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微螺钉种植体对牙根及周围结构的故意损伤的影响

Effects of intentional damage of the roots and surrounding structures with miniscrew implants.

作者信息

Hembree Megan, Buschang Peter H, Carrillo Roberto, Spears Robert, Rossouw P Emile

机构信息

Orthodontic Department, Baylor College of Dentistry, Texas A&M Health Science Center, Dallas, TX 75246, USA.

出版信息

Am J Orthod Dentofacial Orthop. 2009 Mar;135(3):280.e1-9; discussion 280-1. doi: 10.1016/j.ajodo.2008.06.022.

Abstract

INTRODUCTION

The purposes of the study were to evaluate the immediate damage to roots and periodontal structures after initial miniscrew implant (MSI) placement and the short- and long-term damage after MSIs were left in situ.

METHODS

The roots of the maxillary second, third, and fourth premolars of 7 mature beagle dogs were randomly assigned to undergo immediate, short-term (left for 6 weeks), or long-term (left for 12 weeks) damage. Intentional damage was inflicted with self-tapping screws (1.8 x 8 mm) placed with a stent. Alternating tetracycline and calcein labels were administered at 6-week intervals. Undecalcified sections were stained and evaluated histologically to determine the extent of damage; healing was evaluated by using fluorescence labels.

RESULTS

Histology showed damage to 73.8% of the teeth, ranging from displacement of bone into the periodontal ligament to invasion of the pulp chamber. Displacement of bone into the periodontal ligament and direct damage to the periodontal ligament occurred in 3 (7.2%) instances. Damage was isolated to the cementum of 8 (19.0%) teeth, whereas damage occurred in the dentin of 11 (26.2%) teeth. Loss of bone in the furcation was evident in 3 (7.2%) teeth, and severe damage into the pulp occurred in 6 (14.2%) teeth. No differences in the amounts of damage were evident between the immediate, short-, and long-term groups. Healing often occurred with cementum around the unloaded MSIs.

CONCLUSIONS

Extensive damage can be caused by MSIs, with little to no differences evident over time. Unloaded MSIs that remain in contact with roots of teeth can show varying degrees of healing.

摘要

引言

本研究的目的是评估初次植入微型螺钉种植体(MSI)后对牙根和牙周结构的即刻损伤,以及MSI原位留存后的短期和长期损伤。

方法

将7只成年比格犬上颌第二、第三和第四前磨牙的牙根随机分组,分别接受即刻、短期(留存6周)或长期(留存12周)损伤。使用自攻螺钉(1.8×8 mm)并借助支架有意造成损伤。每隔6周交替给予四环素和钙黄绿素标记。对未脱钙切片进行染色并进行组织学评估以确定损伤程度;通过荧光标记评估愈合情况。

结果

组织学显示73.8%的牙齿有损伤,范围从骨移位至牙周膜到牙髓腔受侵。骨移位至牙周膜和牙周膜直接损伤发生在3例(7.2%)。8颗(19.0%)牙齿的损伤局限于牙骨质,而11颗(26.2%)牙齿的损伤发生在牙本质。3颗(7.2%)牙齿的根分叉处有明显骨吸收,6颗(14.2%)牙齿出现严重牙髓损伤。即刻、短期和长期组之间的损伤量无明显差异。未加载的MSI周围牙骨质常出现愈合。

结论

MSI可造成广泛损伤,随时间推移差异不大。与牙齿牙根接触的未加载MSI可表现出不同程度的愈合。

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