Interrelationship between epithelial and connective tissue attachments during wound healing of the periodontal tissues.

本研究旨在探讨牙周组织创面愈合过程中上皮性附着与结缔组织附着的相互关系。在大鼠上颌骨第一磨牙和第二磨牙之间植入弹性橡胶。一周后取出橡胶，用手术刀在暴露的根面的最顶端开一个凹口。取下弹力橡胶后即刻至24周处死动物。光镜、免疫组织化学和电子显微镜观察牙周组织的再生变化。摘除后一周，大部分裸露的牙根表面被渗出液和炎性细胞覆盖，再生的上皮细胞形成袋上皮。4周后，切迹被袋上皮细胞填充，根面在更尖端的位置被长长的连接上皮覆盖。随着时间的推移，长连接上皮的长度和宽度有减小的趋势。拔除后20周，切迹根面被结缔组织覆盖，结缔组织的排列和形态与牙周膜极为相似。免疫组织化学结果显示，层粘连蛋白阳性表达于上皮附着的基底层，纤维连接蛋白阳性表达于结缔组织附着的基底层。这些结果提示，在大鼠暴露的根面上，可以用结缔组织附着代替长连接上皮形成的上皮附着。

The purpose of this study was to investigate the interrelationship between epithelial and connective tissue attachments during wound healing of the periodontal tissues. Elastic rubber was inserted between the first and second molars of the maxilla in rats. The rubber was removed after one week, and a notch was made on the most apical region of the exposed root surface using a scalpel. The animals were fed a powdered fed, and sacrificed from immediately to 24 weeks after the removal of the elastic rubber. Regenerative changes of the periodontal tissues were observed light microscopically, immunohistochemically and electron microscopically. One week after the removal, the majority of the exposed root surface was covered by exudate and inflammatory cells although regenerative epithelial cells revealed to form a pocket epithelium. The notch was filled by epithelial cells of the pocket epitheium and the root surface was covered by a long junctional epithelium at the more apical site after four weeks. The long junctional epithelium tended to decrease in length and width with the passage of time. Twenty weeks after the removal, the notched root surface was covered by connective tissue which was closely similar in arrangement and morphology to the periodontal ligament. Immunohistochemical studies showed that laminin was positive to the basal lamina of the epithelial attachment and fibronectin was positive to that of the connective tissue attachment. From these results it is suggested that the epithelial attachment forming by a long junctional epithelium can be replaced by connective tissue attachment on the exposed root surface in rats.