牙髓血运重建术后根管内矿化组织形成的研究进展

doi:10.13591/j.cnki.kqyx.2022.06.017

摘要/Abstract

摘要： 牙髓血运重建术是治疗年轻恒牙牙髓炎和根尖周病的方法之一,术后根管内矿化组织的形成有助于根管壁增厚、促进根尖孔闭合及根尖正常发育。近年来,学者们对根管内矿化组织开展了大量研究。该文就近年来牙髓血运重建术后根管内矿化组织形成的基础和临床研究作一综述,对牙髓血运重建过程中矿化组织的组成、形成机制及其影响因素进行分析,并提出促进牙髓血运重建术后根管内矿化组织形成的临床决策。

关键词: 牙髓血运重建术, 矿化, 年轻恒牙

Abstract: Dental pulp revascularization is one of the methods for treating young permanent teeth with pulpitis and periradicular lesions. The formation of mineralized tissue in the root canal after surgery helps thicken its wall, promote the closure of apical foramen and the normal development of the root. Recently, scholars have carried out a lot of research on the mineralized tissue in the root canal. This article summarizes both basic and clinical research on the formation of mineralized tissue in the root canal after dental pulp revascularization in recent years, and analyzes the component, formation mechanism and influencing factors of mineralized tissue in the process of dental pulp revascularization. A strategy that will promote the formation of mineralized tissue in the root canal after dental pulp revascularization was proposed as well.

Key words: dental pulp revascularization, mineralization, immature tooth

中图分类号:

R781.05

高碧聪, 吕柯佳, 沈晨露, 叶伟佳, 胡文, 姚华. 牙髓血运重建术后根管内矿化组织形成的研究进展[J]. 口腔医学, 2022, 42(6): 571-576.

GAO Bicong, LYU Kejia, SHEN Chenlu, YE Weijia, HU Wen, YAO Hua. Progress of research on the formation of mineralized tissue in the root canal after dental pulp revascularization[J]. Stomatology, 2022, 42(6): 571-576.

