颌面部撞击伤致牙周膜间接损伤实验研究

An experimental study on indirect injury of periodontal membrane caused by maxillofacial impact injury

目的研究颌面部撞击伤导致的牙周膜间接损伤的特点。方法本研究于2013年11月至2014年1月在第四军医大学口腔颌面创伤实验室进行。将18只实验犬随机均分为6组,以质量0.26 kg的铁质帽状圆柱体撞击致伤犬右下颌骨体部,但不直接伤及牙齿;分别于伤后6、24 h及3、7、14、28 d处死实验犬,观察犬右下颌第四前磨牙、第二前磨牙及左下颌第二前磨牙牙周膜间接损伤的组织病理学变化。结果右下颌第四前磨牙的牙周膜损伤稍明显,但病理变化可逆;右下颌第二前磨牙的牙周膜损伤轻微;左下颌第二前磨牙牙周膜未见明显损伤。结论颌面部撞击伤可导致邻近牙齿的牙周膜发生间接损伤,但病理变化可逆;损伤程度随着牙齿与伤区距离的增加而递减。

Objective To investigate the characteristics of indirect injury of periodontal membrane caused by maxillofacial impact injury. Methods The study was carried out at the laboratory of oral and maxillofacial trauma in Fourth Military Medical University, from November 2013 to January 2014. Totally 18 dogs were divided equally into six groups with random allocation; the right mandible of each dog was impacted by a cylindroid iron cap whose weight was 0.26kg, but teeth were not injured directly ; the animals were killed 6 h, 24 h, 3 d, 7 d, 2 wk and 4 wk later, respectively ; the histo- pathologic manifestations of periodontal membrane of the fourth premolar of right mandible, the second premolar of right mandible and the second premolar of left mandible were observed. Results The injury of periodontal membrane of the fourth premolar of right mandible was relatively obvious, but the pathologic changes were reversible; periodontal membrane of the second premolar of right mandible was injured slightly; yet no obvious histopathologic change could be observed in periodontal membrane of the second premolar of left mandible. Conclusion Maxillofacial impact injury can cause indirect injuries of periodontal membrane of adjacent teeth, but the pathologic changes are reversible ; traumatic severity decreases as the distance of the tooth to the wound area increases.