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Reconsideration of pathogenesis and pathological classification of human caries pulpitis to apical periodontitis

人类龋齿牙髓炎至根尖周炎发病机制及病理分类的再思考

基本信息

批准号：
61570857
负责人：
NAGAI Noriyuki
金额：
$ 1.54万
依托单位：
Okayama University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1986
资助国家：
日本
起止时间：
1986 至 1987
项目状态：
已结题

项目摘要

In this year, unmyelinated nerve fibers in human caries pulpitis were cheifly studied. Pathogenesis and pathological classification of human caries pulpitis were also reconsidered on the base of results of a last and this year.Materials and Methods:Samples were 15 caries teeth with acute severe symptoms. All teeth were upper or lower 3rd molars. After bisection of teeth crowns the pulpal tissue which underlying the caries lesion were, were immediately removed and fixed in 2% glutaraldehyde ・ 2% paraformaldehyde solution. Ultrastructural observation were same manner as a last year.Results:10/15 teeth were identified with the suppurative inflammation. In foci of inflammatory cell infiltration, mainly neutrophils, bundles of unmyelinated nerve fibers irregularly waved, and sometimes showed small spiral masses. On the other hand. 5/15 teeth were identified with fibrosis and tubercular proliferation of unmyelinated nerve fibers, so-called traumatic neuroma-like lesion without inflammatory c … More ell infiltration. Electron microscopically, unmyelinated nerves in the suppurative foci were almost surrounded by collagen fibrils, and no degenerative change of axons and schwann cells was found. In areas of loss of perinervous collagen fibrils, however, some vacuoles and/or dilation of axons was observed, nevertheless the basel lamina of schwann cells was intact. In so-called traumatic neuroma-like lesions, Schwann cells apparently showed reticular arrangements, and axons were involved in their arrangements.Summary:Our findings have allowed the hypothesis that inflammatory process of human caries pulpitis is modified by the chronic stimulation of the dental caries, and pathogenesis of human caries pulpitis differs essentially from the pulpitis caused by chemical of physical effects. Unmyelinated nerve of inflammatory foci may play a role in the intensive acute clinical symptoms of caries pulpitis. Finaly, pathological classification of human caries pulpitis may be summarized as follows: 1. early lesion, 2. suppurative lesion, 3. granulomatous lesion, 4. necrosis or gangrene of the dental pulp. Less

本文对人龋性牙髓炎中的无髓神经纤维进行了初步研究。材料与方法：15颗患龋牙为急性重度牙髓炎的牙体标本。所有牙齿均为上或下第三磨牙。牙冠二分后，立即取出龋损下的牙髓组织，用2%戊二醛· 2%多聚甲醛溶液固定。结果：15颗患牙中有10颗发生化脓性炎症。炎性细胞浸润灶内以中性粒细胞为主，无髓神经纤维束呈不规则波浪状，有时呈小螺旋状团块。从另一方面来说。5/15颗牙齿被鉴定为无髓神经纤维的纤维化和结节性增生，即所谓的创伤性神经瘤样病变，无炎性细胞浸润。 ...更多信息渗透。电镜下，化脓灶内无髓神经几乎被胶原纤维所包围，神经轴突和雪旺细胞未见变性改变，但在神经周围胶原纤维缺失区，神经轴突有空泡和/或扩张，雪旺细胞巴塞尔层完整。在所谓的创伤性神经瘤样病变中，雪旺细胞明显表现出网状排列，轴突参与了它们的arrangement.Summary：我们的研究结果允许的假设，即人类龋齿牙髓炎的炎症过程是由慢性刺激的龋齿修改，和人类龋齿牙髓炎的发病机制本质上不同于由物理化学作用引起的牙髓炎。炎性病灶的无髓神经可能在龋性牙髓炎的急性临床症状中起一定作用。最后，本文对人龋性牙髓炎的病理分类作了如下总结：1.早期病变，2.化脓性病变，3.肉芽肿性病变，4。牙髓的坏死或坏疽。少