Ma Khin Ma, Sae-Lim Varawan
Department of Restorative Dentistry, Faculty of Dentistry, National University of Singapore, Republic of Singapore.
Dent Traumatol. 2003 Apr;19(2):96-102. doi: 10.1034/j.1600-9657.2003.00155.x.
Tetracycline has been reported to possess antiresorptive properties in addition to antimicrobial actions. Systemic administration of tetracycline showed variable results in the control of replacement resorption after replantation with good results in half of the cases, and almost no healing in the rest. The purpose of this study was to evaluate histologically the effect of topically applied minocycline on replacement resorption of replanted monkeys' teeth. Thirty-two roots from seven monkeys were endodontically treated aseptically to prevent inflammatory resorption of pulpal origin, a common sequela after avulsion injury. Teeth were then extracted as atraumatically as possible. Teeth in the negative control group (10 roots) were replanted almost immediately, while teeth in the positive control group (12 roots) were allowed to bench-dry for 1 h prior to replantation, both without further treatment. Teeth in the experimental group (10 roots) were bench-dried for 1 h, rinsed with saline, and then immersed in 1 ml of 50 mg ml(-1) minocycline hydrochloride for 5 min before replantation. No splinting was used. After 12 weeks, the animals were sacrificed and histological sections were prepared and evaluated according to a morphometric analysis modified from that described by Andreasen (1987) as complete healing, inflammatory resorption, and replacement resorption. Kruskal-Wallis test showed significant differences among the three groups in all the three healing categories. Further analysis with Mann-Whitney U-test showed teeth in the negative control group to have significantly higher complete healing and significant lower unfavorable healing, comprising of replacement resorption and inflammatory root resorption than the positive control group and the minocycline group. Topical application of minocycline to the root surface appeared to result in slightly higher occurrence of complete healing (32.46%) compared to the delayed replantation group with no minocycline treatment (positive control) (16.58%), but the difference was not statistically significant (P = 0.09).
据报道，四环素除了具有抗菌作用外，还具有抗吸收特性。全身应用四环素在控制再植后的替代性吸收方面结果不一，一半的病例效果良好，其余病例几乎没有愈合。本研究的目的是通过组织学评估局部应用米诺环素对再植猴牙替代性吸收的影响。对7只猴子的32颗牙根进行无菌牙髓治疗，以防止牙髓源性炎症性吸收，这是撕脱伤后常见的后遗症。然后尽可能无创伤地拔除牙齿。阴性对照组（10颗牙根）的牙齿几乎立即再植，而阳性对照组（12颗牙根）的牙齿在再植前放置干燥1小时，两组均不进行进一步治疗。实验组（10颗牙根）的牙齿放置干燥1小时，用生理盐水冲洗，然后在再植前浸入1ml 50mg/ml（-1）盐酸米诺环素中5分钟。未使用夹板固定。12周后，处死动物，制备组织学切片，并根据Andreasen（1987年）描述的形态计量分析方法进行评估，分为完全愈合、炎症性吸收和替代性吸收。Kruskal-Wallis检验显示，三组在所有三种愈合类别中均存在显著差异。进一步用Mann-Whitney U检验分析表明，阴性对照组的牙齿完全愈合率显著高于阳性对照组和米诺环素组，而包括替代性吸收和炎症性牙根吸收在内的不良愈合率显著低于阳性对照组和米诺环素组。与未用米诺环素治疗的延迟再植组（阳性对照组）（16.58%）相比，在牙根表面局部应用米诺环素似乎导致完全愈合的发生率略高（32.46%），但差异无统计学意义（P = 0.09）。
