Ehnevid H, Jansson L, Lindskog S, Weintraub A, Blomlöf L
Department of Oral Histology and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Endod Dent Traumatol. 1995 Oct;11(5):229-34. doi: 10.1111/j.1600-9657.1995.tb00494.x.
Periapical pathology indicating endodontic infection, when present in marginal periodontitis-affected teeth, has recently been shown to be an aggravating factor in progression of marginal destruction. This has been associated with patency of dentinal tubules in the tooth cervix, an area normally devoid of cementum following periodontal therapy. These studies are, however hampered by that only circumstantial evidence such as presence of periapical destruction have been applied as criteria of endodontic infection. The purpose of the present investigation was to study to what extent a predefined selection of endodontic pathogens inoculated in the root canal can influence periodontal pathology and healing in areas of the root covered by or devoid of cementum, using root resorption as a histomorphometric marker. Exposed dentine surfaces, in the present study showed significantly larger areas of resorption in infected roots compared to non-infected roots, while cementum surfaces showed an almost identical distribution of tissue reactions regardless of root canal infection or not. It was concluded that endodontic pathogens or their products were not able to penetrate the cementum barrier. The significantly larger areas of resorption on exposed dentine surfaces in infected roots compared to non-infected roots indicated that endodontic pathogens or their products could spread through dentinal tubules to a root surface void of cementum. Extrapolated to the marginal situation this indicated that endodontic pathogens in the root canal might be able to aggravate marginal infection in areas of root devoid of cementum.
根尖周病变提示存在牙髓感染，当这种情况出现在患边缘性牙周炎的牙齿时，最近已被证明是边缘性破坏进展的一个加重因素。这与牙颈部牙本质小管的开放有关，在牙周治疗后，该区域通常没有牙骨质。然而，这些研究受到限制，因为仅将诸如根尖周破坏的存在等间接证据用作牙髓感染的标准。本研究的目的是研究根管内接种的预先确定的牙髓病原体在何种程度上会影响覆盖或未覆盖牙骨质的牙根区域的牙周病理和愈合情况，使用牙根吸收作为组织形态计量学指标。在本研究中，与未感染的牙根相比，暴露的牙本质表面在感染的牙根中显示出明显更大的吸收面积，而无论根管是否感染，牙骨质表面的组织反应分布几乎相同。得出的结论是，牙髓病原体或其产物无法穿透牙骨质屏障。与未感染的牙根相比，感染的牙根中暴露的牙本质表面吸收面积明显更大，这表明牙髓病原体或其产物可以通过牙本质小管扩散到没有牙骨质的牙根表面。推断到边缘情况，这表明根管内的牙髓病原体可能会加重牙根无牙骨质区域的边缘感染。
