乳歯生活歯髄切断後の創傷治癒に関する病理組織学的研究
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概要
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Giving vital pulpotomy on deciduous teeth, taking paste-type Calcipulpe out of calcium hydroxide and paste-type Propac and Topdain from zinc oxide eugenol, the teeth were examined histopathologically on healing process of wound following the vital pulpotomy of deciduous teeth. The results were as follows : 1. Forming of necrosis layer observed on the part given vital pulpotomy is comparatively extensive in area in the case of Calcipulpe and slight or sometimes none in the case of Propac and Topdain. 2. In the case of Calcipulpe on 21st day many pieces of calcium, large and small appear in the necrosis layer and show positive reaction on von Kossa. In the case of Propac and Topdain any sign of such active reaction can not be observed. 3. On the boundary area between the necrosis layer and the normal pulp in the case of Calcipulpe from 14 days to 21 days after operation, a crystalized thick layer appears and shows active von Kossa reaction as a boundary line. This fact doesn't agree with the result which was reported by investigaters who used calcium hydroxide in former days. At this stage a calcareous layer is formed right under the layer of von Kossa reaction. Spindle cells, big cells or irregular cells are observed in the pulp circular cells and collagen fiber is enriched among cells. 4. In the case of Propac and Topdain, which are zinc oxide eugenol, a boundary line doesn't appear, but there is an accumulated inflammatory cell layer and forming of abscess is sometimes recognized in the layer. However granulation tissue with fibrous nature increases remarkably and becomes fibrous gradually towards lower part. Thus it shows that forming of hard tissue is impossible when no boundary line appears. 5. After 92 days in the case of Calcipulpe, a rough calcificated barrier as collagen fibrous matrix partly remains in reddish purple or light red color by gilt staining or Elastica van Gieson staining. Forming of a thick dentine barrier follows. In some parts of the dentine barrier reticular fiber invades from the pulp. This reticular fiber is similar to Korff's fiber and relates to the wall of root canal. In the case of Propac and Topdain from 14th day to 21st day, it becomes fibrous and this condition continues after 92 days. 6. When a lump of powdered dentine enters into the pulp, it takes the form of osteoid dentine if the pulp is vital, regardless of the agent used. This fact shows that it is not formed by the action of agent and it gives a suggestion for the future investigation. 7. From the above histopathological observation, Calcipulpe seems to be useful for a pedodontic clinic but Propac and Topdain are not so effective.
- 1981-01-25