Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
J Endod. 2010 Jan;36(1):95-9. doi: 10.1016/j.joen.2009.10.019.
Immunosuppressive drugs are used in clinical medicine for a variety of disorders, but their effects on the reparative capacity of the dental pulp are unknown. This study evaluated the influence of selected immunosuppressive drugs on pulpal tissue healing after direct pulp capping of mechanically exposed dog's teeth with mineral trioxide aggregate (MTA).
Ten healthy male dogs were assigned into 5 experimental groups: a control group in which no drug was received and 4 experimental groups in which the immunosuppressive drugs prednisone, mycophenolate mofetil, sirolimus, and cyclosporine A were administered 45 days before the operative procedures and until the dogs were killed. Class V cavities were prepared on the buccal surfaces of 12 teeth in each dog. In each cavity, the pulp was exposed and capped with MTA. The pulpal tissue responses to capping material were assessed 65 days postoperatively.
Compared with the control group, variable responses was recorded in the groups treated with mycophenolate mofetil, sirolimus, and cyclosporine A, which were characterized by moderate to severe inflammatory reactions, tissue necrosis, and total absence of hard tissue bridging. Pulpal tissue responses in the group treated with prednisone were characterized by inflammatory cell infiltration, limited tissue necrosis, as well as partial to complete hard tissue bridging.
From these findings, it seemed evident that acceptable repair of the dentin-pulp complex, eg, wound healing with hard tissue formation after capping with MTA, is unlikely with mycophenolate mofetil, sirolimus, or cyclosporine A immunosuppressive drug therapy.
免疫抑制剂在临床医学中被用于多种疾病，但它们对牙髓修复能力的影响尚不清楚。本研究评估了在使用矿化三氧化物凝聚体（MTA）直接盖髓治疗机械暴露的犬牙后，几种免疫抑制剂对牙髓组织愈合的影响。
将 10 只健康雄性犬分为 5 个实验组：对照组未接受药物治疗，4 个实验组在手术前 45 天开始给予免疫抑制剂泼尼松、霉酚酸酯、西罗莫司和环孢素 A，直至犬只处死。在每只犬的 12 颗牙齿的颊面制备 5 类洞。在每个窝洞内，牙髓暴露并用 MTA 盖髓。术后 65 天评估盖髓材料对牙髓组织的反应。
与对照组相比，霉酚酸酯、西罗莫司和环孢素 A 治疗组记录到不同的反应，表现为中度至重度炎症反应、组织坏死和完全没有硬组织桥接。泼尼松治疗组的牙髓组织反应表现为炎症细胞浸润、有限的组织坏死以及部分至完全的硬组织桥接。
从这些发现中可以明显看出，在用 MTA 盖髓后，如在硬组织形成的情况下进行牙本质牙髓复合体的可接受修复，即伤口愈合，霉酚酸酯、西罗莫司或环孢素 A 免疫抑制剂治疗不太可能。
