骨形成蛋白复合牙本质陶恣修复髓室底穿孔的实验研究

用骨形成蛋白复合牙本质陶瓷修复髓室底穿孔，以氢氧化钙作为对照组。方法：术后６个月观察骨形成蛋白复合牙本质陶瓷修复髓室底穿孔的生物学作用。结果：骨形成蛋白 合牙本质陶瓷具有诱导骨样组织形成。结 论：骨形成蛋白复合牙本质陶瓷可以用于修复髓室底穿孔。     

骨形成蛋白复合牙本质陶瓷修复髓室底穿孔的临床观察

骨形成蛋白复合牙本质陶瓷修复髓室底穿孔的临床观察李国华朱南洲刘忠动物实验证实，骨形成蛋白复合牙本质陶瓷修复髓室底穿孔，具有良好的组织相容性，促进骨样组织形成修复缺损区，因而具有临床应用价值［１］。髓室底穿孔的发生可分为医源性和病理性两类。医源性穿孔多...     

骨形成蛋白复合牙本质陶瓷修复髓室底穿孔的临床研究

骨形成蛋白复合牙本质陶瓷修复髓室底穿孔的临床研究李国华，朱南洲，刘忠，牛忠英大连市解放军２１０医院（１１６０００）西安第四军医大学口腔医学院（７１００３２）髓室底穿孔的发生可分为医源性和病理性两类，医源性原因多见于牙髓治疗时，术者对髓腔解剖不熟悉，牙...     

异体陶瓷化骨粉复合盖髓的动物实验研究

目的：观察异体陶瓷化骨粉与克林霉素复合盖髓剂对狗性牙本质形成的影响。方法：分别以陶瓷化骨粉克林霉素生理盐水糊剂、陶瓷化骨粉克林霉素鱼肝油糊剂、陶瓷化骨粉生理盐水糊剂作狗牙直接盖髓实验。以氢氧化钙直接盖髓对照.结果：异体陶瓷化骨粉克林霉素生理盐水糊剂盖髓生物相容性好，早期（1周）可见纤维性基质形成，8周大都形成致密骨样修复性牙本质桥。结论：异体陶瓷化骨粉克林霉素生理盐水糊剂盖髓，牙髓修复发生早，牙本质桥形成致密完整，且作盖随剂具有良好发展前景。     

骨形成蛋白复合牙本质陶瓷盖髓的实验研究

用杂种狗2只作实验，在每只狗上下颌前牙唇面开髓，分别以骨形成蛋白（BMP）、牙本质陶瓷（CD）、骨形成蛋白复合物牙本质陶瓷（BMP/CD）盖髓，观察盖髓效果，实验结果发现，单纯CD无诱导牙本质形成的能力。BMP、BMP/CD均可诱导出大量的牙本质。就牙髓细胞的分化。BMP优于BMP/CD，介牙本质桥形成的质量来说BMP/CD优于BMP。作者认为BMP/CD复合物盖髓较为合适。     

人牙源性间充质细胞构建牙本质-牙髓复合体样结构的实验研究

目的以复合生长因子的陶瓷化骨和Collagraft为载体建立人牙源性间充质细胞的体内立体培养模型，构建牙本质-牙髓复合体样结构。方法将经生长因子诱导的人牙源性间充质细胞接种于复合同种生长因子的陶瓷化骨和Collagraft复合材料上，将细胞-支架复合物移植到裸鼠皮下，建立牙源性间充质细胞的体内立体培养模型。4周和10周后取材，对移植物进行组织学观察和人牙本质涎蛋白（DSP）的免疫组化染色。结果10周的实验组标本中，植入细胞在复合生长因子支架上形成了较典型的牙本质-牙髓复合体样结构，人DSP在新生牙本质样组织中呈阳性表达。对照组及4周标本中未观察到此现象。结论用人牙源性间充质细胞和复合生长因子的陶瓷化骨或Collagraft支架材料在裸鼠体内可成功构建出牙本质-牙髓复合体样结构。     

iRoot BP修复磨牙髓室底穿孔的研究

目的 探讨iRoot BP直接修复髓室底穿孔的效果。方法 收集新鲜拔除的人恒磨牙40颗,其中36颗于髓室底中央制备直径2 mm的穿孔洞型,随机分为A、B组,每组18颗,分别用iRoot BP和矿物三氧化聚合体（MTA）修复髓室底穿孔;另外4颗为对照组,只开髓不制备髓室底穿孔。从A、B组中各随机选择3个样本用扫描电子显微镜观察材料和牙本质的结合界面;其余15个样本用葡萄糖氧化酶-蒽酮法检测微渗漏值。结果 A组中,iRoot BP与牙本质结合较为紧密,而B组中MTA和牙本质之间存在不均匀的微小间隙。在观察期内,B组的微渗漏值高于A组,其差异有统计学意义（P<0.05）。结论 iRoot BP修复髓室底穿孔的封闭效果优于MTA。     

