Consolaro Alberto, Consolaro Renata Bianco
Universidade de São Paulo, Faculdade de Odontologia de Bauru (Bauru/SP, Brazil).
Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Programa de Pós-graduação em Odontopediatria (Ribeirão Preto/SP, Brazil).
Dental Press J Orthod. 2018 Aug 1;23(4):36-42. doi: 10.1590/2177-6709.23.4.036-042.oin.
To biologically explain why the orthodontic treatment does not induce pulp necrosis and calcific metamorphosis of the pulp, this paper presents explanations based on pulp physiology, microscopy and pathology, and especially the cell and tissue phenomena that characterize the induced tooth movement. The final reflections are as follows: 1) the orthodontic movement does not induce pulp necrosis or calcific metamorphosis of the pulp; 2) there is no literature or experimental and clinical models to demonstrate or minimally evidence pulp alterations induced by orthodontic movement; 3) when pulp necrosis or calcific metamorphosis of the pulp is diagnosed during orthodontic treatment or soon after removal of orthodontic appliances, its etiology should be assigned to concussion dental trauma, rather than to orthodontic treatment; 4) the two pulp disorders that cause tooth discoloration in apparently healthy teeth are the aseptic pulp necrosis and calcific metamorphosis of the pulp, both only induced by dental trauma; 5) the concussion dental trauma still requires many clinical and laboratory studies with pertinent experimental models, to increasingly explain its effects on the periodontal and pulp tissues.
为从生物学角度解释正畸治疗为何不会引发牙髓坏死及牙髓钙化性变，本文基于牙髓生理学、显微镜检查及病理学，尤其是诱导牙齿移动所特有的细胞和组织现象进行解释。最后的思考如下：1）正畸移动不会引发牙髓坏死或牙髓钙化性变；2）没有文献或实验及临床模型能够证明或起码提供证据表明正畸移动会导致牙髓改变；3）当在正畸治疗期间或拆除正畸矫治器后不久诊断出牙髓坏死或牙髓钙化性变时，其病因应归因于牙震荡创伤，而非正畸治疗；4）在看似健康的牙齿中导致牙齿变色的两种牙髓疾病是无菌性牙髓坏死和牙髓钙化性变，二者均仅由牙外伤引起；5）牙震荡创伤仍需要许多带有相关实验模型的临床和实验室研究，以进一步解释其对牙周组织和牙髓组织的影响。
