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牙本质三氧化物聚合体(Angelus™MTA)或 Biodentine™封闭根分叉穿孔后的根尖周炎症反应、骨质吸收和牙骨质修复。

Periradicular inflammatory response, bone resorption, and cementum repair after sealing of furcation perforation with mineral trioxide aggregate (MTA Angelus™) or Biodentine™.

机构信息

School of Dentistry, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil.

School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492., Porto Alegre, RS, Brazil.

出版信息

Clin Oral Investig. 2019 Nov;23(11):4019-4027. doi: 10.1007/s00784-019-02833-z. Epub 2019 Mar 12.

DOI:10.1007/s00784-019-02833-z
PMID:30864115
Abstract

OBJECTIVE

This study assessed tissue responses after furcation perforation and immediate sealing with either Biodentine™ or MTA Angelus™.

MATERIAL AND METHODS

Sixty male Wistar rats were used (n = 6 per group/period). The mandibular first molars had the furcation mechanically exposed and sealed with either MTA or Biodentine™ and restored with silver amalgam. In an additional test group, teeth were sealed only with Biodentine™. Furcation sealing with gutta-percha and silver amalgam restoration served as positive control, and healthy untreated teeth were the negative control. Histological evaluation was performed after 14 or 21 days. Kruskal-Wallis and Dunn's post hoc tests were performed to analyze the extent and intensity of tissue inflammation, bone resorption, and cementum repair (p < 0.05).

RESULTS

Biodentine™ and MTA presented satisfactory results, showing a milder inflammatory response when compared to the control, regardless of the material used for coronal sealing and of the experimental period evaluated (p < 0.0001). All test groups showed less bone resorption than the positive control after 21 days (p < 0.05), and such differences were more pronounced in teeth restored with silver amalgam. Cementum repair was performed in 30% of MTA and Biodentine™ samples but not carried out in any positive control specimen.

CONCLUSIONS

Biodentine™ and MTA promoted similar responses when used to seal furcation perforations and should therefore be regarded as a promising alternative.

CLINICAL RELEVANCE

Knowledge about tissue responses to restorative materials is essential for improving root perforation sealing protocols. The present results showed that both Biodentine™ and MTA promoted appropriate periradicular tissue reactions in a preclinical test for evaluating furcation perforation treatments.

摘要

目的

本研究评估了使用 Biodentine™或 MTA Angelus™即刻封闭分叉穿孔后的组织反应。

材料和方法

60 只雄性 Wistar 大鼠(n = 6 只/组/期)被用于本研究。下颌第一磨牙的分叉经机械暴露后,使用 MTA 或 Biodentine™进行封闭,并用银汞合金修复。在一个附加的实验组中,牙齿仅用 Biodentine™进行封闭。使用牙胶和银汞合金修复作为阳性对照来封闭分叉,未处理的健康牙齿作为阴性对照。在 14 或 21 天后进行组织学评估。采用 Kruskal-Wallis 和 Dunn 事后检验分析组织炎症、骨吸收和牙骨质修复的程度和强度(p < 0.05)。

结果

Biodentine™和 MTA 的结果令人满意,与对照组相比,无论使用何种材料进行冠部封闭,无论评估的实验期如何,其炎症反应均较轻(p < 0.0001)。与阳性对照组相比,所有实验组在 21 天后的骨吸收程度均较低(p < 0.05),而用银汞合金修复的牙齿差异更为明显。MTA 和 Biodentine™的样本中有 30%进行了牙骨质修复,但在任何阳性对照组样本中均未进行。

结论

使用 Biodentine™和 MTA 封闭分叉穿孔可产生相似的反应,因此可被视为一种有前途的替代材料。

临床意义

了解修复材料对组织的反应对于改善根穿孔封闭方案至关重要。本研究结果表明,在评估分叉穿孔治疗的临床前试验中,Biodentine™和 MTA 均能促进根尖周组织的适当反应。

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