参考文献

[1] Ostby BN. The role of the blood clot in endodontic therapy. An experimental histologic study[J]. Acta Odontol Scand, 1961, 19:324-353.
[2] Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract[J]. Dent Traumatol, 2001, 17(4):185-187.
[3] Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis:New treatment protocol?[J]. J Endod, 2004, 30(4):196-200.
[4] Chueh LH, Huang GT. Immature teeth with periradicular periodontitis or abscess undergoing apexogenesis:A paradigm shift[J]. J Endod, 2006, 32(12):1205-1213.
[5] Zeichner-David M, Oishi K, Su ZY, et al. Role of Hertwig's epithelial root sheath cells in tooth root development[J]. Dev Dyn, 2003, 228(4):651-663.
[6] Wang XJ, Thibodeau B, Trope M, et al. Histologic characteriza-tion of regenerated tissues in canal space after the revitalization/revascularization procedure of immature dog teeth with apical periodontitis[J]. J Endod, 2010, 36(1):56-63.
[7] Yamauchi N, Yamauchi S, Nagaoka H,et al. Tissue engineering strategies for immature teeth with apical periodontitis[J]. J Endod, 2011, 37(3):390-397.
[8] Lei LS, Chen YM, Zhou RH, et al. Histologic and immunohistochemical findings of a human immature permanent tooth with apical periodontitis after regenerative endodontic treatment[J]. J Endod, 2015, 41(7):1172-1179.
[9] Torabinejad M, Alexander A, Vahdati SA, et al. Effect of residual dental pulp tissue on regeneration of dentin-pulp complex:An in vivo investigation[J]. J Endod, 2018, 44(12):1796-1801.
[10] 刘彩霞, 王立. 牙髓血运重建术治疗年轻恒牙根尖周炎的临床疗效[J]. 牙体牙髓牙周病学杂志, 2018, 28(11):644-649.
[11] 叶玲. 再生性牙髓治疗方法的前景[J]. 口腔医学, 2016, 36(11):961-967.
[12] 张映娟, 文春媚, 钟小奕, 等. 无髓年轻恒牙牙髓血运重建术的组织学研究[J]. 牙体牙髓牙周病学杂志, 2016, 26(11):649-653.
[13] Zhu XF, Wang Y, Liu Y, et al. Immunohistochemical and histochemical analysis of newly formed tissues in root canal space transplanted with dental pulp stem cells plus platelet-rich plasma[J]. J Endod, 2014, 40(10):1573-1578.
[14] Lui JN, Lim WY, Ricucci D. Animmunofluorescence study to analyze wound healing outcomes of regenerative endodontics in an immature premolar with chronic apical abscess[J]. J Endod, 2020, 46(5):627-640.
[15] Becerra P, Ricucci D, Loghin S,et al. Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization[J]. J Endod, 2014, 40(1):133-139.
[16] Shimizu E, Ricucci D, Albert J,et al. Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment[J]. J Endod, 2013, 39(8):1078-1083.
[17] Zaky SH, AlQahtani Q, Chen J, et al. Effect of the periapical “inflammatory plug” on dental pulp regeneration:A histologic in vivo study[J]. J Endod, 2020, 46(1):51-56.
[18] Chen MY, Chen KL, Chen CA,et al. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures[J]. Int Endod J, 2012, 45(3):294-305.
[19] Kahler B, Kahler SL, Lin LM. Revascularization-associatedintracanal calcification:A case report with an 8-year review[J]. J Endod, 2018, 44(12):1792-1795.
[20] Ding RY, Cheung SP, Chen J, et al. Pulp revascularization of immature teeth with apical periodontitis: A clinical study[J]. J Endod, 2009, 35(5):745-749.
[21] Kaushik SN, Kim B, Walma AM, et al. Biomimetic microenvironments for regenerative endodontics[J]. Biomater Res, 2016, 20:14.
[22] Albuquerque MT, Valera MC, Nakashima M, et al. Tissue-engineering-based strategies for regenerative endodontics[J]. J Dent Res, 2014, 93(12):1222-1231.
[23] Martin G, Ricucci D, Gibbs JL, et al. Histological findings of revascularized/revitalized immature permanent molar with apical periodontitis using platelet-rich plasma[J]. J Endod, 2013, 39(1):138-144.
[24] Stambolsky C,Rodríguez-Benítez S, Gutiérrez-Pérez JL, et al. Histologic characterization of regenerated tissues after pulp revascularization of immature dog teeth with apical periodontitis using tri-antibiotic paste and platelet-rich plasma[J]. Arch Oral Biol, 2016, 71:122-128.
[25] Almutairi W, Yassen GH, Aminoshariae A,et al. Regenerative endodontics:A systematic analysis of the failed cases[J]. J Endod, 2019, 45(5):567-577.
[26] Alagl A, Bedi S, Hassan K, et al. Use of platelet-rich plasma for regeneration in non-vital immature permanent teeth:Clinical and cone-beam computed tomography evaluation[J]. J Int Med Res, 2017, 45(2):583-593.
[27] Masuki H, Okudera T, Watanebe T,et al. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF)[J]. Int J Implant Dent, 2016, 2(1):19.
[28] Jiang XJ, Liu H, Peng CF. Clinical and radiographic assessment of the efficacy of a collagen membrane in regenerative endodontics:A randomized, controlled clinical trial[J]. J Endod, 2017, 43(9):1465-1471.
[29] Chen W, Thein-Han W, Weir MD,et al. Prevascularization of biofunctional calcium phosphate cement for dental and craniofacial repairs[J]. Dent Mater, 2014, 30(5):535-544.
[30] Thein-Han W, Xu HH. Prevascularization of a gas-foaming macroporous calcium phosphate cement scaffold via coculture of human umbilical vein endothelial cells and osteoblasts[J]. Tissue Eng Part A, 2013, 19(15/16):1675-1685.
