Holland G R
Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan, School of Dentistry, Ann Arbor 48109-1078, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995 Dec;80(6):726-34. doi: 10.1016/s1079-2104(05)80258-6.
Pulpectomy and pulpal necrosis result in severance of the nerves that supply the pulp as well as loss of their target organ. Inflammatory changes commonly extend into the periapical region to involve those nerves. The neural response to pulpal loss combined with periapical inflammation is a derangement of the periodontal plexus normally located in the center of the periodontal space around the apical third of the root; the result is the formation of a disorganized group of sprouting and branching axons that have some features in common with neuromas. The inflammatory and neural responses continue for at least a year even when pulpectomy is followed by canal debridement and obturation. Then the responses are reduced but not eliminated by steroids. Root canal therapy with techniques that do not leave residual inflammation still results in increased periapical innervation; the increase seems to be an organized addition to the normal periradicular plexus.
牙髓摘除术和牙髓坏死会导致供应牙髓的神经被切断以及其靶器官丧失。炎症变化通常会延伸至根尖周区域并累及这些神经。牙髓丧失与根尖周炎症相结合所引发的神经反应是通常位于牙根根尖三分之一周围牙周间隙中央的牙周神经丛紊乱;结果是形成了一组杂乱无章的发芽和分支轴突,这些轴突具有一些与神经瘤共同的特征。即使在牙髓摘除术后进行根管清创和充填,炎症和神经反应仍会持续至少一年。然后,类固醇会使这些反应减轻但不会消除。采用不会留下残余炎症的技术进行根管治疗仍会导致根尖周神经支配增加;这种增加似乎是对正常根尖周神经丛的有组织的补充。