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III类根分叉病变行自体牙根相互移植后的牙周组织愈合情况

Periodontal wound healing following reciprocal autologous root transplantation in class III furcation defects.

作者信息

Takeuchi Naoshi, Shirakata Yoshinori, Shinohara Yukiya, Sena Kotaro, Noguchi Kazuyuki

机构信息

Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

出版信息

J Periodontal Implant Sci. 2017 Dec;47(6):352-362. doi: 10.5051/jpis.2017.47.6.352. Epub 2017 Dec 31.

Abstract

PURPOSE

Furcation involvement in the molars is difficult to treat, and has been recognized as a risk factor for tooth loss. Although periodontal regenerative therapies, including guided tissue regeneration and various types of bone grafts, have been applied to furcation defects, the effects of these treatments are limited, especially in large class III furcation defects. The purpose of this pilot study was to investigate the effect of reciprocal autologous root transplantation on periodontal wound healing and regeneration in class III furcation defects in dogs.

METHODS

Furcation defects (7 mm wide and 6 mm high) were surgically created after root separation of the unilateral third and fourth premolars in 4 dogs. Eight furcation defects were randomized to receive either reciprocal autologous root transplantation (test) or no further treatment (control). In the test group, the mesial and distal roots were transplanted into the distal and mesial extraction sockets, respectively. The animals were sacrificed 10 weeks after surgery for histologic evaluation.

RESULTS

The healing pattern in the control group was characterized by extensive collapse of the flap and limited periodontal regeneration. New bone formation in the test group (3.56±0.57 mm) was significantly greater than in the control group (0.62±0.21 mm). Dense collagen fibers inserting into the residual cementum on the transplanted root surfaces were observed in the test group. Slight ankylosis was observed in 2 of the 4 specimens in the test group on the mesiodistal sides where the root-planed surfaces faced the existing bone. Root resorption (RR) was detected in both the control and test groups.

CONCLUSIONS

Within the limits of this study, it can be concluded that reciprocal autologous root transplantation was effective for bone regeneration in class III furcation defects in dogs. However, further studies are required to standardize the approach in order to prevent unwanted RR prior to clinical application.

摘要

目的

磨牙的根分叉病变难以治疗,并且已被认为是牙齿缺失的一个危险因素。尽管包括引导组织再生和各种类型骨移植在内的牙周再生治疗方法已应用于根分叉缺损,但这些治疗的效果有限,尤其是在大型III类根分叉缺损中。本前瞻性研究的目的是调查自体牙根相互移植对犬III类根分叉缺损牙周伤口愈合和再生的影响。

方法

在4只犬的单侧第三和第四前磨牙牙根分离后,通过手术制造根分叉缺损(宽7mm,高6mm)。将8个根分叉缺损随机分为接受自体牙根相互移植(试验组)或不进行进一步治疗(对照组)。在试验组中,近中根和远中根分别移植到远中和近中拔牙窝中。术后10周处死动物进行组织学评估。

结果

对照组的愈合模式表现为瓣广泛塌陷和有限的牙周再生。试验组的新骨形成(3.56±0.57mm)明显大于对照组(0.62±0.21mm)。在试验组中观察到致密的胶原纤维插入移植根表面的残留牙骨质中。试验组4个标本中有2个在根面平整面对现存骨的近远中侧观察到轻微的牙根粘连。在对照组和试验组中均检测到牙根吸收(RR)。

结论

在本研究的范围内,可以得出结论,自体牙根相互移植对犬III类根分叉缺损的骨再生有效。然而,在临床应用之前,需要进一步研究以规范该方法,以防止不必要的RR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a437/5764761/8c1930f2ac54/jpis-47-352-g001.jpg

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