【作者】 高洪岩；

【导师】 李文颜；

【作者基本信息】 大连医科大学 ， 口腔内科， 2007， 硕士

【摘要】 目的:桂皮醛是天然药物肉桂挥发油的主要成分,具有解热、扩张皮肤血管、促进血液循环、解表、发散(汗)、镇痛、抗真菌、抗肿瘤等药理作用,且毒副作用低。经体外抗厌氧菌实验证明:桂皮醛对临床分离出的122株包括了9属22种常见厌氧菌如产黑色素类杆菌、核梭杆菌、消化链球菌等均可阻碍细胞壁的正常形成,从而起到抗厌氧菌作用,并有抗需氧菌及真菌的作用。由于其为肉桂挥发油类,可利用其良好的挥发性、渗透性和强力杀菌性做乳牙活髓切断术的盖髓剂和根管消毒剂,为探讨其可行性,本实验采用桂皮醛作鼠牙活髓切断术的盖髓剂,和去髓术的根管消毒剂,并与甲醛甲酚和不封药作对照,进行动物实验研究,观察术后牙根、根髓组织及根尖周组织的变化,探讨桂皮醛对根髓组织和根尖周组织的影响,为开发桂皮醛作为一种口腔科临床用药提供组织病理学依据。方法:一、活髓切断术:将30只Wistar大鼠随机分成3组,实验组、对照组、空白对照组各10只。动物麻醉后,常规模拟乳牙活髓切断术。实验组用桂皮醛原液与氧化锌粉适量调拌盖髓,对照组用等量甲醛甲酚、丁香油混合液与氧化锌粉适量调拌盖髓,空白对照组不封任何药物,玻璃离子充填。术后第4、12周处死,取出实验牙牙周矩形颌骨骨块,固定脱钙后,石蜡切片(4μm),HE染色,光学显微镜观察。二、去髓术:将60只Wistar大鼠随机分成3组,实验组、对照组、空白对照组各20只。动物麻醉后,常规模拟去髓术,实验组与对照组分别封入桂皮醛和甲醛甲酚药液纸尖,空白对照组不封入任何药物,玻璃离子充填。术后分别1、2、3、6周处死动物,取出实验牙牙周矩形颌骨骨块,HE切片(4μm),光镜观察。结果:一、活髓切断术:4周:3组分别观察20例标本。实验组所有标本均未见到牙根外吸收、钙化和根尖炎症细胞浸润,1例有轻微的牙根内吸收。对照组2例有牙根内吸收,所有标本均无牙根外吸收、钙化和根尖炎症细胞浸润。空白对照组9例有严重的根管内吸收,6例标本其根尖可见到灶状淋巴细胞浸润,其中3例伴有根尖外吸收。经统计学分析,内、外吸收和钙化:3组均无差异(P>0.25);炎症反应:实验组和对照组无差异(P>0.5),和空白对照组差异显著(P<0.05)。12周:3组分别观察20例标本。实验组无1例标本有牙根外吸收和根尖炎症细胞浸润,1例标本根髓中1/3的血管扩张充血,根管中1/3内侧壁吸收,有2例标本在盖髓剂下方可见到少量散在红染钙化团,未见明显牙本质桥形成。对照组所有标本均无牙根内、外吸收和根尖炎症细胞浸润,2例标本牙髓钙化。空白对照组11例标本有严重的根管内吸收,15例根尖有大量的淋巴细胞,伴明显的血管扩张,其中4例有破骨细胞存在,发生根尖外吸收。经统计学分析,内、外吸收和炎症反应:实验组和对照组无差异(P>0.5),和空白对照组差异显著(P<0.005);钙化情况:3组均无差异(0.25>P>0.1)。二、去髓术:1周时3组均有明显炎症反应,实验组和对照组无差异(P>0.3),空白对照组炎症反应更重,与另两组差异显著(P<0.03);3组血管扩张也很明显,且差异不显著(P>0.2);实验组未见牙周膜纤维排列异常和骨吸收,而另外两组则有很明显的牙周膜纤维排列异常和骨吸收,实验组与另两组差异显著(P<0.05)。2周时3组的炎症和血管扩张均有上升趋势,实验组与对照组两项指标均无差异(P>0.1),与空白对照组两项指标差异显著(P<0.01);对照组和空白对照组牙周膜纤维排列异常和骨吸收略有减轻,实验组则开始出现轻微的牙周膜纤维排列异常和骨吸收,3组差异无显著(P>0.25)。3周时3组的炎症反应开始减轻,实验组与对照组无显著性差异(P>0.3),与空白对照组差异显著(P<0.002);3组的血管扩张,牙周膜纤维排列异常和骨吸收也在逐渐减轻,差异均不明显(P>0.1)。6周时,实验组和对照组4项指标都显著减轻,无显著性差异(P>0.25),但是空白对照组仍有很明显的炎症反应、血管扩张、牙周膜纤维排列异常以及骨吸收,除了骨吸收与另两组差异无显著性(P>0.1),其余3项指标与另两组均有明显差异(P<0.02)。结论:一、桂皮醛作为活髓切断术的盖髓剂,对牙髓组织刺激性小,与甲醛甲酚差异不显著。二、桂皮醛作为去髓术的根管消毒剂,对根尖周组织刺激性较小,有助于炎症恢复,不会加重机械扩挫引起的骨吸收,与甲醛甲酚差异不显著。更多还原