用复合骨形成蛋白加碘仿盖髓的动物实验

选用成年杂种狗３只，在其上下颌前牙、磨牙唇颊面穿髓，分别以复合骨形成蛋白加碘仿、复合骨形成蛋白、羟基磷灰石、氢氧化钙盖髓，锌水门汀充填。术后４、６、１０周分别处死动物取材。结果表明：复合骨形成蛋白可诱导修复性牙本质形成，时间早于羟基磷灰石、氢氧化钙。加入碘仿无拮抗作用，对组织无毒、无刺激性。提示复合骨形成蛋白是一种很有前途的盖髓剂，加入碘仿可能提高其抗感染能力。     

预培养比格犬干细胞的牙本质片复合牙周膜细胞膜片裸鼠体内移植研究

目的：探索预培养干细胞的牙本质片复合牙周膜细胞（PDLCs）膜片对牙周组织再生的可行性。方法：将比格犬牙根制成牙本质片,其上接种骨髓基质干细胞（BMSCs）或PDLCs,应用成骨诱导液或α-MEM培养液培养,电镜观察牙本质片表面细胞附着与基质形成情况。并构建细胞／牙片／膜片／煅烧陶瓷牛骨CBB复合体,裸鼠体内皮下移植,8周后取材HE染色观察。结果：预培养干细胞的牙本质片,电镜检测到表面有足够的细胞和细胞外基质分布。裸鼠体内结果显示牙本质片接种BMSCs或PDLCs经成骨诱导组可见类牙骨质基质形成,但无类牙周膜纤维,未经成骨诱导组无类牙骨质基质形成,但有明显的类牙周膜纤维样组织形成;空白组无类牙骨质基质及类牙周膜纤维样组织形成。结论：在牙本质片上预培养BMSCs或PDLCs,复合PDLC膜片和CBB后异位移植,有利于类牙周膜纤维的形成。加入成骨诱导液诱导,有利于基质的形成。     

复合生物陶瓷修复髓底穿的疗效观察

髓室底穿孔在临床上极为常见,可分为新鲜穿孔和陈旧性穿孔两类。新鲜穿孔是指在髓腔预备或根管扩锉过程中因操作不当而引起的;陈旧性穿孔指就诊时已存在,常因龋而导致。复合生物陶瓷(compound bioactiveceramic, CBC)具有良好的细胞、组织相容性及骨亲和性。我们于1992年开始采用复合生物陶瓷与碘仿(Iodoform,IF)糊剂进行髓室底洞穿的修复,取得了较好的效果,现将其临床疗效分析如下:     

复方珊瑚糊剂治疗髓室底穿孔的临床观察

目的 :观察复方珊瑚糊剂修补髓室底穿孔的临床效果。方法 :髓室底穿孔患牙 62例 ,实验组采用复方珊瑚糊剂作髓室底穿孔修补 ,对照组采用玻璃离子水门汀作髓室底穿孔修补。一年后复查 ,观察疗效。结果 :实验组有效率 84.4% ,对照组有效率 63 .3 %。结论 :髓室底穿孔的患牙经用复方珊瑚糊剂作髓室底修补 ,可长期保存 ,其治疗效果明显优于玻璃离子水门汀作髓室底修补     

分根术加全冠修复大面积髓室底穿孔磨牙的临床疗效观察

目的：观察分根术加全冠修复大面积髓室底穿孔磨牙的临床疗效。方法：门诊收治陈旧性大面积髓室底穿孔（直径〉3mm）的磨牙病例120例。随机分成实验组60例,对照组60例。实验组采用分根术加全冠修复治疗,对照组采用光固化型氢氧化钙,磷酸锌粘固粉垫底,银汞充填。全冠修复治疗。结果：随访3～5年,实验组成功率83．33％,有效率96．67％,对照组成功率43．33％,有效率83133％。实验组临床疗效明显优于对照组（P〈0.01）。结论：分根术加全冠修复大面积髓室底穿孔磨牙具有较好的临床疗效。     

iRoot BP和iRoot BP Plus应用于牙髓治疗的研究现状

iRoot BP和iRoot BP Plus是新型生物陶瓷材料,具有良好的理化性能,可介导牙髓及牙周组织再生,操作简便。在口腔显微镜的配合下,iRoot BP和iRoot BP Plus可用于直接盖髓、活髓切断、髓室底穿孔及根管侧穿修补、根管倒充填等,是一种具有良好临床应用前景的牙髓治疗新材料。     

