Tawfik H, Abu-Seida A M, Hashem A A, Nagy M M
Endodontic Department, Faculty of Dentistry, Ainshams University, Cairo, Egypt.
Int Endod J. 2013 Oct;46(10):910-22. doi: 10.1111/iej.12079. Epub 2013 Mar 11.
To assess the regenerative potential of immature teeth with necrotic pulps following revascularization procedure in dogs.
Necrotic pulps and periapical pathosis were created by infecting 108 immature teeth, with 216 root canals in nine mongrel dogs. Teeth were divided into three equal groups according to the evaluation period. Each group was further subdivided into six subgroups according to the treatment protocol including MTA apical plug, revascularization protocol, revascularization enhanced with injectable scaffold, MTA over empty canal. All root canals were disinfected with a triple antibiotic paste prior to revascularization with the exception of control subgroups. After disinfection, the root length, thickness and apical diameter were measured from radiographs. Histological evaluation was used to assess the inflammatory reaction, soft and hard tissue formation.
In the absence of revascularization, the length and thickness of the root canals did not change over time. The injectable scaffold and growth factor was no more effective than a revascularization procedure to promote tooth development following root canal revascularization. The tissues formed in the root canals resembled periodontal tissues.
The revascularization procedure allowed the continued development of roots in teeth with necrotic pulps.
评估犬牙髓坏死的未成熟牙齿在进行血管再生治疗后的再生潜力。
通过感染9只杂种犬的108颗未成熟牙齿(共216个根管)来制造牙髓坏死和根尖周病变。根据评估期将牙齿分为三个相等的组。根据治疗方案,每组进一步细分为六个亚组,包括MTA根尖封闭、血管再生方案、注射用支架增强的血管再生、空根管上的MTA。除对照亚组外,所有根管在血管再生前均用三联抗生素糊剂消毒。消毒后,从X线片测量根管长度、厚度和根尖直径。组织学评估用于评估炎症反应、软组织和硬组织形成。
在没有血管再生的情况下,根管的长度和厚度不会随时间变化。在根管血管再生后,注射用支架和生长因子在促进牙齿发育方面并不比血管再生程序更有效。根管内形成的组织类似于牙周组织。
血管再生程序可使牙髓坏死的牙齿继续发育牙根。