Ca(OH)2预防再植牙根吸收的实验研究

目的：探讨Ca(OH)2预防再植牙根吸收的作用及机理。方法：选择健康家犬15只，每只犬选择6颗上颌前牙进行研究。6颗上前牙，口腔外自然干燥1小时，行牙再植术，2周后实验组用Ca(OH)2，对照组用氧化锌及牙胶尖进行根管充填，6个月后处死动物光镜观察比较2组的根吸收情况。结果：实验组根吸收为17．8％，对照组为46．7％。两组存在显著差异（P＜0．01）。结论：Ca(OH)2具有减少和预防再植牙根吸收的作用。     

外源性纤维粘连蛋白对即刻再植牙愈合影响的实验

为研究外源性纤维粘连蛋白对再植牙愈合的影响，作者选用２只成年猕猴，拔除上中切牙，实验组牙用０．５ｍｇ／ｍｌ的纤维粘连蛋白溶液处理，以其同名牙作为对照。牙齿即刻原位再植，术后４周、８周时分别切取标本，行普通光学显微镜形态学观察和图像处理分析。结果显示：纤维粘连蛋白的应用不仅可以明显促进再植牙牙周纤维的再附着、降低牙根吸收率，而且可以明显减轻愈合过程中的炎症反应。     

阿仑膦酸钠对延期再植干燥狗牙愈合的影响

目的探讨阿仑膦酸钠(alendronate,ALN)溶液浸泡对延期再植干燥狗牙愈合的影响。方法选用成年杂种狗2条,以上颌双侧第1、2、5牙和下颌双侧第2、3、5牙为受试牙,右侧受试牙归入实验组,左侧受试牙归入对照组。所有受试牙均先做根管处理。7d后拔牙,自然干燥60min;实验组牙再植前被置于1mmol/L的阿仑膦酸钠溶液中浸泡5min;对照组牙再植前不被作其他任何处理。再植12周后取出含牙骨块。经脱钙、切片、HE染色后,对牙根的愈合情况进行组织形态学评价。结果实验组牙骨质愈合的百分比均值明显高于对照组者(P<0.01);实验组牙根炎症性吸收与替代性吸收的百分比均值分别低于对照组者(P<0.05)。结论ALN能有效地改善延期再植干燥牙的愈合,增加牙骨质愈合,减少牙根炎症性吸收与替代性吸收。     

切牙外伤性离体脱位再植疗效探讨

目的 研究影响外伤性脱位牙再植疗效的相关因素,为临床提供借鉴。方法 对27颗外伤性脱位切牙进行再植治疗,并随访3～8年。结果27颗脱位切牙再植后,22颗能正常行使功能,然普遍存在根尖吸收现象,2例5颗牙因牙周感染而拔除。结论 控制感染,规范操作是影响治疗效果的关键因素。     

高压氧辅助治疗再植牙

目的　观察高压氧辅助治疗再植牙的疗效。方法　对 44例外伤致 2颗牙脱位患者进行牙再植术 ,分成实验组与对照组各 2 2例 44颗牙 ,实验组辅助以高压氧治疗 ,对照组作为对照。术后跟踪观察疗效。结果　两组术后牙周愈合速度与结果有非常显著性差异 (P <0 .0 1) ;2年牙再植成功率和 5年失牙率亦有显著性差异 (P <0 .0 5 )。结论　高压氧辅助治疗可提高牙再植术的成功率。     

贝壳多孔羟基磷灰石基骨修复材料和骨形成蛋白-2联合应用引导犬牙周组织再生效果初步评估

目的初步评估贝壳多孔羟基磷灰石基骨修复材料及该材料和骨形成蛋白-2联合应用引导比格犬牙周组织再生的效果。方法选取18月龄比格犬6只,牙周基础治疗后1周,在下颌第二、三、四前磨牙,建立急性牙周骨缺损模型,依照分组情况进行不同治疗。实验组（T组）植入骨修复材料和骨形成蛋白-2;阴性对照组（NC组）植入骨修复材料;空白对照组（BC组）不植入任何材料。实验设计采取同颌同名牙对照,同一只比格犬的3对同颌同名牙分别为：空白对照组和阴性对照组,阴性对照组和实验组,空白对照组和实验组。术后12周,处死动物,Micro-CT检查并对数据进行统计学分析。结果材料植入后,未见材料溢出,植入局部和全身都未见明显不良反应。3组缺损都有一定程度骨再生,以T组再生组织量最多,BC组最少。Micro-CT结果显示：T组、NC组和BC组的骨再生平均高度为（4.50±0.47）mm（、1.75±0.42）mm和（0.87±0.31）mm。NC组和BC组相比,差异有统计学意义（P〈0.05）。T组与NC组和BC组相比,差异均有统计学意义（P〈0.05）,且有临床意义。结论贝壳多孔羟基磷灰石基骨修复材料和骨形成蛋白-2联合应用于比格犬,可以获得更好的引导组织再生效果。     