【Abstract】 Objective: As the main component of cinnamon which is a kind of naturally occurring drugs, cinnamaldehyde has many pharmacologic actions, such as relieving fever, expanding blood vessel, promoting blood circulation, diaphoresis relieving superficies, evaporation, analgesia, anti-eumycete and anti-tumor, and so on, and meanwhile cinnamaldehyde has low poison and side effect. Anti-anaerobian experiment in-vitro demonstrated that cinnamaldehyde can hindrance the cytoderm formation of 122 strains anaerobian isolated from infected tissues, including 9 genera 22 species common anaerobian, such as bacteroides melanogenicus, caryo-fusobacterium, and peptostreptococcus. Thus cinnamaldehyde affects as anti-anaerobian, as well as anti-aerobe and anti-eumycete. As essential oil, its favorable volatility, penetrability and highly disinfectant sex could be used to as pulp-cap and disinfectant. In order to approach it, we did this animal experiment research by adopting cinnamaldehyde as pulp-cap of pulpotomy and as root canal disinfectant of pulpectomy in rat teeth, and compared with formaldehyde cresol formocresol (FC) and blank. We observed the variation of dental root, pulp tissue of root and periapex after treatment, to investigate the influence of cinnamaldehyde to the pulp tissue and periapex, to provide histopathology basement for exploring cinnamaldehyde as a kind of oral clinical medication.Methods:1. Pulpotomy: 30 Wistar rats were divided into 3 groups randomly, experimental group, control group and blank group, for each 10 rats. After anesthesia, we simulated primary teeth pulpotomy routine. Cinnamaldehyde was used as pulp-cap mixed with zinc oxide in experimental group, while FC equaled clove oil mixed with zinc oxide used in control group, whileblank group with no pulp-cap, and then all carves were filled with glass ion. The animals were killed after 4th and 12th week, experimental teeth and periodontal bone blocks were extracted to make HE slides(4-6μm). Observation by light microscope.2. Pulpectomy: 60 Wistar rats were divided into 3 groups randomly, experimental group, control group and blank group, for each 20 rats. After anesthesia, we simulated primary teeth pulpectomy routine. Cinnamaldehyde was used as root canal disinfectant in experimental group, while FC used in control group, and blank group with no root canal disinfectant, and then all carves were filled with glass ion. The animals were killed after 1st, 2nd, 3rd and 6th week, experimental teeth and periodontal bone blocks were extracted to make HE slides(4-6μm). Observation by light microscope.Results:1. Pulpotomy: 4th week: 20 samples were observed for each group. External resorption of root of tooth, calcification and inflammatory cell infiltration to periapical tissue were not seen in experimental group, and slight internal resorption of root of tooth was seen in 1 tooth. 2 examples of internal resorption, no external resorption, calcification or inflammation were observed in control group. While in blank group, 9 examples of severe internal resorption, and 6 examples of focus form lymphocyte infiltrated in which 3 examples accompanied with external resorption of root tip were observed. Through statistic analysis, internal and external resorption and calcification: there was no difference among 3 groups (P > 0.25); inflammation: no difference between the former two groups (P>0.5), and significance difference from the blank group (P< 0.05). 12th week: 20 samples were observed for each group. Experimental group: 1 sample of external resorption and inflammation, 1 internal resorption and 2 samples of calcification. Control group: no external and internal resorption and no inflammation, 2 samples of calcification. Blank group: 11 samples of severe internal resorption, 15 had inflammation with evident hemangiectasia, in which 4 samples had external resorption. By statistic analysis, internal and external resorption and inflammation: no difference between the former two groups (P>0.5), and significance difference from the blank group (P<0.005); calcification: no difference among all (0.25>P>0.1).2. Pulpectomy: 1st week: inflammation was seen in all slides, while blank group was different from others (P<0.03); hemangiectasia was of no difference among all (P > 0.2); periodontal membrane fiber arranged abnormality and bone resorption were seen in the latter two groups, and of significant difference from the experimental group (P<0.05). 2nd week: inflammation and hemangiectasia of the former two groups were different from blank group (P < 0.01); periodontal membrane fiber arranged abnormality and bone resorption were of no difference among all (P>0.25). 3rd week: inflammation was relieving, and the experimental and control group were different from the other (P < 0.002); hemangiectasia, periodontal membrane fiber arranged abnormality and bone resorption were of no difference among all (P>0.1). 6th week: four indexes were of no difference between the former two, and bone resorption of the blank group was different from the other groups (P<0.02).Conclusions:1. As pulp-cap of pulpotomy, cinnamaldehyde stimulates the pulp at a very low level, which has no difference with FC.2. As root canal disinfectant of pulpectomy, cinnamaldehyde stimulates the periapex at a very low level, and conduce to revive, and has no aggravation to the bone resorption, which has no difference with FC.更多还原