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实验性诱导的边缘性牙周炎及牙周刮治对牙髓的影响。

Effect of experimentally induced marginal periodontitis and periodontal scaling on the dental pulp.

作者信息

Bergenholtz G, Lindhe J

出版信息

J Clin Periodontol. 1978 Feb;5(1):59-73. doi: 10.1111/j.1600-051x.1978.tb01907.x.

Abstract

Experimental breakdown of the periodontal attachment apparatus was produced in six young adult monkeys to study the effect on the tissue of the dental pulp by (1) periodontitis, (2) scaling and plaque accumulation on exposed root dentin. Periodontal tissue breakdown was induced by the placement of ligatures around the neck of 92 permanent teeth. Subsequent plaque formation caused marked loss of periodontal tissue support, which after a period of 5--7 months amounted to 30--40% of the root length. One group of teeth received no further treatment. Other teeth were subjected to scaling and root planing. Following treatment, plaque was allowed to accumulate for 2, 10, and 30 days on the freshly planed root dentin surfaces. Histologic examination revealed that in comparison to teeth with normal periodontal conditions, 57% of the teeth exposed to periodontitis exhibited pathologic pulp tissue alterations. Secondary dentin formation and/or inflammatory cell infiltrates were observed within localized areas of the pulp subjacent to root surfaces exposed to periodontal tissue destruction. The changes within the pulp were of "mild" nature and only one tooth displayed signs of total pulp necrosis. Lateral canals communicating with both the pulp cavity and the exposed root surface were never detected. Teeth subjected to scaling and subsequent plaque accumulation in comparison with teeth with periodontitis alone exhibited no obvious aggravation or increased incidence of pathologic pulp reactions. The findings show that in the monkey (1) periodontal destruction limited to the cervical half of the root and (2) plaque accumulation on exposed root dentin does not cause severe alteration in the pulp of the roots involved.

摘要

在六只成年幼猴身上造成牙周附着装置的实验性破坏,以研究以下因素对牙髓组织的影响:(1)牙周炎,(2)暴露的牙根牙本质上的牙石形成和菌斑堆积。通过在92颗恒牙颈部放置结扎丝来诱导牙周组织破坏。随后形成的菌斑导致牙周组织支持明显丧失,5至7个月后,丧失程度达牙根长度的30%至40%。一组牙齿未接受进一步治疗。其他牙齿进行了刮治和根面平整。治疗后,让菌斑在新平整的牙根牙本质表面堆积2天、10天和30天。组织学检查显示,与牙周状况正常的牙齿相比,57%暴露于牙周炎的牙齿出现了病理性牙髓组织改变。在牙根表面暴露于牙周组织破坏区域下方的牙髓局部区域观察到继发性牙本质形成和/或炎性细胞浸润。牙髓内的变化为“轻度”,只有一颗牙齿显示出牙髓完全坏死的迹象。从未检测到与牙髓腔和暴露的牙根表面相通的侧支根管。与仅患有牙周炎的牙齿相比,接受刮治并随后有菌斑堆积的牙齿未表现出明显加重或病理性牙髓反应发生率增加。研究结果表明,在猴子身上,(1)仅限于牙根颈部一半的牙周破坏和(2)暴露的牙根牙本质上的菌斑堆积不会导致受累牙根牙髓的严重改变。

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