阿仑膦酸钠联合四环素局部应用对延期再植干燥狗牙愈合的影响

目的:探讨阿仑膦酸钠(alendronate,ALN)联合四环素(tetracycline,TET)局部应用对延期再植干燥狗牙愈合的影响。方法:采用成年杂种狗3条,选择上颌双侧第1、2、5牙和下颌双侧第2、3、5牙为受试牙,共18对同名受试牙。随机将每对中的2颗同名受试牙分入实验组或对照组。所有受试牙均先接受根管处理。7d后拔牙,随即自然干燥60min;再植前实验组牙先被置于1mmol/L浓度的ALN溶液中浸泡5min,接着再被置于10ml/L TET溶液中浸泡5min;对照组牙仅被置于1mmol/L浓度的ALN溶液中浸泡5min。植后12周后取出含牙骨块,进行脱钙、制片、HE染色,对牙根的愈合情况进行组织形态学评价。结果:实验组牙骨质愈合的百分比均值高于对照组者,差异无显著性(P>0.05);实验组牙根炎症性吸收的百分比均值低于对照组者,差异有显著性(P<0.05)。结论:与单纯ALN局部应用比较,ALN联合TET局部应用不能增加延期再植干燥牙的牙骨质愈合,但能减少牙根炎症性吸收,有利于延长牙的使用寿命,具有一定的临床价值。     

釉基质蛋白衍生物对大鼠牙移动后复发和牙根修复的影响

目的:观察釉基质蛋白衍生物对大鼠正畸牙移动后早期复发和牙根吸收的影响.方法:选用20只10周龄雄性SD大鼠,实验组和对照组各10只,在左上第一磨牙施加100 g力,使其近中移动,加力14d后拆除装置.自拆除加力装置起,实验组局部注射釉基质蛋白衍生物,对照组不注射任何药物.分别于拆除装置后当天及第14天分别行Micro-CT活体扫描,分析牙根吸收陷窝以及牙移动距离的变化.采用SPSS19.0软件包对数据进行统计学分析.结果:拆除装置14 d后,实验组与对照组牙根吸收陷窝体积修复量分别为(0.0295±0.0052) ×1 07 μm3、(0.0189±0.0086)×107 μm3;牙移动后复发距离及复发百分率分别为(0.089±0.005)mm、(64.76±3.63)％和(0.127±0.010)mm、(92.28±1.90)％.统计学分析表明,拆除装置14 d后,牙根吸收陷窝体积修复量、牙移动后复发距离及复发百分率均有显著差异(P＜0.05).结论:一定浓度的釉基质蛋白衍生物可在一定程度上加强大鼠正畸移动后牙根吸收后修复效应,减弱牙移动后早期复发.     

Diode激光辅助治疗对服用钙通道拮抗剂老年患者龈沟探诊出血改善的研究

目的：比较Diode激光辅助牙周基础治疗（实验组）与单纯牙周基础治疗（对照组）对服用钙通道拈抗剂老年患者龈沟出血的改善效果。方法：选择10位服用钙通道拮抗剂的老年患者共30颗牙,左右对称,随机确定一侧为实验组,对侧牙为对照组。口腔卫生宣教和龈上洁治后2周为基线,治疗2周、4周、8周后记录龈沟出血指数（SBI）,并进行统计分析。结果：实验组和对照组的SBI在2周、4周和8周后与基线比较均有明显改善（P〈0．01）;两组之间比较,SBI的改善没有明显差异（P〉0．01）;实验组中、深牙周袋位点SBI的改善较浅袋明显（P〈0．01）,对照组不同袋深位点SBI的改善没有明显差异（P〉0．01）。结论：Diode激光辅助牙周基础治疗能显著改善服用钙通道拮抗剂老年患者的SBI,尤其在中深牙周袋位点;Diode激光辅助牙周基础治疗与牙周基础治疗在SBI改善的差异上没有显著性。     

