Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
J Endod. 2017 Aug;43(8):1279-1287. doi: 10.1016/j.joen.2017.03.005. Epub 2017 May 31.
INTRODUCTION: The aim of this study was to evaluate histologically the newly formed tissues after regenerative endodontic procedures (REPs) in dogs using either a blood clot (BC) or 2 different formulations of a chitosan hydrogel as scaffolds. METHODS: Apical periodontitis was induced by inoculating immature teeth with oral plaque in 4 beagle dogs. Teeth (n = 96) were divided into 2 control (n = 20) and 4 test groups (n = 76) according to the treatment: apexification and REPs with BC, sodium hyaluronate:chitosan (HA:CS) scaffolds, or pectin:chitosan (P:CS) scaffolds. All root canals were disinfected with 2.5% sodium hypochlorite and a triple antibiotic paste intracanal medicament before evoked bleeding, clot formation, or scaffold placement. Thirteen weeks after treatment, the animals were sacrificed and the jaw blocks harvested for histologic processing, histomorphometric analysis, and statistical analysis. RESULTS: The lumens of the root canals were completely filled with mineral trioxide aggregate with evidence of a mineralized apical bridge between the root canal walls in 83% of the samples in the apexification group. Vital vascularized tissue was found in the REP groups; apical closure happened in 66.7% of these treatments, and root growth was detected more often as an increase in thickness (85.6%) than in length (45.6%). The greatest amount of mineralized tissue inside the canal was observed in the BC group, with statistical significance compared with the HA:CS and P:CS groups (P < .05). Further histologic evaluation revealed the presence of apical papilla. CONCLUSIONS: The addition of chitosan scaffolds to blood in regenerative procedures in dogs did not improve the formation of new mineralized tissues along the root canal walls or the histologic evidence of the regeneration of a pulp-dentin complex.
简介:本研究旨在通过在犬牙中使用血凝块(BC)或 2 种不同配方的壳聚糖水凝胶作为支架,评估再生牙髓治疗(REP)后新形成的组织的组织学表现。
方法:通过在 4 只比格犬的未成熟牙中接种口腔菌斑,诱导根尖周炎。根据治疗方法将牙齿(n=96)分为 2 个对照组(n=20)和 4 个实验组(n=76):根尖封闭术和 BC 联合 REP、透明质酸钠:壳聚糖(HA:CS)支架或果胶:壳聚糖(P:CS)支架。所有根管均用 2.5%次氯酸钠和三联抗生素糊剂进行根管内消毒,然后进行诱发出血、血凝块形成或支架放置。治疗后 13 周,处死动物,采集颌骨块进行组织学处理、组织形态计量学分析和统计学分析。
结果:根尖封闭组 83%的样本中,根管腔完全被三氧化物多聚体填充,根管壁之间有矿化的根尖桥形成。REP 组中发现有活力的血管化组织;这些治疗中有 66.7%发生根尖封闭,并且更常见的是通过增加厚度(85.6%)而不是长度(45.6%)来检测到根尖生长。在 BC 组中观察到管内矿化组织最多,与 HA:CS 和 P:CS 组相比具有统计学意义(P<0.05)。进一步的组织学评估显示存在根尖乳头。
结论:在犬牙再生治疗中,将壳聚糖支架添加到血液中并不能改善沿根管壁形成新的矿化组织的情况,也不能提供牙髓-牙本质复合体再生的组织学证据。
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