罹患牙周病牙齒的牙髓鈣化研究

An Vitro Study of the Pulpal Calcification with Periodontaly Involved Teeth

陳錦(Kam Chan) ； 姚少珍(Siu-Jan Yew)

《中華民國牙周病醫學會雜誌》 8卷3期 (2003/09) Pp. 177-183

摘要

牙周與牙髓組織之間的關係是相當密切而且是相互影響。牙髓發炎可經由牙根根尖或其他副根管的相通引起牙周炎。類似的情形也可以發生在牙周炎的牙齒上。過去的研究顯示罹患牙周疾病的牙齒，牙髓組織較易有病變發生如退化性牙髓鈣化，慢性牙髓炎，和牙髓壞死等。本研究目的在觀察不同年齡病患有慢性或急性牙周疾病的牙齒，其牙髓病變及鈣化的發生可能性。總數116顆因成人型牙周炎或進展型牙周炎導致齒槽骨破壞嚴重而需要拔除的牙齒作為實驗樣本。這些牙齒沒有任何齲蝕，接受過填補或嚴重磨耗的結果。牙齒經拔除後，以不破壞牙髓組織的情況下予以髓腔開口，再浸泡於15%福爾馬林溶液中。最後將牙齒縱切劈開成左右兩半，並小心取出牙髓組織作病理組織切片與染色。並於光學顯微鏡下觀察牙髓組織的病變與組織鈣化的情形與嚴重程度，記錄並分析結果。實驗結果發現有高達60%的牙周病牙齒都會有發生牙髓鈣化等退化性的病理變化現象。而且，年齡愈大與多根管牙齒等因素，影響發生的機率也愈高。因此，牙周支持組織及齒槽骨破壞愈加嚴重，則可能促使牙髓組織受更大損害至退化萎縮，甚至於壞死的機會遠較其他沒有牙周病的牙齒來得多。

關鍵字

成年型牙周病 ； 急性進展型牙周病 ； 牙髓病變 ； 退化性牙髓鈣化

並列摘要

The close relationship between pulp and periodontium was well established. Inflammation. products emanates from pulp exit into the periodontal structures by way of the apical foramen and any existing accessory canals. The effect of periodontal disease on dental pulp was reported similar. Past studies revealed periodontal involved teeth might induced dystrophic pulpal changes, chronic pulpitis and pulp necrosis. The purpose of this study was to observe the changes and calcification of pulp in different age of patient with acute or chronic periodontitis. A total of 116 severe bony destructive teeth in adult periodontitis (AP) or rapidly progressive periodontitis (RPP) patients were selected as the experimental teeth. After extraction, they were soaked in 15% formalin, and prepared to access the pulp chamber. All the specimens were sectioned longitudinally and split into two halves, pulp tissue were removed carefully for histological sectioned. All the sectioned were examined under light microscopy to observe the degree and severity of pulpal changes and calcification patterns. The results of this study showed that more than 60% periodontal involved teeth induced pulpal dystrophic changed. Meanwhile, the Occurrence was increased in those teeth with old ages and multiple root canals. Therefore, the severity of destruction of the periodontal supporting tissue and alveolar bone will have the chance to influence the damage or pathologic change of the relative pulp tissue. Even the possibility of pulp necrosis was higher than those teeth without periodontal disease involved.

並列關鍵字

adult periodontitis ； rapid aggressive periodontitis ； pulpal changes ； dystrophic calcification