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乙二胺四乙酸冲洗对未成年大鼠磨牙模型再生牙髓治疗的影响。

Influence of ethylenediaminetetraacetic acid irrigation on the regenerative endodontic procedure in an immature rat molar model.

机构信息

Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.

Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil.

出版信息

Int Endod J. 2023 Jan;56(1):69-79. doi: 10.1111/iej.13846. Epub 2022 Oct 25.

Abstract

AIM

To analyse the influence of ethylenediaminetetraacetic acid (EDTA) on the repair process in immature rat molars after a regenerative endodontic procedure (REP).

METHODOLOGY

The lower first molars of 12 4-week-old Wistar rats underwent pulpectomy in the mesial root and were divided into the following groups: sodium hypochlorite (NaOCl; n = 6) - the mesial canals were irrigated with 2.5% NaOCl for 5 min, and NaOCl-EDTA (n = 6) - the canals were irrigated with 2.5% NaOCl, followed by 17% EDTA for 5 min each. After evoking bleeding using a size 10 K-file, the cavities were sealed. Three molars on the untreated side were randomly used as control (control-15 d; n = 3), and three molars from the other three rats untreated were used as immediate control (n = 3). After 15 days (NaOCl, NaOCl-EDTA and control-15 d groups) or immediately (control-immediate), the animals were euthanized, and the teeth were subjected to histologic evaluation of tissue regeneration and presence of collagen fibres. Mann-Whitney U-test was used (p < .05).

RESULTS

The experimental groups had newly formed cementum-like tissue and increased root length and thickness. Half of the specimens in NaOCl-EDTA group showed apical foramen closure, whilst the NaOCl group had partial apical closure. The experimental groups showed inflammatory infiltrate extending mainly to the medium third of the root canal. These parameters were similar between experimental groups (p > .05). Newly formed connective tissue in the pulp space was significantly higher in the NaOCl-EDTA group than in NaOCl group (p < .05). Regarding the collagen fibres, the NaOCl-EDTA group had more collagen fibres in the root tip, but there was no significant difference compared to NaOCl group, and both groups showed greater amount of immature fibres in this area; in the centre of the apical third of root canal, there was equivalence between mature and immature fibres from both groups (p > .05).

CONCLUSIONS

Ethylenediaminetetraacetic acid irrigation improved newly formed intracanal connective tissue after REP in immature molars of rats; however, EDTA did not influence cementum-like tissue formation, apical closure, inflammatory infiltrate and maturation of collagen fibres.

摘要

目的

分析乙二胺四乙酸(EDTA)对再生牙髓治疗后未成熟大鼠磨牙修复过程的影响。

方法

12 只 4 周龄 Wistar 大鼠的下颌第一磨牙近中根行牙髓切除术,分为以下两组:次氯酸钠(NaOCl;n=6)-近中根管用 2.5% NaOCl 冲洗 5 分钟,NaOCl-EDTA(n=6)-根管先用 2.5% NaOCl 冲洗 5 分钟,再用 17% EDTA 冲洗 5 分钟。用 10 号 K 锉诱发出血后,封闭窝洞。未处理侧的 3 颗磨牙随机作为对照(对照-15d;n=3),另 3 只大鼠未处理的 3 颗磨牙作为即刻对照(n=3)。15 天后(NaOCl、NaOCl-EDTA 和对照-15d 组)或即刻(对照-即刻)处死动物,对牙齿进行组织再生和胶原纤维存在的组织学评价。采用曼-惠特尼 U 检验(p<.05)。

结果

实验组有新形成的类牙骨质组织和增加的牙根长度和厚度。NaOCl-EDTA 组有一半标本出现根尖孔闭合,而 NaOCl 组则有部分根尖闭合。实验组均表现为炎症浸润主要延伸至根管中三分之一。这些参数在实验组之间无显著差异(p>.05)。NaOCl-EDTA 组牙髓腔内新生的结缔组织明显高于 NaOCl 组(p<.05)。关于胶原纤维,NaOCl-EDTA 组根尖处有更多的胶原纤维,但与 NaOCl 组相比无显著差异,且两组在该区域均显示出更多不成熟纤维;在根尖三分之一的根管中心,两组成熟和不成熟纤维数量相当(p>.05)。

结论

EDTA 冲洗可改善未成熟大鼠磨牙再生牙髓治疗后的根管内新形成的结缔组织,但 EDTA 对类牙骨质组织形成、根尖闭合、炎症浸润和胶原纤维成熟无影响。

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