Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, Universidade Estadual Paulista, Rua José Bonifácio 1193, Araçatuba, Brazil.
Dent Traumatol. 2012 Jun;28(3):226-32. doi: 10.1111/j.1600-9657.2011.01071.x. Epub 2011 Nov 3.
Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkey's teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex(®) ). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy.
牙髓治疗是牙再植术方案的重要步骤，但理想的再植牙永久性根管充填时机尚未确定。本研究通过组织形态计量学分析，评估了猴牙即刻再植后用氢氧化钙（CH）治疗 1 个月和 6 个月，并用 CH 基密封剂（Sealapex(®)）进行根管充填的修复过程。5 只雌性卷尾猴的上颌和下颌侧切牙被拔出，在无菌盐水中保存 15 分钟，再植并用不锈钢正畸丝和复合树脂夹板固定 10 天。在 I 组（对照组），在拔牙前进行永久性根管充填。在 II 组和 III 组，在拆除夹板后开始 CH 治疗，分别在 1 个月和 6 个月后进行永久性根管充填。再植后 9 个月，动物被处死，取标本进行组织形态计量学分析。在所有组中，上皮附着于牙骨质牙釉质交界处或非常接近该区域；根表面的吸收区域面积较小，深度较浅，被新形成的牙骨质修复；牙周膜有组织。组织形态计量学参数评分的统计学分析显示，各组之间无统计学差异（P=0.1221）。结果表明，即刻再植后 10 天开始牙髓治疗并联合应用抗生素时，短期 CH 治疗后可进行永久性根管充填。
