上海口腔医学

上海口腔医学 ›› 2017, Vol. 26 ›› Issue (5): 561-564.doi: 10.19439/j.sjos.2017.05.020

• 论著 • 上一篇    下一篇

视觉模拟评分法联合疼痛相关因子评估不同正畸力对人活体牙髓的影响

陈婉红, 蔡世雄, 孙玉环   

  1. 福建医科大学附属泉州市第一医院 口腔科,福建 泉州 362000
  • 收稿日期:2017-05-18 修回日期:2017-07-12 出版日期:2017-10-25 发布日期:2017-11-23
  • 通讯作者: 陈婉红, E-mail: szhaozhong660@163.com
  • 作者简介:陈婉红（1977-）,学士,主治医师

Use of visual analogue scale and pain-related factors to evaluate the impact of different orthodontic forces on human dental pulp in patients who underwent fixed dental treatment

CHEN Wan-hong, CAI Shi-xiong, SUN Yu-huan   

  1. Department of Dentistry, the First Affiliated Hospital of Quanzhou City, Fujian Medical University. Quanzhou 362000, Fujian Province, China
  • Received:2017-05-18 Revised:2017-07-12 Online:2017-10-25 Published:2017-11-23

PDF (PC)

140

被引次数

16

摘要： 目的研究视觉模拟评分法（visual analog scales,VAS）联合疼痛相关因子肿瘤坏死因子α（tumor necrosis factor-alpha,TNF-α）、白细胞介素8（interleukin 8,IL-8）、白细胞介素6（interleukin-6,IL-6）和白细胞介素1β（interleukin-1 beta,IL-1β）,评估不同正畸力对人牙髓的影响。方法收集2014年1月—2015年4月在泉州市第一医院口腔科拔除上颌单侧第一前磨牙进行固定矫治的患者156例,随机分为4组,即对照组（42例）、100 g力组（40例）、150 g力组（39例）和200 g力组（35例）。施力后和拔除前,采用VAS评价法记录患者正畸力后的疼痛程度,治疗后1周的牙髓病理改变及牙髓组织中TNF-α、IL-8、IL-6和IL-1β的表达。采用SPSS 13.0软件包对计量资料进行组间方差分析,牙髓病理改变等级资料进行秩和检验。结果除对照组外,所有组别施力后1~7 d均有疼痛,3~5 d达到高峰,10 d时疼痛消失,且随施力的增大,VAS也增大(P<0.05);除对照组外,所有组别施力后1~2周,牙髓组织中TNF-α、IL-8、IL-6和IL-1β高表达（P<0.05）,随施力的增大,TNF-α、IL-8、IL-6和IL-1β表达增高（P<0.05）;施力后3~4周,所有组别牙髓组织中TNF-α、IL-8、IL-6和IL-1β的表达恢复正常状态（P>0.05）。除对照组外,所有组别施力后1周,牙髓组织血管明显增多、增粗,偶见淤血;成牙本质细胞核增大、核染色质及胞质嗜碱性染色增强,部分成牙本质细胞空泡变性,牙髓中央的结缔组织水肿,随着施力的增加,上述病变越来越明显。结论持续施力越大,可引起疼痛、牙髓疼痛因子和病理改变加重,3周后恢复正常。

关键词: 视觉模拟评价, TNF-α, IL-8, IL-6, IL-1β, 正畸力, 牙髓

Abstract: PURPOSE: To investigate the role of visual analogue scale (VAS) and pain-related factors, like tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL- 8), interleukin-6 (IL-6) and interleukin-1 beta (IL-1β) in evaluation of the impact of different orthodontic forces on human dental pulp in patients who underwent fixed dental treatment. METHODS: From January 2014 to April 2015, 156 patients with maxillary bilateral premolar treated with tooth fixed were randomly divided into 4 groups, 42 patients in control group, 40 patients in 100 g-force group, 40 patients in 150 g-force group, and 39 in 200 g-force group. VAS was used to evaluate before and after removed. TNF-α, IL-8, IL-6 and IL-1β in pulp tissues were measured by ELISA and pathological changes of pulp were observed on HE staining sections. The data were analyzed with SPSS 13.0 software package. RESULTS: Except for the control group, all patients in other groups had pain after 1-7 days, and the pain peaked at 3~5 days. The pain reaction disappeared on 10th day, and VAS increased in a force dependent manner (P<0.05). TNF-α, IL-8, IL-6 and IL-1β were higher in different force groups than in control group after 1~2 weeks of treatment, and in a force dependent manner (P<0.05). After 3~4 weeks, the expression of IL-8, IL-6 and IL-1β returned to normal (P> 0.05). Except for the control group, blood vessels on the pulp tissue increased and thickened at 1 week after application of force. Occasionally, odontoblast nucleus was enlarged and the nuclear chromatin and cytoplasmic basophilic staining were enhanced, some odontoblasts displayed vacuolar degeneration, connective tissue in the central pulp presented edema; with the increase of applied force, the changes above mentioned became more obvious, in a force dependent way. CONCLUSIONS: The larger the sustained force, the pain, pain-related factors and pathological changes became more obvious, but restored to normal within 3 weeks.

Key words: Visual analog scale, TNF-α, IL-8, IL-6, IL-1β, Orthodontic force, Dental pulp

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