Kamibayashi T
Fukuoka Shika Daigaku Gakkai Zasshi. 1989;16(4):522-48.
Although a number of reports on the formation of periapical lesions have been down, little study on the healing stage of this one is seen. Therefore, the aim of this study was to investigate the changes of the fine structure of the healing stage of the artificial periapical lesions after root canal filling and to make an experimental model for the further screening test of various kinds of medicaments and materials for root canal treatment and root canal filling. In this study, the first mandibular molars of male Wistar strain rats were used. Periapical lesions were induced by 0.5% carrageenin and after three weeks, the root canals of the first molars were filled with gutta-percha points and sealers. Then, the healing stage of the periapical lesion was observed light microscopically, electron-microscopically and enzyme (alkaline phosphatase, ALP, and acid phosphatase, ACP)-histochemically. The results were as follows after the root canal filling with carrageenins: 1. At 1 to 7 days, a great number of neutrophils and histiocytes were observed and expansion of periapical lesions caused by the irritation followed by root canal filling was observed. 2. At 2 to 3 weeks, a great number of leukocytes, histiocytes and fibroblasts were observed in the vicinity of the root apex. 3. At 4 to 5 weeks, a great number of histiocytes and mast cells were observed and granulated tissues of the periapical lesions had a tendency to become fibrosis and new calcified cement increased at the root apex. 4. At 7 to 10 weeks, the fibroblast granulation tissue around the periapical lesions synthesized active collagen fibers and the deposition of new alveolar bone was seen within the resorbed alveolar bone. 5. At 15 to 20 weeks, the periapical lesions could be thought to be healing histopathologically although some of inflammatory cells were seen 20 weeks after treatment. 6. At 10 weeks, strong positive responses of ALP were recognized. At 20 weeks, the general appearance of both the ALP and ACP staining showed almost the same response as that of normal periodontium. 7. As for the prognosis, "over filling" showed better healing than that of "under filling". 8. In the case which the root apex was fractured, inflammation lasted for a long period.
虽然已经有许多关于根尖周病变形成的报道，但关于其愈合阶段的研究却很少见。因此，本研究的目的是调查根管充填后人工根尖周病变愈合阶段的细微结构变化，并建立一个实验模型，用于进一步筛选各种根管治疗和根管充填的药物及材料。在本研究中，使用雄性Wistar品系大鼠的第一下颌磨牙。用0.5%角叉菜胶诱导根尖周病变，三周后，用牙胶尖和封闭剂充填第一磨牙的根管。然后，通过光学显微镜、电子显微镜和酶（碱性磷酸酶、ALP和酸性磷酸酶、ACP）组织化学观察根尖周病变的愈合阶段。用角叉菜胶充填根管后的结果如下：1. 在1至7天，观察到大量中性粒细胞和组织细胞，并观察到根管充填后刺激引起的根尖周病变扩大。2. 在2至3周，在根尖附近观察到大量白细胞、组织细胞和成纤维细胞。3. 在4至5周，观察到大量组织细胞和肥大细胞，根尖周病变的肉芽组织有纤维化倾向，根尖处新的钙化牙骨质增加。4. 在7至10周，根尖周病变周围的成纤维细胞肉芽组织合成活性胶原纤维，并在吸收的牙槽骨内观察到新牙槽骨的沉积。5. 在15至20周，尽管治疗20周后仍可见一些炎症细胞，但根尖周病变在组织病理学上可认为正在愈合。6. 在10周时，ALP呈强阳性反应。在20周时，ALP和ACP染色的总体外观与正常牙周组织几乎相同。7. 至于预后，“超充”比“欠充”愈合更好。8. 在根尖骨折的情况下，炎症持续很长时间。
