Study of Arising Mechanism and Therapy for Endodontal Periodontal Lesion

我们对这项研究进行了概述。1.牙周内病变的临床状态分析：收集标本，按病史、临床表现和X线表现进行分类。然后将牙髓的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B、组织蛋白酶H、L等酶活性与临床状态的关系。2.牙周和牙髓联合病变的研究：1采用复制法、扫描电子显微镜和图像分析等方法检测副根管的出现频率。2研究了通过测量根管与牙周组织间的电阻值来诊断牙周炎的方法。3从组织液流向的角度考察炎症的传播途径。因此，牙髓病变容易扩散到牙周组织，但只有牙周严重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：根管微生物密度较低，而牙周袋微生物密度较高。可培养菌群比根管中的菌群更简单。对某些特定细菌的免疫球蛋白抗体效价较高，但细菌种类不同。观察治疗前后根管和牙周袋细菌菌群(尤其是厌氧菌)的变化。至于细菌总数，仅通过一次根管治疗，我们没有发现根管中的任何细菌，也没有发现仅仅通过治疗，牙周袋中的细菌数量有任何变化。4.治疗方法的研究：组织病理学观察动物牙再植后牙周创面愈合情况。凝血因子FXIII对创面愈合有影响。

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.