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低强度激光疗法对正畸移动过程中牙髓的影响。

Effect of low level laser therapy on dental pulp during orthodontic movement.

作者信息

Domínguez Angela, Ballesteros Rosa Emilia, Viáfara Jairo Hernán, Tamayo Oscar Mario

机构信息

Ángela Domínguez, Rosa Emilia Ballesteros, Jairo Hernán Viáfara, Department of Orthodontics, Faculty of Dentistry, Universidad del Valle, Cali 76001000, Colombia.

出版信息

World J Methodol. 2013 Jun 26;3(2):19-26. doi: 10.5662/wjm.v3.i2.19.

Abstract

AIM

To validate the protocol described here to be used in future clinical trials related to the effect of laser therapy on dental pulp.

METHODS

Histologically treated samples from eight human healthy premolar teeth obtained from the middle root level were distributed in four groups: group 1 (G1) absolute control; group 2 (G2) only laser irradiation; group 3 (G3) exposed only to orthodontics; and group 4 (G4) treated with orthodontics and laser. Laser treatment was performed at 830 nm wavelength, 100 mW (energy 80 J/cm(2), 2.2 J), for 22 s in the vestibular surface and 22 s in the palatal surface, 1 mm away from the dental root mucosa. Three staining methods were performed: hematoxylin-eosin (HE), Masson's Trichrome method and Gomori's method.

RESULTS

The pulp histology parameters were evaluated and the results classified in to 3 parts: an inflammatory response, soft tissue response (dental pulp) and hard tissue response (dentin and predentin). There was no inflammation (chronic or acute) in any of the evaluated groups. The zones of pulp necrosis were found in one premolar of G3 and in one of G4; in groups G2 and G4 there was higher angiogenesis than in the other two groups. G4 group presented the highest level of vascularization. A reduced nerve density was observed in G3. A G2 specimen showed increased nerve density. A higher rate of calcification was observed in G1 compared to G2. Denticles, either real or false, were observed in G1, G2 and G3. Sclerosis of dentin and focal dentin loss was observed among all the groups. Secondary dentin was present in one sample in G1 and G2. A necrosis zone was found in one sample of G3 and G4. No differences between groups were observed in the odontoblast irregularity layer but the layer was wider in the group treated with laser only. A notable difference was detected in reduction of the cell-free layer between the groups G1 and G4. The findings in pulp tissue favor its adaptative response against dental movement induced by orthodontics. No definitive conclusions may be derived as this is a pilot study.

CONCLUSION

The protocol described here was shown to be an effective method to evaluate changes in dental pulp submitted to low level laser in teeth under orthodontic movement.

摘要

目的

验证本文所述方案,以便用于未来与激光治疗对牙髓影响相关的临床试验。

方法

从八颗人类健康前磨牙牙根中部获取经组织学处理的样本,分为四组:第1组(G1)绝对对照组;第2组(G2)仅接受激光照射;第3组(G3)仅接受正畸治疗;第4组(G4)接受正畸治疗和激光治疗。激光治疗在830nm波长、100mW(能量80J/cm²,2.2J)条件下进行,在距牙根黏膜1mm处的前庭面照射22秒,腭面照射22秒。进行了三种染色方法:苏木精-伊红染色(HE)、Masson三色染色法和Gomori染色法。

结果

对牙髓组织学参数进行评估,结果分为三部分:炎症反应、软组织反应(牙髓)和硬组织反应(牙本质和前期牙本质)。在任何评估组中均未发现炎症(慢性或急性)。在G3组的一颗前磨牙和G4组的一颗前磨牙中发现了牙髓坏死区域;在G2组和G4组中,血管生成比其他两组更高。G4组的血管化程度最高。在G3组中观察到神经密度降低。G2组的一个标本显示神经密度增加。与G2组相比,G1组观察到更高的钙化率。在G1、G2和G3组中观察到了真性或假性牙本质小体。在所有组中均观察到牙本质硬化和局灶性牙本质丧失。在G1组和G2组的一个样本中存在继发性牙本质。在G3组和G4组的一个样本中发现了坏死区域。在成牙本质细胞不规则层中未观察到组间差异,但仅接受激光治疗的组中该层更宽。在G1组和G4组之间观察到无细胞层减少存在显著差异。牙髓组织中的发现有利于其对正畸诱导的牙齿移动的适应性反应。由于这是一项初步研究,无法得出明确结论。

结论

本文所述方案被证明是评估正畸移动牙齿中接受低水平激光照射的牙髓变化的有效方法。

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