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微螺钉植入所致故意损伤后的牙根及牙髓反应

Root and pulp response after intentional injury from miniscrew placement.

作者信息

Renjen Rahul, Maganzini Anthony L, Rohrer Michael D, Prasad Hari S, Kraut Richard A

机构信息

Division of Orthodontics, Department of Dentistry, Montefiore Medical Center, University Hospital for the Albert Einstein College of Medicine, Bronx, NY, USA.

出版信息

Am J Orthod Dentofacial Orthop. 2009 Nov;136(5):708-14. doi: 10.1016/j.ajodo.2007.12.031.

Abstract

INTRODUCTION

The purpose of this study was to evaluate the effects on the pulp and supporting tissues when miniscrews severely abrade the root surface.

METHODS

Sixty self-drilling and self-tapping miniscrews were placed between the premolars and molars of 3 beagles (20 miniscrews per dog). The miniscrews were placed according to the protocol suggested by the manufacturer, but with the intention of inflicting root damage. Radiographs were taken of all 60 interdental alveolar sites, 5 in each quadrant, and sites that evidenced root proximity were identified. The animals were killed at 12 weeks, and 20 of the most probable injury sites were selected for histologic analysis. Serial nondecalcified sections and microcomputed tomography scans were obtained with the implants in place.

RESULTS

There was no histologic evidence of inflammatory response either at the root surface or in the pulp. Pulp necrosis, external resorption, and ankylosis were not found, but reparative cementum was seen at each injury site. The presence of woven bone along miniscrew threads lends evidence to support the osseointegration of miniscrews.

CONCLUSIONS

Permanent damage to the pulp and supporting tissues is not a regular occurrence when miniscrews abrade or even enter the root surface.

摘要

引言

本研究的目的是评估微型螺钉严重磨损牙根表面时对牙髓和支持组织的影响。

方法

在3只比格犬的前磨牙和磨牙之间植入60枚自攻自钻微型螺钉(每只犬植入20枚)。微型螺钉按照制造商建议的方案植入,但有意造成牙根损伤。对所有60个牙槽间隙部位进行了X线片拍摄,每个象限5个部位,识别出牙根邻近的部位。在12周时处死动物,选择20个最可能出现损伤的部位进行组织学分析。在植入物在位的情况下获取连续的不脱钙切片和微型计算机断层扫描。

结果

在牙根表面或牙髓中均未发现炎症反应的组织学证据。未发现牙髓坏死、外部吸收和牙骨质粘连,但在每个损伤部位均可见修复性牙骨质。微型螺钉螺纹周围有编织骨,这为微型螺钉的骨整合提供了证据。

结论

当微型螺钉磨损甚至进入牙根表面时,牙髓和支持组织不会经常受到永久性损伤。

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