狗下颌骨枪弹伤对牙髓间接损伤的组织学研究

Histopathologic study of the indirect injury of dental pulp caused by shotgun wound

目的：对狗下颌骨火器伤牙髓间接损伤进行病理学观察，为临床诊断和治疗提供实验依据。方法：应用光镜和透射电镜技术。结果：伤侧第二磨牙、第三前磨牙及尖牙伤后２ｈ就有成牙本质细胞层空泡变性，牙髓充血，局限于冠髓，随时间的延长其牙髓组织水肿、充血、出血、炎细胞浸润，成牙本质细胞层空泡变性加重，牙齿愈接近伤道病理改变愈严重，最长观察到７ｄ，伤侧第二磨牙牙髓变性，有大部分坏死，余牙有轻度恢复。对侧牙病变出现较晚，程度较轻。结论：颌面部火器伤无论是接近伤道还是远离伤道的牙齿均有不同程度的间接损伤，而前者多发生不可逆的病理改变。

Aim: To provide experimental basis for clinical diagnosis and treatment by histopathologic study of dental pulp indirect injury. Methods: Using microscopy and transmission electron microscopy. Results: Some initial histopathologic changes had occurred at injured side from post-injury time of 2h, involoving vacuolar degeneration of the odontoblastic layer, pulp hyperemia, swelling, degeneration, thrombus and inflammation cell infiltration, and became deteriorative as a function of time, finally resulting in partly necrosis in the second molar pulp at the injured side, while there were also mild changes after injury at the opposite side, just coming late and tending to recover till post-injury 7d. Conclusions: The findings indicated that the both side of the teeth will suffer from indirect injury after gunshot in the mandibular area. The pathological changes at the injured side were more severe than that at the opposite side.