[31] Nosrat A, Kolahdouzan A, Khatibi AH,et al. Clinical, radiographic, and histologic outcome of regenerative endodontic treatment in human teeth using a novel collagen-hydroxyapatite scaffold[J]. J Endod, 2019, 45(2):136-143.
[32] 余梦佳, 姜治伟, 邓淑丽, 等. 支架材料在牙髓血运重建术中的研究进展[J]. 口腔医学, 2020, 40(4):371-375.
[33] Wang S, Huang G, Dong Y. Directional migration and odontogenic differentiation of bone marrow stem cells induced by dentin coated with nanobioactive glass[J]. J Endod, 2020, 46(2):216-223.
[34] Farhad AR, Shokraneh A, Shekarchizade N. Regeneration or replacement? A case report and review of literature[J]. Dent Traumatol, 2016, 32(1):71-79.
[35] Cheng Q, Zeng K, Kang Q, et al. The antimicrobial peptide LL-37 promotes migration and odonto/osteogenic differentiation of stem cells from the apical papilla through the Akt/wnt/β-catenin signaling pathway[J]. J Endod, 2020, 46(7):964-972.
[36] Pizzatto LN, Meneses CCB, Diniz EA,et al. Angiotensin Ⅱ regulates proliferation and function of stem cells of apical papilla[J]. J Endod, 2020, 46(6):810-817.
[37] Zarei M, Jafarian AH, Harandi A, et al. Evaluation of the expression of VⅢ factor and VEGF in the regeneration of non-vital teeth in dogs using Propolis[J]. Iran J Basic Med Sci, 2017, 20(2):172-177.
[38] Chang CC, Lin T, Wu SY, et al. Regeneration of tooth with allogenous, autoclaved treated dentin matrix with dental pulpal stem cells:An in vivo study[J]. J Endod, 2020, 46(9):1256-1264.
[39] Bezgin T, Yilmaz AD, Celik BN,et al. Efficacy of platelet-rich plasma as a scaffold in regenerative endodontic treatment[J]. J Endod, 2015, 41(1):36-44.
[40] Zhu W, Zhu X, Huang GT, et al. Regeneration of dental pulp tissue in immature teeth with apical periodontitis using platelet-rich plasma and dental pulp cells[J]. Int Endod J, 2013, 46(10):962-970.
[41] Chai JH, Jin RZ, Yuan GH,et al. Effect of liquid platelet-rich fibrin and platelet-rich plasma on the regenerative potential of dental pulp cells cultured under inflammatory conditions:A comparative analysis[J]. J Endod, 2019, 45(8):1000-1008.
[42] Pelissari C, Paris AFC, Mantesso A, et al. Apical papilla cells are capable of forming a pulplike tissue with odontoblastlike cells without the use of exogenous growth factors[J]. J Endod, 2018, 44(11):1671-1676.
[43] American association of endodontists. American Association of Endodontics clinical considerations for a regenerative procedure[EB/OL]. Regenerat Endod(2018-04-01)[2020-09-14]https://www.aae.org/specialty/clinical-resources/regenerative-endodontics.
[44] Lin JC, Zeng Q, Wei X, et al. Regenerative endodontics versus apexification in immature permanent teeth with apical periodontitis:A prospective randomized controlled study[J]. J Endod, 2017, 43(11):1821-1827.
[45] Andreasen JO, Bakland LK. Pulp regeneration after non-infected and infected necrosis, what type of tissue do we want? A review[J]. Dent Traumatol, 2012, 28(1):13-18.
[46] He L, Zhong J, Gong QM, et al. Treatment of necrotic teeth by apical revascularization:Meta-analysis[J]. Sci Rep, 2017, 7(1):13941.
[47] Tan EN, Quah SY, Bergenholtz G, et al. Antibiotics used in regenerative endodontics modify immune response of macrophages to bacterial infection[J]. J Endod, 2019, 45(11):1349-1356.
[48] Chrepa V, Joon R, Austah O,et al. Clinical outcomes of immature teeth treated with regenerative endodontic procedures-A San antonio study[J]. J Endod, 2020, 46(8):1074-1084.
[49] Shawli H, Iohara K, Taroush M, et al. Nanobubble-enhanced antimicrobial agents:A promising approach for regenerative endodontics[J]. J Endod, 2020, 46(9):1248-1255.
[50] Shivashankar VY, Johns DA, Maroli RK,et al. Comparison of the effect of PRP, PRF and induced bleeding in the revascularization of teeth with necrotic pulp and open apex:A triple blind randomized clinical trial[J]. J Clin Diagn Res, 2017, 11(6):ZC34-ZC39.
[51] Ulusoy AT, Turedi I, Cimen, et al. Evaluation of blood clot, platelet-rich plasma, platelet-rich fibrin, and platelet pellet as scaffolds in regenerative endodontic treatment:A prospective randomized trial[J]. J Endod, 2019, 45(5):560-566.
[52] Diogenes A, Ruparel NB. Regenerativeendodontic procedures:Clinical outcomes[J]. Dent Clin North Am, 2017, 61(1):111-125.
[53] Tian J, Zhang YH, Lai ZH, et al. Ion release, microstructural, and biological properties of iRoot BP plus and ProRoot MTA exposed to an acidic environment[J]. J Endod, 2017, 43(1):163-168.
[54] Lu J, Li Z, Wu X,et al. iRoot BP Plus promotes osteo/odontogenic differentiation of bone marrow mesenchymal stem cells via MAPK pathways and autophagy[J]. Stem Cell Res Ther, 2019, 10(1):222.
[55] 江义笛, 汪成林, 叶玲. 再生性牙髓治疗的并发症[J]. 国际口腔医学杂志, 2019, 46(1):73-77.
[56] Song M, Cao Y, Shin SJ, et al. Revascularization-associated intracanal calcification: Assessment of prevalence and contributing factors[J].J Endod, 2017, 43(12):2025-2033.