生物活性玻璃微粒修复髓室底穿孔的临床观察

目的观察生物活性玻璃微粒(Bioglass)修复髓室底穿孔的临床疗效.方法选择髓室底穿孔病例75例,患牙86个,随机分为两组,试验组采用生物活性玻璃微粒,对照组采用光固化玻璃离子修复.1年后观察临床效果.结果试验组成功率81.3%,进步13.9%,对照组成功率46.5%,进步23.3%,两组间有显著性差异(P<0.05).其疗效与穿孔直径密切相关,与穿孔原因关系不明显.结论生物活性玻璃微粒是一种良好的髓室底穿孔的修复材料.     

Potential Roles of Bone Morphogenetic Protein 9 in the Odontogenic Differentiation of Dental Pulp Cells

IntroductionThe differentiation of dental pulp cells (DPCs) plays an important role in the repair of dental pulp injury. Bone morphogenetic protein 9 (BMP9) is one of the most effective BMPs to induce the differentiation of stem cells. However, the role of BMP9 in promoting the odontogenic differentiation of DPCs and dentinogenesis is worth knowing.MethodsFluorescence in situ hybridization and immunohistochemistry staining were performed to detect the BMP9 expression in human dental pulp. BMP9 was overexpressed in human DPCs (hDPCs), and the mineralization of hDPCs was tested by alkaline phosphatase staining and alizarin red staining. The expression of odontogenic differentiation-related genes was examined by quantitative real-time polymerase chain reaction and western blotting. The subcutaneous transplantation experiment was performed to test the odonto-induction ability of BMP9 in vivo. The rat direct pulp-capping experiment was performed to test the function of BMP9 in promoting dentin formation.ResultsBMP9 showed an increased expression in odontoblast layer at both the mRNA and protein levels. BMP9 enhanced the mineralization and induced the expression of odontogenic differentiation-related genes in hDPCs. More mineralized nodules, and increased expression of dentin sialophosphoprotein (DSPP) and dentin matrix protein-1 (DMP1) were detected in the beta-tricalcium phosphate scaffold/cells composites of BMP9 group compared with the control group. Meanwhile, there was thicker reparative dentin formation in the BMP9 group in the rat pulp exposure experiment.ConclusionsBMP9 participates in the process of DPC differentiation and promotes DPC mineralization and dentinogenesis. BMP9 might be a potential therapeutic target in the repair of dental pulp injury.     

SOD盖髓术后牙髓组织免疫组化染色的观察

目的：探讨ＳＯＤ作为盖髓剂促进牙髓修复的作用机理。方法：应用ＢＭＰ－ＡＢＣ法对盖髓后获得成功的标本进行免疫组化染色。结果：空白组、正常对照组标本ＢＭＰ染色结果为阴性；ＳＯＤ盖髓后有牙本质桥、牙本质瘤形成的标本，ＢＭＰ染色均呈不同程度的阳性反应，显微镜下观察为黄褐色颗粒。主要分布在牙本质桥下成牙本质细胞、牙髓细胞浆中和牙髓组织。结果：ＳＯＤ用于盖髓促进牙髓组织修复、牙本质桥形成与ＢＭＰ作用有关，ＳＯＤ一方面抑制炎症反应，改善局部微环境，为组织自身修复创造条件；另一方面则刺激牙髓组织增生、诱导牙髓细胞合成分泌ＢＭＰ。     

Proliferative activity of cells from remaining dental pulp in response to treatment with dental materials

