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직접치수복조재에 따른 비글견 치수의 조직반응에 대한 연구

PULP RESPONSE OF BEAGLE DOG TO DIRECT PULP CAPPING MATERIALS: HISTOLOGICAL STUDY

김영균|최용훈|윤필영|조병훈|배지현
대한치과보존학회 (Korean Academy Of Conservative Dentistry)|2010.01|Restorative Dentistry and Endodontics|제35권 제1호|pp. 5-12

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키워드

Direct pulp capping상아질교Dentinal bridgeBeagle dog직접치수복조Pulp inflammationHistological evaluation조직학적 평가비글견치수염증
주제분류치의학

초록

본 연구에서는 인위적으로 노출시킨 비글견의 치수조직을 기존의 수산화칼슘제재와 MTA, 접착성 레진, 광중합형 수산화칼슘제재를 사용하여 직접치수복조한 후 각 재료에 따른 치수의 반응을 광학현미경 하에서 조직학적으로 관찰하여 비교분석하였다. 2마리 비글견의 36개 치아를 이용하여, 실험적으로 치수를 노출시키고 노출된 치수에 치수복조재를 적용한 후 와동은 복합레진으로 충전하여 직접치수복조술을 시행하였다: (1) Mineral Trioxide Aggregate (MTA: ProRoot R MTA, Dentsply,Tulsa, USA), (2) Clearfil SE Bond (Dentin adhesive system: Kuraray, Osaka, Japan), (3) Ultra-Blend (Photopolymerized Calcium hydroxide: Ultradent, South Jordan, USA), (4) Dycal (Quick setting Calcium hydroxide:LD Caulk Co., Milford, USA). 희생전 90일, 30일, 7일 전에 각 복조재별로 3개씩의 와동을 충전하였고 비글견을 희생시키고 조직시편을 제작하였다. 시편을 H&E 염색 후 광학 현미경으로 치수염증반응과 경조직 형성 정도를 관찰하였다. MTA 군은 초기에는 경조직 형성이 관찰되지 않고 치수조직의 위축과 부분괴사가 관찰되었으나 시간이 지나면서 경조직 형성이 관찰되었다. Clearfil SE Bond군은 초기에 염증세포의 침윤과 치수세포의 괴사를 관찰할 수 있었고 시간이 지날수록 치수 세포의 괴사가 더욱 진행한 양상을 보였다. Ultra-blend 군과 Dycal 군은 MTA 군과 비슷하게 초기에는 경조직 형성을 보이지 않고 중등도의 염증반응이 관찰되었으며 시간이 지나면서 경조직 형성이 관찰되었다. MTA, 수산화칼슘제재와 광중합 수산화칼슘제재는 초기의 치수염증반응 이후 조상아세포층, 상아질교 형성을 보여 직접치수복조재로 적당하였으며, 접착성 레진은 심한 염증반응과 치수 조직의 괴사 양상을 보여 직접치수복조재로 부적당하다는 결론을 얻을 수 있었다.

Abstract

The purpose of this study was to evaluate the pulp tissue reaction to direct pulp capping of mechanically exposed beagle dogs’pulp with several capping materials. A total of 36 teeth of 2 healthy beagle dongs were used. The mechanically exposed pulps were capped with one of the followings: (1) Mineral Trioxide Aggregate (MTA: ProRoot R MTA, Dentsply, Tulsa, USA), (2) Clearfil SE Bond (Dentin adhesive system: Kuraray, Osaka, Japan), (3) Ultra-Blend (Photo-polymerized Calcium hydroxide: Ultradent, South Jordan, USA), (4) Dycal (Quick setting Calcium hydroxide: LD Caulk Co., Milford, USA) at 7, 30, and 90 days before sacrificing. The cavities were restored with Z350 flowable composite resin (3M ESPE, St. Paul. MN, USA). After the beagle dogs were sacrificed, the extracted teeth were fixed, decalcified, prepared for histological examination and stained with HE stain. The pulpal tissue responses to direct pulp capping materials were assessed. In MTA, calcium hydroxide, and photo-polymerized calcium hydroxide groups, initial mild inflammatory cell infiltration, newly formed odontoblast-like cell layer and hard tissue bridge formation were observed. Compared with dentin adhesive system, these materials were biocompatible and good for pulp tissue regeneration. In dentin adhesive system group, severe inflammatory cell infiltration, pulp tissue degeneration and pulp tissue necrosis were observed. It seemed evident that application of dentin adhesive system in direct pulp capping of beagle dog teeth cannot lead to acceptable repair of the pulp tissue with dentine bridge formation. [J Kor Acad Cons Dent 35(1):5-12, 2010]

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