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吲哚美辛对犬再植牙表面处理及根管内封药的影响。

Effect of indomethacin on surface treatment and intracanal dressing of replanted teeth in dogs.

作者信息

Zanetta-Barbosa Darceny, Moura Camilla Christian Gomes, Machado Juliana Reis, Crema Virginia Oliveira, Lima Cirilo Antônio de Paula, de Carvalho Antônio Cesar Perry

机构信息

Professor, Division of Buccal and Maxillofacial Surgery, Department of Oral Surgery, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil.

Professor, Department of Histology, Federal University of Triângulo Mineiro; and Researcher, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil.

出版信息

J Oral Maxillofac Surg. 2014 Jan;72(1):127.e1-9. doi: 10.1016/j.joms.2013.08.028.

Abstract

PURPOSE

This study evaluated the healing process of teeth replanted after root treatment and intracanal dressing with indomethacin alone or indomethacin with calcium hydroxide (Ca[OH]2).

MATERIALS AND METHODS

Through a case-control study, 24 teeth of 6 adult dogs were extracted, dried, and divided into 4 groups according to the root surface treatment protocols performed before replantation and the intracanal medication used after replantation. In group 1 (negative control), root surfaces were treated by immersion in a 0.9% saline solution and then replanted. In the other groups, the roots were immersed for 10 minutes in Ca(OH)2 (group 2), indomethacin (group 3), or a solution of indomethacin and Ca(OH)2 (group 4). After 2 weeks, group 1 teeth were subjected to single-visit root canal treatment and obturation with gutta-percha and sealer consisting of zinc oxide and eugenol. The teeth in the other groups were subjected to intracanal dressing with the same material used for immersion. After an additional period of 28 weeks, the animals were euthanized and the jaws containing the replanted teeth were processed for histologic analysis. Histometric values were statistically analyzed, with significance set at a P value less than or equal to .05.

RESULTS

Group 1 exhibited significantly more normal periodontium than group 4 (P = .02). Total resorption was greater in group 4 than in group 1 (P = .02). No statistically significant difference in the percentage of surface resorption or in total inactive resorption was observed between the groups.

CONCLUSIONS

The findings of this study suggest that intracanal dressing and topical root treatment with Ca(OH)2 with or without indomethacin is not recommended for teeth dried for 50 minutes, but the use of indomethacin alone as root surface treatment for delayed tooth replantation deserves further study using longer drying periods. In addition, the present results suggest that a single-visit root canal, performed up to 2 weeks after replantation, might be indicated for teeth dried for up to 50 minutes.

摘要

目的

本研究评估了在进行根管治疗并用吲哚美辛单独或与氢氧化钙(Ca[OH]₂)进行根管内封药后再植牙的愈合过程。

材料与方法

通过病例对照研究,拔除6只成年犬的24颗牙齿,干燥后根据再植前进行的牙根表面处理方案以及再植后使用的根管内药物分为4组。第1组(阴性对照组),牙根表面通过浸入0.9%的盐溶液进行处理,然后再植。在其他组中,牙根在氢氧化钙(第2组)、吲哚美辛(第3组)或吲哚美辛与氢氧化钙的溶液(第4组)中浸泡10分钟。2周后,第1组牙齿接受一次性根管治疗并用牙胶尖和由氧化锌和丁香酚组成的封闭剂进行充填。其他组的牙齿用用于浸泡的相同材料进行根管内封药。再过28周后,对动物实施安乐死,并对含有再植牙的颌骨进行组织学分析。对组织测量值进行统计学分析,显著性设定为P值小于或等于0.05。

结果

第1组显示出比第4组明显更多的正常牙周组织(P = 0.02)。第4组的总吸收比第1组更大(P = 0.02)。各组之间在表面吸收百分比或总无活性吸收方面未观察到统计学上的显著差异。

结论

本研究结果表明,对于干燥50分钟的牙齿,不建议使用氢氧化钙联合或不联合吲哚美辛进行根管内封药和局部牙根处理,但单独使用吲哚美辛作为延迟牙再植的牙根表面处理方法值得使用更长干燥时间进行进一步研究。此外,目前的结果表明,对于干燥长达50分钟的牙齿,在再植后长达2周进行一次性根管治疗可能是合适的。

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