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具有活动期和静止期牙本质龋的乳磨牙牙髓组织病理学

Histopathology of the pulp of primary molars with active and arrested dentinal caries.

作者信息

Di Nicolo R, Guedes-Pinto A C, Carvalho Y R

机构信息

Department of Pediatric Dentistry, School of Dentistry, Sao Paulo State University, UNESP, Sao Jose dos Campos-SP, Brazil.

出版信息

J Clin Pediatr Dent. 2000 Fall;25(1):47-9.

Abstract

The purpose of this study was to compare the histological appearance of the pulp of human primary molars with active and arrested lesions. The sample consisted of 36 primary molars (18 with active lesions and 18 with arrested lesions) extracted from 35 children between 5 to 9 years of age. The histological diagnosis was classified in normal pulp, transitional stage, partial pulpitis, total pulpitis and total necrosis, and then subdivided in three subgroups: treatable, untreatable and questionable. Results showed that normal pulp or transitional stage (treatable category) was diagnosed in 50% of teeth with arrested lesions, compared to 11.1% of teeth with active lesions. Partial pulpitis (questionable category) was present in 38.8% with arrested lesions compared to 22.2% with active lesions. Total pulpitis and total necrosis (untreatable category) was diagnosed in 11.2% with arrested lesions compared to 66.7% with active lesions. The observed frequencies of histological categories between both groups were statistically significant (P < 0.05). Histologically, pulp reaction under active and arrested lesions in primary molars revealed the formation of a basophilic calcio-traumatic line at the junction of the primary and reparative dentin, formation of reparative dentin and a regular odontoblastic layer in 60% of the cases. Results indicated that the type of lesion (active or arrested) is a good indicator of the histological status of the pulp.

摘要

本研究的目的是比较患有活动性病变和静止性病变的人类乳磨牙牙髓的组织学表现。样本包括从35名5至9岁儿童中拔除的36颗乳磨牙(18颗患有活动性病变,18颗患有静止性病变)。组织学诊断分为正常牙髓、过渡阶段、部分牙髓炎、全牙髓炎和完全坏死,然后再细分为三个亚组:可治疗、不可治疗和可疑。结果显示,50%患有静止性病变的牙齿被诊断为正常牙髓或过渡阶段(可治疗类别),而患有活动性病变的牙齿这一比例为11.1%。38.8%患有静止性病变的牙齿存在部分牙髓炎(可疑类别),而患有活动性病变的牙齿这一比例为22.2%。11.2%患有静止性病变的牙齿被诊断为全牙髓炎和完全坏死(不可治疗类别),而患有活动性病变的牙齿这一比例为66.7%。两组之间组织学类别的观察频率具有统计学意义(P < 0.05)。组织学上,乳磨牙活动性和静止性病变下的牙髓反应显示,在60%的病例中,原发性牙本质和修复性牙本质交界处形成了嗜碱性钙创伤线,形成了修复性牙本质和规则的成牙本质细胞层。结果表明,病变类型(活动性或静止性)是牙髓组织学状态的良好指标。

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