Iqbal Mian K
Department of Endodontics, School of Dental Medicine, Robert Schatnar Center, University of Pennsylvania, Philadelphia, PA 19104, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jun;103(6):e49-54. doi: 10.1016/j.tripleo.2007.01.020. Epub 2007 Apr 23.
This case report presents clinical and morphological features of severe invasive cervical resorption (ICR) involving a maxillary first molar. Surface morphology of the ICR defect that extended into enamel was studied using a scanning electron microscope. The topography and morphology of resorbed enamel and pulpal surfaces are described. The pulpal space was characterized by proliferation of fibrovascular tissue invaded by a number of > or = 15-microm-large dentinoclastlike cells. The vertical orientation and hexagonal geometric outlines of enamel rods indicated that the resorptive defect had extended into the outer surface of enamel. Preferential odontoclastic dissolution of interprismatic enamel was noted. Deposits of a cementumlike substance were noticed on enamel surfaces, indicating that resorptive process was coupled with repair. Complete destruction of dentin was associated with no response by the tooth to cold stimulus, supporting the hydrodynamic theory of dentinal sensitivity. The results of this study indicate that in addition to predentin and cementum, the outer surface enamel may be resistant to the resorptive process as well.
本病例报告展示了累及上颌第一磨牙的严重侵袭性颈部吸收（ICR）的临床和形态学特征。使用扫描电子显微镜研究了延伸至牙釉质的ICR缺损的表面形态。描述了吸收的牙釉质和牙髓表面的地形和形态。牙髓腔的特征是被许多≥15微米大的破牙本质细胞样细胞侵入的纤维血管组织增生。牙釉质柱的垂直方向和六边形几何轮廓表明吸收性缺损已延伸至牙釉质外表面。注意到柱间质牙釉质的优先破牙本质溶解。在牙釉质表面发现了类牙骨质物质的沉积，表明吸收过程与修复过程同时发生。牙本质的完全破坏与牙齿对冷刺激无反应相关，支持牙本质敏感的流体动力学理论。本研究结果表明，除前期牙本质和牙骨质外，牙釉质外表面也可能对吸收过程具有抵抗力。
