損傷歯髄の修復に関する実験的研究
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概要
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The present study was conducted to investigate the pulp healing process, especially the formation of hard tissue after cavity preparation and pulp exposure without pulp capping. Two experiments were undertaken to determine : I) the correlation between the regeneration of odontoblasts immediately under the cavity and the formation of the reparative dentin after the preparation of Class V cavity in the incisors of rhesus monkeys, II) the pulp responses after allowing pulp exposure to remain without pulp capping in the rat molars. The results were as follows. Experiment I : 1. If the pulp damage and destruction in both the cell-free zone of Weil and cell-rich zone were slight, replacement with undifferentiated mesenchymal cells in the cell-rich zone led to regeneration of disappeared odontoblasts, and the reparative dentin formation similar to the primary dentin in quantity and direction of the dentinal tubules was observed under the prepared cavity. 2. If the damage in the odontoblastic layer, cell-free zone of weil, and cell-rich zone was severe, dentin matrix like predentin was formed with the cellular inclusions, and the irregular quantity and direction of the dentinal tubules immediately under the cavity. Under the matrix the arrangement of large irregular cells was observed. These cells were differentiating undifferentiated mesenchymal cells to the odontoblast. Thereafter the reparative dentin similar to the tubular dentin was formed inside the matrix. Experiment II : 1. At one or two weeks, rather extensive necrosis or gangrene developed at the exposed surface and hyalinization of the pulp tissue advanced beneath the surface with granular deposition of calcified tissue. Further below, the pulp tissue was replaced by inflammatory granulation tissue with partial hyalinization, and the hard tissue formation by the deposition of calcified tissue was observed in some instances. Simultaneously the calcified tissue was observed along the dentinal walls in the root canal. 2. Hard tissue formation was significant in the rat molars. The types were as follows. i) At the superficial layer, masses of structure-less and irregular hard tissue were observed and appeared to cover the amputated pulp surface. In addition, these hard tissues were seen within the pulp chamber. Also, the calcified tissue deposited at the dentinal walls of the root canal appeared gradually to form the thick hard tissue. ii) A hard tissue formation similar to osteoid-dentin with irregular massive lacunae in the hyaline degenerated pulp tissue was observed within the pulp chamber and along the dentinal lateral wall. iii) The hard tissue formations observed in i) and ii) were present simultaneously in the same pulp chamber. 3. In the cases where the pulp exposure was not capped and gangrene or necrosis was seen at the surface or even where the pulp tissue was replaced by inflammatory granulation tissue, total gangrene, severe inflammatory infiltration, or the occurrence of pathosis in the apical area was not observed.
- 九州歯科学会の論文
- 1981-09-25
著者
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