Matsuda S, Memida T, Mizuno N, Ogawa I, Ouhara K, Kajiya M, Fujita T, Sugiyama E, Kurihara H
Department of Periodontal Medicine, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University Hospital, Hiroshima, Japan.
Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.
Int Endod J. 2018 Sep;51(9):1059-1066. doi: 10.1111/iej.12914. Epub 2018 Mar 14.
To report a case of reparative bone-like tissue formation in the tooth of a patient with systemic sclerosis.
A 58-year-old Japanese female patient with systemic sclerosis was referred because of tooth fracture. Cone beam computerized tomography (CBCT) revealed multiple root resorption and the unclear transition from alveolar bone to root profile. A sample from a fractured tooth was analysed histologically. Haematoxylin and eosin-stained sections revealed the irregular replacement of pulp and dentine by bone-like tissue. Calcinosis was noted in various parts of the body and a histological analysis identified it as dystrophic calcification on sclerosed fibrous connective tissue. Bite force and the occlusal area were markedly weaker than the means for female of the same age.
CBCT may be more useful than dental radiography for diagnosing multiple root resorption in systemic sclerosis patients. When systemic sclerosis patients have calcinosis, their root status must be examined carefully. When root resorption is present in systemic sclerosis patients, reparative bone-like tissue formation in teeth needs to be taken into account prior to the initiation of dental treatment.
报告一例系统性硬化症患者牙齿中出现修复性骨样组织形成的病例。
一名58岁的日本女性系统性硬化症患者因牙齿骨折前来就诊。锥形束计算机断层扫描（CBCT）显示多处牙根吸收，以及牙槽骨与牙根外形之间的过渡不清晰。对一颗折断牙齿的样本进行了组织学分析。苏木精和伊红染色切片显示牙髓和牙本质被骨样组织不规则替代。在身体各部位均发现钙质沉着，组织学分析将其确定为硬化性纤维结缔组织上的营养不良性钙化。咬合力和咬合面积明显低于同年龄女性的平均值。
对于诊断系统性硬化症患者的多处牙根吸收，CBCT可能比牙科X线摄影更有用。当系统性硬化症患者出现钙质沉着时，必须仔细检查其牙根状况。当系统性硬化症患者存在牙根吸收时，在开始牙科治疗前需要考虑牙齿中修复性骨样组织的形成。
