Rafter M, Baker M, Alves M, Daniel J, Remeikis N
University of Illinois at Chicago, Chicago, IL, USA.
Int Endod J. 2002 Sep;35(9):775-83. doi: 10.1046/j.1365-2591.2002.00566.x.
The purpose of this study was to evaluate healing responses following repair of furcation perforations, with and without an internal matrix. Two matrix materials, HAPSET (65% non-resorbable hydroxyapatite and 35% plaster of paris) and hydroxyapatite were compared.
Four adult female baboons (Papio anubis) served as experimental models. Furcation perforations were made in the molar and premolar teeth, which were then randomly assigned to one of the five groups, according to the method of perforation repair: 1 Experimental group 1 (16 teeth): The matrix material was HAPSET and the sealing material, amalgam. 2 Experimental group 2 (16 teeth): The matrix material was hydroxyapatite and the sealing material, amalgam. 3 Experimental group 3 (16 teeth): No matrix was placed. The sealing material was amalgam. 4 Positive control group (16 teeth): The perforation was not sealed. 5 Negative control group (16 teeth): No perforation was made. The animals were sacrificed at 1 week and 1, 3 and 7 months. Specimens were prepared for examination with light microscopy.
The data revealed that when amalgam was used alone without a matrix, there was marked extrusion of the material into the underlying bone with an associated severe inflammatory response, which continued throughout the observational period. When an internal matrix was used, there was an initial acute inflammatory response that diminished with time such that at 7 months, 75% of these specimens were free of inflammation. There was no difference in the tissue response to the different matrix materials. HAPSET and hydroxyapatite underwent connective tissue encapsulation in the early stages followed by new bone deposition in direct contact with the materials.
Within this animal model healing responses are better when an internal matrix, whether HAPSET or hydroxyapatite, is used in the repair of furcation perforations.
本研究旨在评估有或无内部基质时根分叉穿孔修复后的愈合反应。比较了两种基质材料,即HAPSET(65%不可吸收羟基磷灰石和35%巴黎石膏)和羟基磷灰石。
选用4只成年雌性狒狒(埃及狒狒)作为实验模型。在磨牙和前磨牙上制造根分叉穿孔,然后根据穿孔修复方法将其随机分为五组之一:1. 实验组1(16颗牙):基质材料为HAPSET,封闭材料为汞合金。2. 实验组2(16颗牙):基质材料为羟基磷灰石,封闭材料为汞合金。3. 实验组3(16颗牙):未放置基质。封闭材料为汞合金。4. 阳性对照组(16颗牙):穿孔未封闭。5. 阴性对照组(16颗牙):未制造穿孔。在1周以及1、3和7个月时处死动物。制备标本用于光学显微镜检查。
数据显示,单独使用汞合金而无基质时,材料会明显挤压到下方骨组织中,并伴有严重的炎症反应,且在整个观察期内持续存在。使用内部基质时,最初会出现急性炎症反应,随着时间推移炎症反应减弱,以至于在7个月时,这些标本中有75%无炎症。不同基质材料的组织反应无差异。HAPSET和羟基磷灰石在早期会经历结缔组织包裹,随后有新骨沉积并与材料直接接触。
在此动物模型中,使用内部基质(无论是HAPSET还是羟基磷灰石)修复根分叉穿孔时,愈合反应更好。