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采用部分厚度双蒂结缔组织移植术实现牙根覆盖的人体组织学评估。病例报告。

Human histologic evaluation of root coverage obtained with a connective tissue with partial thickness double pedicle graft. A case report.

作者信息

Harris R J

出版信息

J Periodontol. 1999 Jul;70(7):813-21. doi: 10.1902/jop.1999.70.7.813.

Abstract

The use of a connective tissue graft combined with a pedicle graft has been proven an effective method to achieve root coverage. However, little is known about the histologic results in humans. A connective tissue with partial thickness double pedicle graft was performed on 2 teeth scheduled for extraction for prosthetic reasons. The procedures were clinically successful (100% and 83.3% root coverage). At 6 months postoperative, the teeth were extracted with conservative block sections and analyzed histologically. Two different healing patterns were seen. The first was characterized by a long junctional epithelial attachment that extended well beyond the original gingival margin and occasionally almost to the original bone level with minimal connective tissue adjacent to the tooth. The other pattern was a short junctional epithelium that stopped at the previously exposed root surface. In this pattern, there was predominately connective tissue adjacent to the tooth with some isolated areas of epithelium. No new bone or cementum was seen in any section. The use of a technique that combines a connective tissue graft with a pedicle graft can produce root coverage and a successful clinical result. However, the histological evaluation of this case report revealed that true regeneration was not seen in this study, only repair.

摘要

使用结缔组织移植联合带蒂移植已被证明是实现牙根覆盖的有效方法。然而,关于人体组织学结果的了解却很少。对两颗因修复原因计划拔除的牙齿进行了部分厚度双蒂结缔组织移植。这些手术在临床上取得了成功(牙根覆盖率分别为100%和83.3%)。术后6个月,将牙齿连同保守的块状切片一并拔除并进行组织学分析。观察到两种不同的愈合模式。第一种模式的特征是长结合上皮附着,其延伸远远超出原来的牙龈边缘,偶尔几乎延伸到原来的骨水平,与牙齿相邻的结缔组织极少。另一种模式是短结合上皮,其止于先前暴露的牙根表面。在这种模式中,与牙齿相邻的主要是结缔组织,有一些孤立的上皮区域。在任何切片中均未见到新骨或牙骨质。使用将结缔组织移植与带蒂移植相结合的技术可实现牙根覆盖并取得成功的临床效果。然而,本病例报告的组织学评估显示,本研究中未见到真正的再生,只有修复。

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