纤维蛋白粘接剂盖髓的动物实验研究

The Effect of Fibrin Sealant on Dental Pulp for pulp Capping in Experimental Dogs

目的 :观察纤维蛋白粘接剂 (FS)对人工暴露的牙髓组织愈合的影响。方法 :采用FS行狗牙直接盖髓术 ,常规制备牙 -颌骨联合切片 ,光学显微镜观察牙髓创面的愈合及牙本质的修复。结果 :FS盖髓后牙髓无出血 ,炎性反应轻。氢氧化钙盖髓后牙髓出血多 ,炎性反应较重。FS组术后 42d出现骨样牙本质桥修复 ,氢氧化钙组术后 2 8d出现骨样牙本质桥修复 ,术后 6 3d ,FS组 6例中 4例有牙本质桥形成 ,氢氧化钙组 6例均有牙本质桥形成。结论 :FS虽无牙本质诱导活性但因其良好的保护及促进牙髓组织创面愈合能力仍不失为一种较为理想的盖髓剂。

Objective: To investigate the pulp tissue reaction and reparative dentine formation of dog pulp capped with Fibrin Sealant (FS). Methods: The fibrin was from a tisseel Kit (Immuno AG, Vienna, Austria) consisting of solution A (freeze dried human fibrinogen, factor ⅩⅢ, Aprotinine) and solution B (thrombin powder, calcium chloride) with 0 02ml from each for each tooth. The Ca(OH)\-2 paste (Calar, China) was served as the control. Forty nine cuspid, premolar and molar teeth in 4 adult dogs weighed 11～13kg were used. Surgical anesthesia was obtained by muscle injection of 3% sodium pentobarbital (1ml/kg). The pulp were exposed by using sterile high speed rotary cutting instruments with water cooling. The pulps were treated with 0 02ml fibrin or Ca(OH)\-2 paste respectively. The cavity was filled with zine phosphate cement. The animals were killed at intervals of 1,4,6,9 weeks after surgery and perfused with phosphate buffered saline followed by 10% formalin in phosphate buffered saline. The jaws were resected and the samples prepared by removing each experimental tooth in block, further fixing them by immersion in 10% formalin in phosphate buffered saline. The specimen were processed for histologic examination. Serial sections (5nm thick) were made, stained with hematoxylin and eosin, examined using a light microscope. Results: 7 days after operation, the samples treated with the FS showed no hemorrhage and degeneration of pulp tissue and a small amount inflammatory cells near the wounds. The samples treated with Ca(OH)\-2 showed hemorrhage and degeneration (2/6) and a large amount inflammatory cells near the wounds. 28 days after operation, pulp health of teeth treated with FS and Ca(OH)\-2 was nearly recovered. Dentin bridges were observed in 2 out of 6 cases treated with Ca(OH)\-2. 42 days after operation, pulp health of teeth treated with FS and Ca(OH)\-2 was totally recovered. Dentin bridges were observed in 2 out of 7 cases of pulp treated with FS and four out of 6 cases treated with Ca(OH)\-2. 63 days after operation, pulp health of teeth treated with FS and Ca(OH)\-2 was soundly resumed. The dentine bridge was observed in 4 out 6 cases of pulp treated with the FS and in all 6 cases treated with Ca(OH)\-2. Conclusion: FS has no dentin inducing activity, but can enhance exposed pulp healing, so FS can be served as a promised pulp capping agent. \;