釉基质蛋白联合骨髓基质细胞膜片促进类牙骨质异位生成的实验研究

目的:研究釉基质蛋白(enamel matrix proteins,EMPs)诱导犬骨髓基质细胞(bone marrow stromal cells,BMSCs)在裸鼠体内促进类牙骨质异位生成的作用和意义。方法:体外分离培养犬骨髓基质细胞并制备细胞膜片,包裹于牙本质根片上,与煅烧骨块紧密贴合捆绑后,制成牙根片/细胞膜片/煅烧骨复合物,体外模拟根周系统。据牙根片是否事先涂覆釉基质蛋白(EMPs),分为实验组和对照组。将2组的"牙根片/细胞膜片/煅烧骨复合物"分别植入裸鼠背部皮下,8周后取材,进行组织学观察和免疫组化检测。结果:实验组的根片上新生出了不规则类牙骨质样物质,并有矿化基质沉淀,有较强骨桥素(osteopontin,OPN)表达;对照组根片上未见类牙骨质样物质或矿化基质沉淀,OPN表达较弱。结论:釉基质蛋白在体内能诱导骨髓基质细胞向类成牙骨质细胞方向分化,从而促进牙周再生。     

The effect of Emdogain gel on periodontal healing in replanted monkeys' teeth

OBJECTIVE: We sought to histologically evaluate the effect of Emdogain gel on periodontal healing in monkeys' teeth undergoing delayed replantation.Study design Mature monkey teeth simulating avulsion were endodontically treated before extraction. Negative control teeth (group N = 10 roots) underwent immediate replantation, whereas the rest were bench-dried for 1 hour and treated in one of the following ways before replantation: the positive control teeth (group P = 12 roots) had no further treatment; group C teeth (4 roots) had the periodontal ligament removed; group D teeth (10 roots) were treated with Emdogain gel; group E teeth (6 roots) had the periodontal ligament removed before the application of Emdogain gel; and group F teeth (7 roots) had the periodontal ligament removed, the root surface conditioned, and Emdogain gel applied. Periodontal healing was evaluated after 16 weeks by undertaking histomorphometric analysis. RESULTS: The Kruskal-Wallis and Mann-Whitney U tests revealed that group N teeth had a statistically higher occurrence of complete healing than did all other groups, whereas group P was not significantly different in any of the healing categories from D, E, and F, the groups in which Emdogain gel was used. Group C teeth had a significantly higher occurrence of replacement root resorption than did the teeth in groups P and F-but were not significantly different from teeth in groups D and E. CONCLUSION: Emdogain gel did not appear to significantly reduce replacement resorption in monkeys' teeth that had undergone delayed replantation.     

Periodontal healing after replantation and autotransplantation of incisors in monkeys

The effect of injury to the cemental or alveolar part of the periodontal ligament upon periodontal healing after replantation and autotransplantation of teeth was studied in green Vervet monkeys. Sixty-six maxillary central incisors were replanted or autotransplanted after extra-alveolar periods of 18 min. saline storage or 120 min. dry storage. The animals were sacrificed after 8 weeks and the teeth examined histometrically. Identical healing was found in the following experimental groups: replantation or autotransplantation after 18 min. and replantation with or without removal of periodontal ligament in the alveolus. A significant increase in replacement resorption (ankylosis) compared to the 18 min. replantation group was found in the following groups: replantation and autotransplantation after 120 min., replantation after removal of periodontal ligament on the root surface and autotransplantation after 120 min. to a socket where the tooth was extracted 18 min. earlier. Autotransplantation after 18 min. to a socket where a tooth had been extracted 120 min. earlier led to a significant increase in the amount of replacement resorption compared to transplantation to an 18 min. socket. Based on these findings, it is concluded that the presence of an intact and viable periodontal ligament on the root surface is the most important factor in assuring healing without root resorption. The length of the extra-alveolar period also seems to exert some influence upon the socket, enhancing the development of ankylosis.     

成熟狗牙深低温保存延期再植的实验研究

目的 研究被长期冻存的成熟狗牙在再植后的牙根愈合情况。方法 成熟狗牙在根管充填后被拔除,采用Schwatz的下周膜冻存法,分别保存1周、3月、牙被再植8周后取出标本,用5％甲酸脱钙,横断切片,HE染色,参照Andreasen的方法进行组织学评价。结果 冻存1周组牙周膜愈合的百分比为64．53％,低于即刻再植组者（85％）,无显著性差异（P＞0．05）;冻存3月组者为50．3％,与即刻再植组者差异有显著性（P＜0．05）。结论 同人体角膜、牙肤、胰岛等组织一样,人体牙周膜也可以被长期冻存,并且再植后获得愈合;但新制备的牙槽窝一定程度上影响牙周膜愈合。     

Periodontal healing of extracted dogs' teeth air-dried for extended periods and soaked in various media

