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[羟基磷灰石颗粒对比格犬实验性根分叉病变愈合过程的影响]

[Effect of hydroxylapatite particles during healing of experimental furcation involvement in beagle dogs].

作者信息

Yaegashi T

出版信息

Nihon Shishubyo Gakkai Kaishi. 1989 Mar;31(1):83-99. doi: 10.2329/perio.31.83.

Abstract

The present study was performed to evaluate the effects of hydroxylapatite (HAP) on tissue regeneration in various types of furcation involvement. Upper premolar tooth sites of 9 beagle dogs (3-6 years old) were used. HAP particles were implanted into three types of furcation defects: Class III lesion (by Glickman) in 2nd premolar sites, artificially caused by intrafurcal suturing or spontaneously developed about 3 months after extraction of the 1st premolar; Class IV lesion in 4th premolar sites artificially produced 2 months before implantation; and through-and-through furcal bony defects in 3rd premolar sites at the time of HAP implantation. Macroscopic, radiographic and microscopical investigations of the postoperative status were carried out at intervals of 1, 2, 3 and 6 months. The appearance of the gingiva in bony defect sites was almost the same as that in the presurgical status 2 weeks after implantation, although gingival inflammation was persistent in Class III and IV lesions. Most particles in Class III and IV lesions exfoliated until 2 weeks after implantation, and the junctional space between recipient bone and particles could not be distinguished, probably as a result of incorporation of HAP and osseous tissue. Histological observation revealed that HAP particles were surrounded by new bone located at the top of the alveolar crest in all defects. However, there were no obvious signs of coronal bone formation or connective tissue attachment in Class III and IV lesions up to 3 months after the operation. At 6 months there was evidence of new bone formation over the presurgical crests in Class III and IV lesions. On the other hand, there were obvious signs of connective tissue attachment and bone formation in bony defect sites, probably induced by the tissue of the periodontal ligament remaining after the surgical procedure, and nonphysiological ankylosis between root and bone was frequently observed. There were notable findings, such as newly formed osteoid tissue intervening with the adhesive particles, calcified tissue intervening between HAP particles and root surface showing ankylosis, and peripheral osteoid formation in the HAP particles. It is postulated that HAP has no apparent role in induction of bone formation, although there is chemical affinity to calcified tissue, and it is effective in yielding a volume of bone-like tissue where osseous repair could be performed. However, HAP did not enhance regeneration of lost periodontal structures including connective tissue attachment.

摘要

本研究旨在评估羟基磷灰石(HAP)对各类根分叉病变组织再生的影响。使用了9只比格犬(3至6岁)的上颌前磨牙部位。将HAP颗粒植入三种类型的根分叉缺损:第二前磨牙部位的III类病变(根据Glickman分类),通过根内缝合人为造成或在第一前磨牙拔除后约3个月自发形成;第四前磨牙部位在植入前2个月人为制造的IV类病变;以及在植入HAP时第三前磨牙部位的贯通性根分叉骨缺损。术后分别在1、2、3和6个月对其状态进行宏观、影像学和显微镜检查。植入后2周,骨缺损部位牙龈的外观与术前状态几乎相同,尽管III类和IV类病变中牙龈炎症持续存在。III类和IV类病变中的大多数颗粒在植入后2周内脱落,受体骨与颗粒之间的结合间隙无法区分,这可能是由于HAP与骨组织融合的结果。组织学观察显示,在所有缺损中,HAP颗粒被位于牙槽嵴顶部的新骨所包围。然而,在术后3个月内,III类和IV类病变中没有明显的冠向骨形成或结缔组织附着的迹象。在6个月时,有证据表明III类和IV类病变中术前嵴上方有新骨形成。另一方面,在骨缺损部位有明显的结缔组织附着和骨形成迹象,可能是由手术过程后残留的牙周膜组织诱导的,并且经常观察到牙根与骨之间的非生理性骨粘连。有一些显著的发现,如新形成的类骨质组织介入粘附颗粒之间、HAP颗粒与显示骨粘连的牙根表面之间有钙化组织介入以及HAP颗粒外周有类骨质形成。据推测,尽管HAP与钙化组织有化学亲和力,但在诱导骨形成方面没有明显作用,并且在产生可进行骨修复的一定量类骨组织方面是有效的。然而,HAP并没有增强包括结缔组织附着在内的缺失牙周结构的再生。

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