Evaluation of Direct Adhesive Pulp Capping through Wound Healing and Hard Tissue Regeneration

本研究的目的是评估粘接树脂通过伤口愈合和硬组织再生直接盖髓的效果。用Bis-GMA(BG)或4-META/MMA-TBB(MMA)树脂直接植入日本猴暴露的洞。分析牙髓组织的反应和树脂-牙髓界面的超微结构，并通过矿化组织的多重荧光标记来研究牙本质桥的形成。BG在3~7天内可一期愈合。7~14d后硬组织开始再生，随着时间的推移，在窝洞准备的刺激下，牙本质桥逐渐与次生牙本质形成。矿化初期，标记线呈扇形，显示不规则的牙本质桥形成。每条线的两端都是相同的，显示了相同末端的修复性牙本质薄层被放置和分层。90天时，树脂wi…下方出现完整的牙本质桥。更多的是缺口形成。在桥的前方形成了一层与蛋白多糖基质结合的薄界面层，其结构类似于骨组织重塑过程中经常出现的反转线。在MMA标本中，3d时在树脂下可见大量急性炎症细胞。许多巨噬细胞包围着它，推测它没有被识别为自己的组织，已经变成了可吞噬的组织。这一区域被认为是树脂渗入或扩散到牙髓组织的组织杂交层。得到了几乎完整的桥面，没有界面层。树脂和牙桥之间仍有一层薄薄的牙髓组织，这表明杂交体可能会推迟迅速愈合。结论：不同盖状粘接系统的牙髓愈合和硬组织再生过程不同，多重荧光标记技术是牙髓愈合动态分析的有效方法。较少

The objective of this study was to evaluate adhesive resins for direct pulp capping through wound healing and hard tissue regeneration. The exposed cavities prepared in Japanese monkeys were placed directly with Bis-GMA (BG) or 4-META/MMA-TBB (MMA) resin. The response of pulpal tissue and ultramorphology of the resultant resin-pulp interface were analyzed, and also the formation of dentin bridge was investigated through multiple fluorescent labelling of mineralizing tissue. BG exhibited primay healing within 3-7 days. Hard tissue regeneration occurred after 7-14 days, and dentin bridge was formed with time with secondary dentin by stimulation of the cavity preparation. At the initial stage of mineralization, labelling lines exhibited scalloping, showing irregular formation of dentin bridge. Both ends of each line were identical, demonstrating thin layrs of reparative dentin with the same ends were placed and stratified. At 90 days, a complete dentin bridge appeared beneath the resin wi … More thout gap formation. A thin interfacial layr with proteoglycan matrix was produced at the front of the bridge, whose structure was similar to that of the reversal line which usually appeared in the remodeling process of bone tissue. In the MMA specimen, a region with many acute inflammatory cells was found beneath the resin at 3 days. Many macrophages surrounded it, indicating presumably that it had not been recognized as their own tissue and had turned to phagocytable. This region is considered to be th sof tissue hybrid layr in which the resin penetrated or diffused into pulp tissue. An almost complete bridge was produced without any interfacial layr. A thin layr of pulp tissue remained between the resin and bridge, demonstrating that the hybrid might delay the prompt healing. It was concluded that the process of healing and hard tissue regeneration was different according to the capped bonding system, and that the multiple fluorescent labelling technique was effective for the dynamic analysis of pulpal healing. Less