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アブストラクト（36巻1号：神奈川歯学）
Japanese
| Title ： | 2種混合抗菌薬添加α－TCP糊剤の乳歯生活歯髄切断法への影響 |
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| Subtitle ： | |
| Authors ： | 中山聡 |
| Authors（kana） ： | なかやまあきら |
| Organization ： | 松本歯科大学小児歯科学講座 |
| Journal ： | 神奈川歯学 |
| Volume ： | 36 |
| Number ： | 1 |
| Page ： | 23-40 |
| Year/Month ： | 2001 / 3 |
| Article ： | 原著 |
| Publisher ： | 神奈川歯科大学学会 |
| Abstract ： | 乳歯の保存は, 小児の正常な後継永久歯への生理的交換および顎顔面の咬合発育を促すために重要である. とりわけ, その解剖学的形態, 組織学的, 物理化学的特徴から齲蝕の初発より歯髄疾患への移行の早い乳歯では, 生活歯髄切断法は頻度の高い処置法である. Masterton1)以来, 乳歯生活歯髄切断法に水酸化カルシウム法が広く臨床応用されている. 水酸化カルシウムを断髄面に貼薬した場合, これに接する残存歯髄の表層面は水酸化カルシウムの強アルカリにより壊死層を形成し, 保護層となり, また歯髄細胞の増殖および未分化間葉細胞から象牙芽細胞への分化を促進させ, 庇蓋硬組織の形成に関与することが報告された2～5). しかし, 自覚症状の信頼性に乏しく歯痛錯誤も多い小児では, 明確な歯髄診断は極めて困難であり6～8), 厳密な制腐下での処置を求められる同法の適応も, 処置に際しては慎重かつ困難であるとされている9). また, 水酸化カルシウムは強アルカリであるため強い細胞毒性があり10), さらに庇蓋硬組織形成後も残存歯髄組織の石灰化は進行を続け11～12), 根管狭窄やそれに伴う歯髄壊死に至る退行性変化も指摘されている11,13). |
| Practice ： | 歯科学 |
| Keywords ： | 乳歯生活断髄, 抗菌性α－TCP, 組織影響 |
English
| Title ： | Influence ofα-TCP Paste Containing Two Types Antibacterial Agents for Vital Pulpotomy of Deciduous Teeth |
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| Subtitle ： | |
| Authors ： | Akira NAKAYAMA |
| Authors（kana） ： | |
| Organization ： | Department of Pediatric Dentistry,Matsumoto Dental University |
| Journal ： | Kanagawa Shigaku |
| Volume ： | 36 |
| Number ： | 1 |
| Page ： | 23-40 |
| Year/Month ： | 2001 / 3 |
| Article ： | Original article |
| Publisher ： | Kanagawa Odontological Society |
| Abstract ： | In this study, in applyingα-TCP paste to which two types of mixed antibacterial agents were added (α-TCP^++ ), to the vital pulpotomy of deciduous teeth as an inclusion paste, changes in pH of the paste and the amounts of absorption and dissolution of Ca and P in the paste in pseudo-tissue fluid were measured, and the presence of calcification-inducing ability by auto-histoplasia in vivo, and that of pulp irritation were evaluated. In vitro, to evaluate the influence of α-TCP^++ on cells in pulp tissue which was in contact with the paste, changes in cellular morphology and cytolysis were observed using cultivated cells, and cytotoxicity was investigated. Furthermore, acute toxicity in the pulp tissue which was in contact with α-TCP^++ was evaluated by a hemolytic examination, regarding the elution of hemolytic substances and physical hemolytic action on the surface of α-TCP^++ . In addition to these investigations, healing conditions of remaining pulp tissue after vital pulpotomy of rat pulp, which were caused by α-TCP^++ -inclusion, were patho-histologically investigated, and the possibility of clinical application of α-TCP^++ to the vital pulpotomy of deciduous teeth as an inclusion paste with bio-affinity was evaluated. As a result, changes in pH of the paste ranged 6.62-7.45 within the neutral zone 5 minutes after the start of measurement until the sixth day, which revealed the absence of tissue irritation. No marked changes in the amounts of absorption and dissolution of Ca and P in the pseudo-tissue fluid were observed, which revealed that α-TCP^++ did not change the amounts of Ca and P in tissue fluid. Neither toxicity nor influence on the changes in cellular morphology was observed in NCTC clone 929 cells, and hemolytic rate was 4.O% by the hemolytic examination, which revealed the absence of local acute toxicity. Furthermore, in the patho-histological evaluation of the rat pulp, although matrix formation in the very early stage was observed in the area that was in contact with the applied surface of the paste on the fourteenth day, main tissue was granulation tissue, and although calcification-like tissue was partly observed on the thirtieth day, healing of granulation tissue was mainly observed, which revealed that the pulp tissue retained vitality, and the paste was harmless to the tissue. |
| Practice ： | Dentistry |
| Keywords ： |
