Farges J C, Joffre A, Magloire H
Laboratoire de Développement et Pathologie des Tissus Dentaires, Faculté d'Odontologie, Lyon.
C R Seances Soc Biol Fil. 1993;187(5):582-95.
The odontoblast responds to caries by the formation of sclerotic as well as reparative dentin. Sclerotic dentin is deposited during the early stages of the dentinal injury. It is characterized by the amplification of the collagen synthesis and the increase in alkaline phosphatase activity in the odontoblastic cell layer. Reparative dentin will be deposited under the sclerotic zone after the destruction of odontoblasts. At this stage, specific components from damaged dentinal tissues and/or odontoblastic necrotic debris will trigger pulpal cells to elaborate a cartilage-like matrix layer (fibrodentin). The latter may induce pulpal odontoblast-like cells to give rise to the tubular reparative dentin. Thus, pulpal cell response seems to be similar to bone-cell response to injury. Molecular signals responsible for this tissular healing remain largely unknown, but dentin is a potential source of matrical or soluble organic molecules that may be released after demineralization. Some of these factors have been identified in the sound tissue (glycoproteins, proteoglycans, growth factors, ...), but their role in the stimulation of the elaboration of the cicatricial tissue remains to be elucidated.
成牙本质细胞通过形成硬化性牙本质和修复性牙本质来应对龋齿。硬化性牙本质在牙本质损伤的早期阶段沉积。其特征是成牙本质细胞层中胶原蛋白合成增加以及碱性磷酸酶活性增强。在成牙本质细胞被破坏后，修复性牙本质将沉积在硬化区下方。在此阶段，受损牙本质组织的特定成分和/或成牙本质细胞坏死碎片会触发牙髓细胞形成类似软骨的基质层（纤维性牙本质）。后者可能诱导牙髓成牙本质样细胞产生管状修复性牙本质。因此，牙髓细胞反应似乎与骨细胞对损伤的反应相似。负责这种组织愈合的分子信号在很大程度上仍然未知，但牙本质是矿化后可能释放的基质或可溶性有机分子的潜在来源。其中一些因子已在健康组织中被鉴定出来（糖蛋白、蛋白聚糖、生长因子等），但其在刺激瘢痕组织形成中的作用仍有待阐明。
