究：采用组织病理学方法观察动物牙再植的牙周创面愈合情况。凝血因子FXIII对创面愈合有促进作用。

We give an outline of this study. 1.Analysis of the clinical state on endodontal periodontal lesion: We collected specimens and classified them according to case histories, clinical findings and radiographical findings. Then we compared the histopathological state of the dental pulp with the clinical state. And the relationships between the proteinases such as elastase, cathepsins B, H and L in gingival crevicular fluid and clinical states were examined. 2.The study on the combination of periodontal and endodontal lesions: 1 We examined the frequency of accessory canals using the methods of Replica, SEM and image analysis. 2 We studied the diagnosing method by measuring the electric resistance value between root canal and periodontal tissue. 3 We examined the spreading pathway of inflammation from the pursuit of the derection of tissue fluid flow. As a result, endodontic lesion easily spread periodontal tissue, but only periodontal lesion with severe periodontal breakdown spread the pulp and the maxillary sinus. 3.The study on bacterial flora: Microbial density was low in root canals, but it was high in periodontal pockets. Cultivable bacterial flora was simpler than that in root canals. IgG antibody titers to some specific bacterias were high, but the kind of bacteria was different case by case. Then we examined the relationship between the treatment and the change of bacterial flor a(especially anaerobe) in root canals and periodontal pockets. As for the total number of bacteria, we could neither detect any bacteria in the canal by just one root canal treatment, nor did we find any change of the number in periodontal pockets just only by the treatments. 4.The study on the treatment: We histopathologically observed the periodontal wound healing in the case of animal tooth reimplantation. Blood coagulation factor FXIII was effetive on the wound healing.