Background:  The biological examination of pulp injury, repair events and response of dental pulp stem cells to dental restorative materials is important to accomplish restorative treatment, especially to commonly used dental materials in paediatric dentistry, such as glass ionomer cement (GIC) and calcium hydroxide (Ca(OH)₂) lining cement.
Methods:  Healthy patients aged between 9 to 11 years with carious primary molars without pulp exposure were selected and divided into two groups: Group 1 (teeth restored with GIC) and Group 2 (teeth lined using Ca(OH)₂ and restored with GIC). The proliferative activity of stem cells of teeth between these two groups was compared using colourimetric cell proliferation reagent, alamarBlue. Immunocytochemistry and flow cytometry confirmation were performed using mesenchymal stem cell markers, CD105 and CD166.
Results:  The proliferative activity using alamarBlue™ assay showed that cells derived from the remaining dental pulp of exfoliated deciduous teeth were positive for CD105 and CD166 and exhibited no difference between the two groups.
Conclusions:  It can be concluded that the use of Ca(OH)₂ or GIC as a lining material in indirect pulp capping procedures has the same effect on cells derived from the remaining dental pulp of exfoliated deciduous teeth which have responded favourably to the restorative treatments.     

Smad1,4,5在人牙髓组织中的表达分析

目的：观察骨形态发生蛋白（BMP）下游信号转导分子Smad1,4,5在正常、龋坏和炎症人牙髓组织中的表达及表达差异,探讨Smad1,4,5在牙髓损伤修复过程中的作用。方法：制备正常、龋坏和炎症人牙髓组织标本,采用免疫组化方法检测Smad1,4,5在各类牙髓组织中的表达。结果：Smad1,4,5在正常和龋坏牙髓的成牙本质细胞层呈强阳性表达,在下方的富细胞区及牙髓中心部位为阳性或弱阳性表达,炎症牙髓浸润的炎细胞中Smad1,4,5呈强阳性表达。其中Smad4在各类牙髓中表达最强,Smad1次之,Smad5最弱。结论：观察到Smad1,4,5在正常、龋坏和炎症人牙髓组织中的表达及其差异,提示Smad1,4,5作为BMP的胞内信号转导分子,可能参与牙髓组织的自身修复过程。     

The effect of intentionally perforating the floor of the pulp chamber on pulpal healing after tooth replantation in mice

ObjectivesShortening the root of a mouse molar prior to tooth replantation results in early revascularization in the pulp cavity and activation of the dental pulp quiescent stem cells. This study aimed to validate the effects of pulp chamber floor perforation on pulpal healing after tooth replantation as a strategy to promote early revascularization into the pulp.MethodsThe maxillary first molars of three-week-old Crlj:CD1 mice were extracted and repositioned into the original socket: the left teeth were immediately replanted (control group: CG), whereas the floor of the pulp chamber of the right teeth was perforated with a tungsten carbide bur before tooth replantation (experimental group: EG). The samples were collected from three days to eight weeks postoperatively. In addition to the TUNEL assay, immunohistochemistry for Nestin, CK14, and Ki-67 was conducted.ResultsIn the EG, early revascularization occurred with a decrease in apoptosis and an increase in cell proliferation, facilitating pulpal healing, compared with the CG. The rate of Nestin-positive perimeter in the distal root significantly increased on days 5 and 14 and the amount of Nestin-positive hard tissue increased on day 14. However, on day 7, the number of epithelial cell rests of Malassez in the EG significantly decreased, making the EG susceptible to ankylosis at the floor.ConclusionsIntentionally perforating the floor of the pulp chamber provides a route for early revascularization, resulting in better pulpal healing after tooth replantation.     

RUNX2突变牙髓细胞转化生长因子-β相关信号通路基因表达的分析

目的利用第二代功能分类基因芯片检测颅骨锁骨发育不良患者成骨细胞特异性转录因子(runt-related gene 2,RUNX2)基因突变的牙髓细胞在转化生长因子-β(transforming growth factor-β,TGF-β)-骨形成蛋白(bone morphogenetic protein,BMP)信号传导通路上的基因表达差异。方法利用本课题组前期成功分离培养的携带RUNX2致病基因突变的牙髓细胞,通过第二代TGF-β/BMP信号传导通路功能分类基因芯片,进行实时定量PCR基因芯片,检测携带突变的颅骨锁骨发育不良患者牙髓细胞与正常牙髓细胞的基因表达差异,进行数据分析。结果基因芯片的实时定量PCR结果分析表明,在TGF-β/BMP信号传导通路上,RUNX2基因突变的牙髓细胞有18条基因表达上调,14条基因表达下调。结论 RUNX2基因可能通过调节TGF-β/BMP信号传导通路相关基因表达而影响牙髓细胞生物学特性。