窩洞形成, 充填後の歯髄の変化に関する神経組織学的研究
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This investigation was undertaken to study the nerve distribution in the pulp of rhesus monkeys and its variation following cavity preparations and fillings. For each tooth a Class V cavity was prepared. Specimens were taken immediately after cavity preparations and intermittently for 9 weeks after the zinc phosphate cement pulp caps and amalgam cavity fillings were completed. The microscopic findings were as follows : 1. Both immediately and 2 hours after cavity preparations there were cases which showed no distinct changes. Most cases, however, showed vascular degeneration, atrophy and disappearance of odontoblasts directly underneath the cavity floor as well as congestion of blood vessels and hemorrhage in some areas. In the region showing a notable change, many nerve fibers disappeared. Others were observed to have alternate areas of constriction and swelling as well as a decrease in staining. Moreover, a few intact nerve fibers were left. It was felt that the intact nerve fibers caused pain after cavity preparation. 2. The greatest changes were seen in the pulp 24 hours and 3 days after the cavity fillings were placed. They were seen in the region directly underneath the cavity floors, just as in the cases observed immediately after cavity preparations. A congestion of blood vessels, edema and hemorrhage were seen in some cases. Some slightly degenerated nerve fibers and a few intact nerve fibers were observed in the region which showed the greatest change directly underneath the cavity floor. On the other hand, nerve fibers were recognized to have migrated to the surrounding intact tissues in order to escape from the degenerated region. 3. Seven days after cavity fillings the pulp showed repair in the areas of notable change. The changes in the pulp were localized directly underneath the cavity floor. The congestion of blood vessels was decreased throughout the pulp. In the region directly underneath the cavity floor, there was a tendency for reparative dentin to form. No degenerated nerve fibers were present in this region, but a few thin regenerated nerve fibers were present. 4. In the process of forming reparative dentin, tissues such as predentin, which were evident by their slight staining with eosin, were at first seen on the dentin wall directly underneath the cavity floor. The round or polygonal cells, which had larger nuclei and were larger than other cells, were recognized in the stratified arrangement on the inside of the tissues such as predentin. These were the undifferentiated odontoblasts. More than 3 weeks after cavity fillings, the reparative dentin showed an increase in thickness as the cells differentiated into odontoblasts, increasing both in height and in the amount of cytoplasm. In this case, the nerve distribution in the region with the undifferentiated odontoblasts was extremely sparse. Consequently, the regenerated nerve fibers were not considered to actively affect the differentiation of the odontoblasts. 5. Five weeks and nine weeks after cavity fillings the formation of a thick layer of reparative dentin was observed. Also observed was an arrangement of normal shaped odontoblasts on the inside of the reparative dentin. In the nerve fibers directly underneath the odontoblastic layer, a tendency to form Raschkow's nerve networks was seen. Moreover, the nerve terminals of the nerve networks which terminated in the odontoblastic cell layer showed a decrease in number compared to the normal case. In addition, nerve fibers penetrating the predentin were infrequently observed.
- 九州歯科学会の論文
- 1978-09-30
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