全脱位牙延期再植根面牙周膜不同去除方法的比较

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (3): 296-300.

全脱位牙延期再植根面牙周膜不同去除方法的比较

陈晖, 张旸, 汪俊

上海交通大学医学院附属第九人民医院·口腔医学院儿童口腔科, 上海市口腔医学重点实验室,上海 200011

收稿日期:2015-09-16 修回日期:2015-11-20 出版日期:2016-06-25 发布日期:2016-07-22
通讯作者: 汪俊,E-mail: wangjun202@hotmail.com E-mail:falls_chen@189.cn
作者简介:陈晖（1981-）,女,硕士研究生

Different ways to remove necrotic periodontal ligament on delayed tooth replantation: scanning electron microscopy and histomorphometric analysis

CHEN Hui, ZHANG Yang, WANG Jun

Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine;Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2015-09-16 Revised:2015-11-20 Online:2016-06-25 Published:2016-07-22

摘要/Abstract

摘要： 目的研究全脱位牙延期再植前去除其根面坏死牙周膜的有效方法。方法取35颗因正畸需要拔除的健康右下颌第一前磨牙,室温下干燥保存超过1 h,随机平均分为5组。①阴性对照组;②机械去除组：用手术刀片刮除根面坏死牙周膜;③化学去除组1以1%NaClO溶液浸泡实验牙5 min;④化学去除组2以2%NaClO溶液浸泡实验牙5 min;⑤化学去除组3以1%NaClO溶液浸泡实验牙10 min。然后用扫描电镜和组织学切片观察评价各组间牙周膜残留和牙骨质剥脱情况,采用SAS 8.02软件包对数据进行统计学分析。结果牙周膜残留方面,阴性对照组显著高于机械去除组和3个化学去除组（P<0.05）,机械去除组显著高于3个化学去除组（P<0.05）,但3个化学去除组之间无显著差异。牙骨质缺损方面,机械去除组显著高于阴性对照组和3个化学去除组（P<0.05）;阴性对照组和3个化学去除组之间无显著差异。结论在本实验条件下,机械去除法既无法去净根面坏死牙周膜,又会导致根面牙骨质层破坏。化学去除法能在有效去除根面牙周膜的同时,很好地保持牙骨质层的完整性,较机械去除法更佳,是一种较理想的方法。

关键词: 全脱位牙, 延期再植, 牙周膜, 牙骨质, 次氯酸钠溶液

Abstract: PURPOSE: To seek the most effective technique for removal of root-adhered periodontal ligament. METHODS: Thirty-five roots of healthy right mandibular first premolars extracted for orthodontic purposes were selected. After extraction, the teeth were kept dry at room temperature for at least 1 h, and then divided into five groups as follows: Group 1(control)-the root-adhered periodontal ligament was preserved; Group 2 (mechanical removal)-periodontal ligament remnants were removed by scraping root surface with a scalpel blade; Group 3 (chemical removal 1)-removal of the periodontal ligament by immersing the root in 1% sodium hypochlorite solution for 5 minutes; Group 4 (chemical removal 2)-removal of the periodontal ligament by immersing the root in 2% sodium hypochlorite solution for 5 minutes; Group 5 (chemical removal 3)-removal of the periodontal ligament by immersing the root in 1% sodium hypochlorite solution for 10 minutes. The specimens were analyzed histomorphometrically and examined under scanning electron microscopy. Both periodontal ligament remnants and preservation or removal of the cementum layer concomitantly with these procedures were assessed. The data were analyzed using one-way ANOVA and Tukey's test with SAS 8.02 software package. RESULTS: In regard to periodontal ligament remnants, group 1 presented the largest areas(P<0.05), group 2 showed smaller area than group 1 (P<0.05), but much larger than group 3-5 (P<0.05); The three chemical removal groups had no significant difference. As for preserved cementum layer, group 2 lost most areas, which showed the worst result(P<0.05). The other 4 groups had no significant difference. CONCLUSIONS: Scraping root surface with a scalpel blade could not wipe off the root-adhered periodontal ligament, and might damage the cementum layer. Sodium hypochlorite solution could clean up the periodontal ligament remnants and preserve cementum layer, which might be an ideal choice.

Key words: Avulsion, Delayed tooth replantation, Periodontal ligament, Cementum, Sodium hypochlorite solution

中图分类号:

R788.4

陈晖, 张旸, 汪俊. 全脱位牙延期再植根面牙周膜不同去除方法的比较[J]. 上海口腔医学, 2016, 25(3): 296-300.

CHEN Hui, ZHANG Yang, WANG Jun. Different ways to remove necrotic periodontal ligament on delayed tooth replantation: scanning electron microscopy and histomorphometric analysis[J]. Shanghai Journal of Stomatology, 2016, 25(3): 296-300.

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