犬根尖周炎未成熟恒牙坏死牙髓的组织工程:影像学和组织学评价

Tissue Engineering of Necrotic Dental Pulp of Immature Teeth with Apical Periodontitis in Dogs: Radiographic and Histological Evaluation.

作者信息

El Ashiry Eman A, Alamoudi Najlaa M, El Ashiry Mahmoud K, Bastawy Hagar A, El Derwi Douaa A, Atta Hazem M

出版信息

J Clin Pediatr Dent. 2018;42(5):373-382. doi: 10.17796/1053-4625-42.5.9. Epub 2018 May 15.

Abstract

AIM

To evaluate tissue engineering technology to regenerate pulp-dentin like tissues in pulp canals of immature necrotic permanent teeth with apical periodontitis in dogs.

STUDY DESIGN

The study was performed on 36 teeth in 12 dogs. The experiment was carried out using split mouth design. In each dog 3 teeth were selected for implementing the study procedure. Apical periodontitis was induced in Group A and B teeth. Group (A): immature upper left 2 permanent incisors that were transplanted with a construct of autologous dental pulp stem cells with growth factors seeded in a chitosn hydrogel scaffold. Group (B): immature upper right 2 permanent incisor that received only growth factors with scaffold. A third tooth in each dog was selected randomly for isolation of dental pulp stem cells (DPSCs). Both groups were closed with a double coronal seal of white MTA (Mineral trioxide aggregate) and glass ionomer cement. Both groups were monitored radiographically for 4 months and histologically after sacrificing the animals.

RESULTS

There was no statistically significant difference in radiographic findings between group (A) and group (B) for healing of radiolucencies, while there was statistically significant difference between group (A) and group (B) regarding radicular thickening, root lengthening and apical closure. Histologically, group (A) teeth showed regeneration of pulp- dentin like tissue while group (B) teeth did not show any tissue regeneration.

CONCLUSION

Dental pulp stem cells and growth factors incorporated in chitosan hydrogel are able to regenerate pulp- dentine like tissue and help in complete root maturation of non-vital immature permanent teeth with apical periodontitis in dogs.

摘要

目的

评估组织工程技术在犬未成熟坏死恒牙根尖周炎的牙髓腔中再生牙髓-牙本质样组织的效果。

研究设计

对12只犬的36颗牙齿进行研究。实验采用双侧对照设计。每只犬选择3颗牙齿进行研究。A组和B组牙齿均诱导根尖周炎。A组:左上2颗未成熟恒切牙,移植自体牙髓干细胞构建体,该构建体中含有接种于壳聚糖水凝胶支架的生长因子。B组:右上2颗未成熟恒切牙,仅接受含支架的生长因子。每只犬随机选择第三颗牙齿用于分离牙髓干细胞(DPSCs)。两组均用白色MTA(三氧化矿物凝聚体)和玻璃离子水门汀进行双冠封闭。两组均进行4个月的影像学监测,并在处死动物后进行组织学检查。

结果

A组和B组在射线透影愈合方面的影像学表现无统计学显著差异,而在牙根增厚、牙根延长和根尖封闭方面,A组和B组有统计学显著差异。组织学上,A组牙齿显示出牙髓-牙本质样组织的再生,而B组牙齿未显示任何组织再生。

结论

壳聚糖水凝胶中掺入的牙髓干细胞和生长因子能够再生牙髓-牙本质样组织,并有助于犬患有根尖周炎的无活力未成熟恒牙的牙根完全成熟。

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