Abstract The aim of this study was to determine the periodontal healing of replanted dogs’ teeth which, after extended extra-oral dry times, had been soaked in various media before replantation. Incisors and premolars of beagle dogs were root canal treated, extracted and bench dried. The teeth were grouped according to dry times of 30, 45 and 60 minutes. Each group of teeth was soaked in one of three media, Hank's balanced salt solution, Via Span (Belzer UW-CSS, Dupont Pharmaceuticals), or Conditioned Medium (supernatant of confluent culture of human gingival fibroblasts) for 30 minutes before replantation. Controls consisted of teeth extracted and replanted without drying or soaking (negative control), and bench-dried teeth replanted without soaking in the media (positive control). The dogs were killed 6 months after replantation of the teeth, which were prepared for histologic evaluation. Five um cross-sections (every 70 Jim) of the root and surrounding tissue were evaluated for healing/resorption according to Andreasen's criteria. The best healing occurred for the roots which had been immediately replanted. Healing in the positive control groups decreased with increased dry time. For the 30–minute dry time groups, soaking in media had no beneficial effect on periodontal healing compared with the controls. Soaking in ViaSpan resulted in an increased healing incidence for both the 45- and 60- minute bench-dried groups while soaking in the other media had no consistent beneficial effect. It appears from this study that an avulsed tooth that has been left dry for 30 minutes should be replanted immediately without soaking. However, teeth that have been dry for 45 or 60 minutes would benefit from soaking for 30 minutes in ViaSpan.     

Attachment formation after transplantation of teeth cultured with enamel matrix derivative in dogs

Background: Implantation of cultured cells may be applied for periodontal regeneration in the future. However, a donor is essential in each case and tooth extraction is required to obtain the periodontal ligament–derived cell. We developed a novel regenerative technique combining tissue culture and transplantation of teeth. The purpose of this study is to evaluate the effect of enamel matrix derivative (EMD) on periodontal healing using this technique in dogs. Methods: A total of 32 incisors from seven beagle dogs were used. The periodontal ligament and cementum 5 mm from the coronal part of the roots were removed, whereas those in the apical part were preserved. Teeth were transplanted after the following treatments: 1) culture with application of EMD to the root surface for 6 weeks (n = 11); 2) culture without application of EMD for 6 weeks (n = 11); and 3) immediately transplanted without culture as control (n = 10). Eight weeks after transplantation, periodontal healing was analyzed. Results: The downgrowth of junctional epithelium on the roots of the EMD and culture groups was significantly smaller than that in the control group (P <0.01). Most of the root‐planed surfaces in the EMD group were covered with new cementum (72.2% ± 8.6%). This was significantly greater than that in the culture (29.1% ± 22.9%) and control groups (0.3% ± 1.1%). Conclusions: Transplantation of tissue‐cultured teeth decreased epithelial downgrowth and increased connective tissue attachment on the root‐planed surface. Furthermore, EMD could remarkably increase the new connective tissue attachment in this periodontal regenerative technique.     

The effect of topical minocycline on replacement resorption of replanted monkeys' teeth

Abstract – Tetracycline has been reported to possess antiresorptive properties in addition to antimicrobial actions. Systemic administration of tetracycline showed variable results in the control of replacement resorption after replantation with good results in half of the cases, and almost no healing in the rest. The purpose of this study was to evaluate histologically the effect of topically applied minocycline on replacement resorption of replanted monkeys' teeth. Thirty‐two roots from seven monkeys were endodontically treated aseptically to prevent inflammatory resorption of pulpal origin, a common sequela after avulsion injury. Teeth were then extracted as atraumatically as possible. Teeth in the negative control group (10 roots) were replanted almost immediately, while teeth in the positive control group (12 roots) were allowed to bench‐dry for 1 h prior to replantation, both without further treatment. Teeth in the experimental group (10 roots) were bench‐dried for 1 h, rinsed with saline, and then immersed in 1 ml of 50 mg ml^?1 minocycline hydrochloride for 5 min before replantation. No splinting was used. After 12 weeks, the animals were sacrificed and histological sections were prepared and evaluated according to a morphometric analysis modified from that described by Andreasen (1987) as complete healing, inflammatory resorption, and replacement resorption. Kruskal–Wallis test showed significant differences among the three groups in all the three healing categories. Further analysis with Mann–Whitney U‐test showed teeth in the negative control group to have significantly higher complete healing and significant lower unfavorable healing, comprising of replacement resorption and inflammatory root resorption than the positive control group and the minocycline group. Topical application of minocycline to the root surface appeared to result in slightly higher occurrence of complete healing (32.46%) compared to the delayed replantation group with no minocycline treatment (positive control) (16.58%), but the difference was not statistically significant (P = 0.09).     

