暫間受力對牙周組織的影響

Influence of Transient Load on Periodontium

吳英璉(Wu Ying-Lien)

指導教授 ： 吳忠憲

臺北醫學大學/口腔學院/牙醫學系碩博士班/碩士(1998年)

摘要

牙周組織因外力影響而造成的反應變化, 由於外力的大小,次數與受力時間等差異, 諸 多的研究結果皆不 相同,亦有不少爭議之處.本實驗利用光學顯微鏡和掃描式電子顯微 鏡等形態學研究方法,觀察牙周組織: 含牙齦,牙周韌帶,齒槽骨和牙根面牙骨質, 在受到 單次而強大的外力後, 局部組織結構的變化. 實驗在54隻12週齡的SD 雄性大 白鼠之左側第一大臼齒上, 施予單次的1.5公斤之短暫而強大的力量. 右側第一大臼 齒則不施力以作為對照組. 實驗動物分成兩組, 分別是36隻作為光學顯微鏡觀察組, 和18 隻 作為掃描式電子顯微鏡觀察組. 前者在施力後第12小時,1,3,7,14,21 天後以Bouin 氏液灌流固定, 製作試 料,石臘切片, 並於H & E 染色後, 以光學顯微鏡觀察. 後者則 於相同實驗時間, 以2.5% 戊二醛灌流固定 後, 注入樹脂, 並於後固定, 脫水, 乾燥, 與 鍍金處理後, 以掃描式電子顯微鏡進行觀察. 結果發現, 施力後十二小 時的牙齦組織中可見到發炎細胞的聚積, 一天後達最多, 之後隨時間漸減, 而十 四天 後則已不復見. 同時, 施力後十二小時亦可見到接合上皮的細胞間隙有變大的現象. 齒槽 骨則在施力第一天, 可見骨吸收性細胞存在於骨吸收凹窩內, 第七天時吸收破壞最嚴重, 可見到許多骨吸收性細胞. 而十四天仍可見到骨吸收凹窩存在. 二十一天時, 齒槽骨上可 見許多捲曲, 圓鋸狀的接合線. 受力後第三天 的牙周韌帶, 可見夏庇氏纖維平行於牙齒 長軸聚集成束狀, 之後則隨實驗時間漸被骨基質所包埋. 牙根表面在齒頸部自受力當天即 可見受力牽引破壞的現象, 第三天的吸收破壞最為嚴重, 局部可見許多吸收性多核巨細胞 的存在. 但在受力後第十四天牙根表面已不見吸收性細胞, 並可見基質開始沉積和修復. 由觀察結果可知, 暫間受力會使健康的牙周組織, 包含牙齦, 齒槽骨, 牙 周韌帶與牙根表面牙骨質產生結構上的變化, 特別是在齒頸部靠近齒槽骨脊的牙周組織變 化最為明顯, 但若無持續的刺激下, 這些變化是可回復的.

關鍵字

暫間受力 ； 牙周組織

並列摘要

The influence of transient and strong load on periodontium was investigated. Fift -four Sprague-Dawley rats at the age of 12 weeks old were used as experimental animals and divided into 2 groups. The left first molar of each rat was loaded with a transient force of 1.5 Kg, and the contra-lateral first molar served as the control. On the 12th hours, 1st,3rd,7th,14th and 21st days,6 rats of each group were harvested. The specimens were sectioned, H-E stained and observed with light microscopy. Another 3 rats were perfused with Ringers' and fixed with 2.5% glutaraldehyde followed by injection with methacrylate,post-fixation,dehydration ion-coating, and then observed with scanning eelectron microscopy. The results showed increase of intercellular space in junctional epithelium on the 12th hours. On the 1st day, numerous inflammatory cells were noted in gingival tissue. On the 3rd, 7th days, the exposed Sharpey's fibers aggregrated as long-clustered shape paralleling the tooth axis on the alveolar socket wall. There were lots of Howship's lacunaes and multinuclear giant cells present in the alveolar bone and tooth surface, especially in the cervical part. On the 14th days, matrix deposition on the root surface could be seen. A high number of crenated cement lines were observed in the alveolar bone on the 21st days. Sharpey's fibers were embedded in the newly formed bony matrix, indicating the remodeling was in progress. The observation demostrated that transient and strong load resulted in the structural changes of the periodontal tissues, especially the area near th cervical part of teeth. The changes were reversible.

並列關鍵字

transient load ； periodontium