Plata R L, Kelln E E, Linda L
Oral Surg Oral Med Oral Pathol. 1976 Jul;42(1):100-8. doi: 10.1016/0030-4220(76)90036-0.
In this study, intact and untreated roots of twelve teeth in three dogs were submerged 2 mm. below the alveolar bone crest. On eight regeneration of alveolar bone was seen in 3 weeks, with complete bone coverage in 5 weeks. A complete lamina dura surrounded the buried roots, the original root canal tissue remained vital, and vessels and other structures now entered (or exited) from both ends. Cementum covered the cut end, making the end similar to a normal apex. Bone failed to regenerate completely over four of the twelve roots. Two of these had dentinal spicules which impeded complete bone coverage (Fig 9). Another was a case of delayed healing due to the early loss of sutures and subsequent infection where a sinus tract developed, connecting the oral environment with the resected root. This led to bone resorption and a partial pulp necrosis. In the fourth case the decreased depth of root burial and subsequent lack of bone cover led to external resorption of the cut dentin. Histologic examination after 12 weeks revealed the regeneration of bone, a regenerated periodontal membrane, and a layer of cementoblasts over the cut and exposed root dentin in a typical manner. This study suggests that when healthy bone and roots are present, particularly in an otherwise edentulous mandible retaining only a few nonrestorable anterior teeth, the roots can be retained in a nonpathologic state by means of a simple surgical technique.
在本研究中,将三只狗的十二颗牙齿完整且未经处理的牙根埋入牙槽嵴下方2毫米处。三周时可见八颗牙齿的牙槽骨再生,五周时实现完全骨覆盖。完整的硬骨板围绕着埋入的牙根,原根管组织保持活力,血管和其他结构现在从两端进入(或穿出)。牙骨质覆盖了牙根的切割端,使牙根末端类似于正常根尖。十二颗牙根中有四颗未能完全再生骨组织。其中两颗有牙本质尖刺,阻碍了完全骨覆盖(图9)。另一例是由于早期缝线脱落及随后的感染导致愈合延迟,形成了一个窦道,将口腔环境与切除的牙根相连。这导致了骨吸收和部分牙髓坏死。第四例中,牙根埋入深度减小及随后缺乏骨覆盖导致切割的牙本质发生外部吸收。12周后的组织学检查显示,骨组织再生、牙周膜再生,以及在切割和暴露的牙根牙本质上以典型方式形成了一层成牙骨质细胞层。本研究表明,当存在健康的骨组织和牙根时,特别是在仅保留少数无法修复的前牙的无牙下颌骨中,通过一种简单的手术技术可以将牙根保持在非病理状态。