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从阻生第三磨牙获取牙髓的超声技术。

Ultrasonic techniques to obtain dental pulp from impacted third molars.

作者信息

Becchio Jorge G, Rosende Roque O, Monzón Jorge E, Fernández Darío, Said-Rücker Patricia B

机构信息

Cirugía III Traumatología Bucomaxilofacial, Facultad de Odontología, UNNE, Argentina. (Surgery III Oral-Maxillofacial Traumatology, UNNE, Argentina).

Cirugía I Técnicas Quirúrgicas y Anestésicas, Cirugía III Traumatología Bucomaxilofacial, UNNE. (Surgery I-Surgical and Anesthetic Techniques, Surgery III Oral-Maxillofacial Traumatology, UNNE, Argentina).

出版信息

J Clin Exp Dent. 2021 Jan 1;13(1):e1-e7. doi: 10.4317/jced.56658. eCollection 2021 Jan.

Abstract

BACKGROUND

In the dental clinic impacted teeth are frequent findings, especially upper and lower third molars, leading to their exodontia. Among surgical techniques piezosurgery is advantageous for delicate structures in the oral cavity. Extracted teeth, usually discarded, have been revalued as biological material, providing living tissues with possible applications in regenerative dentistry. The aim was to compare cross-section methods of upper included third molars by ultrasonic piezoelectric technique to obtain dental pulp, with diamond-coated tip (DT) against titanium nitride-coated tip (TN), according to the pulp tissue cell viability and the section surface characteristics.

MATERIAL AND METHODS

Patients attending dental consultation were evaluated. Upper third molars (n= 24) were avulsed from 15 patients with exodontia indication, age 18-26 years old, who agreed to participate of the study. Third molars were cross-sectioned at amelocemental junction level with piezoelectric device using DT or TN inserts. Pulps were mechanic and enzymatically treated, and tissue viability determined by Trypan Blue test. Sectioned teeth were visualized using Scanning Electron Microscope (SEM). Ethical principles of biomedical research were respected; all patients gave their informed consent.

RESULTS

Viability of pulp tissue was 84.71% not associated to sex (p= 0.141) nor to teeth position, upper right third molar or upper left third molar (p= 0.580). According to the insert used, pulp tissue viability was 85.21% with TN, similar to 84.00% with DT (p= 0.611). By SEM, cut performed by TN insert showed smooth and uniform surfaces, while DT insert surfaces were irregular, porous, with fissures.

CONCLUSIONS

Piezosurgery applied to cross-section upper third molars with both types of inserts showed differences in the cut surfaces but similar effectiveness regarding preservation of pulp tissue with high viability, thus, they could be allocated for further cellular developments. Impacted teeth, third molars, piezosurgery, regenerative dentistry.

摘要

背景

在牙科诊所中,阻生牙是常见的发现,尤其是上下颌第三磨牙,常需拔除。在手术技术中,超声骨刀手术对于口腔内的精细结构具有优势。通常被丢弃的拔除牙齿已被重新评估为生物材料,为再生牙科中的活组织提供了可能的应用。目的是根据牙髓组织细胞活力和断面表面特征,比较使用超声压电技术获取上颌阻生第三磨牙牙髓的两种断面方法,即使用金刚石涂层刀头(DT)与氮化钛涂层刀头(TN)。

材料与方法

对前来牙科咨询的患者进行评估。从15名有拔牙指征、年龄在18 - 26岁且同意参与研究的患者中拔除上颌第三磨牙(n = 24颗)。使用DT或TN刀头的压电装置在釉牙骨质界水平对上颌第三磨牙进行断面切割。牙髓经过机械和酶处理,并通过台盼蓝试验测定组织活力。使用扫描电子显微镜(SEM)观察切割后的牙齿。遵循生物医学研究的伦理原则;所有患者均签署了知情同意书。

结果

牙髓组织活力为84.71%,与性别无关(p = 0.141),也与牙齿位置(右上颌第三磨牙或左上颌第三磨牙)无关(p = 0.580)。根据使用的刀头,使用TN刀头时牙髓组织活力为85.21%,与使用DT刀头时的84.00%相似(p = 0.611)。通过扫描电子显微镜观察,使用TN刀头切割的断面表面光滑均匀,而使用DT刀头的断面表面不规则、多孔且有裂缝。

结论

超声骨刀手术应用于两种刀头切割上颌第三磨牙时,断面表面存在差异,但在保存高活力牙髓组织方面效果相似,因此,它们可用于进一步的细胞研究。阻生牙、第三磨牙、超声骨刀手术、再生牙科。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11dc/7781209/9e21d2b29e33/jced-13-e1-g001.jpg

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