摘要
个体患牙髓病或根尖周病后,年轻恒牙牙根的继续生长发育受阻,因此,如何保证患牙根尖的正常形成和继续生长发育对口腔医生而言极具挑战。近年来报道的牙髓再生治疗病例,其利用根管内残余牙髓组织、根尖周或牙周组织中干细胞的再生分化能力,在合适的条件诱导下再生出新的高度血管化并富含结缔组织的活髓,促使牙根继续生长发育,牙根长度增加、根管壁增厚、根尖孔缩窄闭合,而且临床检查和影像学辅助检查的结果均较理想,这具有划时代的意义。牙髓再生基于组织工程学,以达到用新生牙髓组织代替原有病变牙髓组织目的。其包括两种理念:一是牙髓血运重建,诱导根尖部干细胞迁移和分化,在患牙根管内新生出有活力的牙髓样组织,完成牙根继续生长发育;二是运用组织工程技术,将具有增殖分化潜能的干细胞和适宜的生物活性支架物质置入患牙根管内,在一定的生长因子诱导下,产生新的牙本质牙髓复合体(dentin-pulp complex,DPC),实现牙髓再生。笔者就这两部分的研究进展作一阐述。
The pulpal or periapical diseases of immature permanent teeth often lead to incomplete root develop?ment. It is a challenge for us to figure out how to ensure the continuous growth of the teeth and the formation of roots.There are many cases about pulp regeneration reported recently. With the regeneration and differentiation ability ofstem cells, which exist in residual pulp tissue, periapical and periodontal tissues, the regeneration of new vital pulp tis?sue was induced under proper conditions, which is highly vascularized and rich in connective tissue, thus promptingcontinuous root growth and development, increasing root length, thickening root canal walls, and facilitating the coarcta?tion of the apical foramen. Besides, clinical and radiographic examinations shows successful results about the regenera?tive treatment, which is of milestone significance. The pulp regeneration treatment is designed to replace the pathologi?cal dental pulp tissue with new regenerated pulp tissue, based on biological tissue engineering process. This process in?cludes two key parts: one is pulp revascularization, regenerating new vital pulp tissue in the root canal to achieve thecontinuous root growth and development; the other is tissue engineering, new pulp dentin complex is regenerated by thestem cells under the induction of suitable biological active scaffolds and growth factors. This article reviews about the re?search progress and clinical characteristics of aforementioned two key parts.
作者
宋光泰
靳秋晨
SONG Guang.tai;JIN Qiu.chen(Department of Pediatrics Dentistry, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China)
出处
《口腔疾病防治》
2016年第12期681-687,共7页
Journal of Prevention and Treatment for Stomatological Diseases
基金
湖北省自然科学基金(2015CFB258)
关键词
年轻恒牙
牙髓再生
牙髓再血管化
组织工程
生长因子
Immature permanent tooth
Pulp regeneration
Pulp revascularization
Tissue engineering
Growth factor