The effect of apicoectomy before replantation on periodontal and pulpal healing in teeth in monkeys

The effect of resection of the apical part of the root before replantation upon periodontal and pulpal healing was studied in 7 green Vervet monkeys (Cercopithecus aethiops) using teeth with incomplete and complete root formation. Maxillary central incisors, mandibular lateral incisors and first and second mandibular molars were used in this experiment. On one side, the tooth was extracted and replanted with an intact root while the contralateral tooth had 2 mm of the apex resected for the purpose of facilitating pulpal repair and eliminating resorption in the resorption-prone region of the root. The replanted teeth were examined histologically 8 weeks after replantation. The histometric analysis revealed no significant difference in periodontal healing between teeth with or without apical resection. With regard to pulpal healing, apical resection was found to lead to significantly less vital pulp tissue in teeth with immature root formation. A similar, but not significant difference was found for mature teeth. Based on these findings, it could not be recommended that apices be resected prior to replantation in order to improve pulpal repair.     

The effect of removal of the coagulum in the alveolus before replantation upon periodontal and pulpal healing of mature permanent incisors in monkeys

The effect of removal of the coagulum in the alveolus before replantation upon periodontal and pulpal healing was studied in green Vervet monkeys (Cercopithecus aethiops). Mandibular lateral incisors were extracted. The extra-alveolar period before replantation was 60 min. The storage medium for the extracted teeth was physiologic saline. On the right side of the mandible, the coagulum was removed before replantation, using syringe with saline assisted by a spoon-shaped excavator. On the left side, the tooth was replanted with the coagulum in situ. The replanted teeth were examined histologically after 8 weeks. The histometric analysis showed no significant difference in periodontal or pulpal healing between the two groups. Based on this finding, it is suggested that replantation of avulsed mature teeth be carried out immediately, without any attempt to remove the coagulum.     

The effect of systemic tetracycline on resorption of dried replanted dogs' teeth

Abstract— The use of systemic penicillin after an avulsion injury has been recommended to decrease the occurrence of resorption complications. Tetracycline antibiotics have been reported to possess anti-resorptive propemes in addition to their anti-microbial actions. The purpose of this study was to evaluate histologically the effect of systemically administered tetracycline and amoxicillin on the inhibition of resorption due to attachment damage after replantation of dogs' teeth. Thuty-one roots from the teeth of four beagle dogs were endodontically treated to inhibit subsequent inflammatory root resorption of pulpal origin. They were then extracted and left to bench dry for 1 h to ensure severe periodontal ligament damage before replantation. For the teeth in the experimental groups, two dogs were given tetracycline hydrochloride and the other two dogs were given amoxicillin, administered orally, on the day of extraction/replantation and for the following 6 days.
The control group were teeth in these animals treated in the same manner but where no antibiotics had been given. After 12–16 weeks, the dogs were sacrificed and histological sections were prepared and evaluated for complete healing, inflammatory and replacement root resorption, and the groups were compared. It was shown that healing in the amoxicillin and the control groups was poor (10.90% and 11.28%, respectively), while for the tetracycline group, 35.45% showed complete healing. Individual teeth with over 50% complete healing sites were considered as having good healing, and sigdicantly more of these teeth were found in the tetracycline group (5 of 11 teeth) compared to the amoxicillin (1 of 11 teeth) or control group (1 of 8 teeth).     

Effect of stannous fluoride and tetracycline on repair after delayed replantation of root-planed teeth in dogs

Mandibular incisors were extracted and allowed to dry in air for 45 min. They were then root-planed extensively, leaving a cervical collar and the apical region uninstrumented, to prevent direct contact between root surface and alveolar bone after replantation while, at the same time, enabling precise and stable reseating of the tooth. Control teeth were replanted either without further treatment or after treatment with citric acid for 3 min. Experimental teeth were treated before replantation with 1% SnF2 for 5 min, 1% tetracycline HCl for 5 min, or 1% SnF2 followed by 1% tetracycline. Histometric analysis of healing in the root-planed areas showed minimal amounts of inflammatory resorption and ankylosis after 21 days in experimental teeth as compared with the control teeth. A persisting inflammatory reaction in the periodontal ligament without root resorption was, however, frequently seen. The observations confirm that the frequency of adverse healing reactions after delayed replantation of teeth from which nonvital soft tissue remnants have been removed can be reduced by demineralizing the root surface and preventing mechanical trauma to the root surface in the postoperative period. Root surface treatment with SnF2 followed by tetracycline resulted in complete absence of inflammatory resorption and ankylosis in this short-term experiment.