牙体预备对高嵌体修复下颌第一磨牙力学影响的初步研究

目的：通过有限元法,探讨高嵌体修复根管治疗后的下颌第一磨牙后,牙体预备形式对牙体组织受力的影响,为临床提供力学理论依据。方法：模拟右侧下颌第一磨牙的三维有限元模型,磨牙存在合面I类洞缺损,根管治疗后采用高嵌体修复,分别设计三种牙体预备形式,即覆盖全部牙尖、覆盖全部功能尖和覆盖部分功能尖的高嵌体修复,对模型进行加载,观察牙体组织的应力大小及分布。结果：覆盖全部牙尖高嵌体修复时牙釉质出现一个应力集中区,其他两种设计出现两个应力集中区。垂直载荷下,釉质的最大主应力在全部牙尖组分别低于其他两组92．29％和89．76％;舌颊向载荷下比其他两组分别降低80．91％和76．53％。三组牙本质的应力集中区趋于一致。垂直载荷下,牙本质的最大主应力在全部牙尖组分别高出其他两组12．92％和14．73％;舌颊向载荷下较其他两组高1．26％和5．08％。结论：从生物力学角度,覆盖全部牙尖的高嵌体更有利于牙体硬组织的受力,可以更好的对牙釉质起到保护作用。     

新型激光光敏根管消毒剂在牙本质中渗透性的研究

目的：观察新型激光光敏根管消毒剂、甲苯胺蓝和亚甲基蓝在牙本质中的渗透效果,评价三种光敏剂在牙本质中的渗透性。方法：收集新鲜拔除的离体单根管牙90颗,根管预备后随机分为三组。每组30颗。A组为新型激光光敏根管消毒剂组;B组为甲苯胺蓝组;c组为亚甲基蓝组。A、B、C三组实验根管内分别用浸有饱和的新型激光光敏根管消毒剂、甲苯胺蓝和亚甲基蓝的棉捻在根管内停留60秒。沿牙体长轴颊舌纵向劈开,倒置荧光显微镜下观察并拍照,用Photoshop8．01软件测量三种光敏剂渗透入牙本质的平均深度。结果：新型激光光敏根管消毒剂在牙本质内的渗透平均深度为553．25μm,甲苯胺蓝在牙本质内的渗透平均深度为350．75μm,亚甲基蓝在牙本质内的渗透平均深度为168．25μm。结论：新型激光光敏根管消毒剂在牙本质渗透性明显优于甲苯胺蓝和亚甲基蓝,具有良好的牙本质渗透性。     

微种植体支抗内收及压低上前牙的有限元研究

目的:探讨在利用微种植体支抗整体内收前牙过程中增加前牙区不同位置压低力对上颌前后牙的生物力学效应的影响。方法:采用螺旋CT扫描获取图像并结合MIMICS等软件进行三维重建,建立拔除上颌第一前磨牙整体内收前牙的三维有限元模型,分析利用第二前磨牙与第一磨牙间微种植体整体内收前牙过程中,增加前牙区不同位置压低力后前后牙的生物力学效应。结果:增加前牙区压低力后,前牙舌向倾斜移动明显减小,不同位置的垂直向力对前牙的影响不同,第一磨牙在整体内收过程中表现为远中倾斜移动。结论:1增加前牙区压低力能够实现对前牙转矩的有效控制;2增加前牙区的压低力使前牙更趋向于整体移动;3在微种植体支抗内收前牙过程实现了较好的垂直向控制。     

新型激光光敏根管消毒剂在牙本质中渗透性的研究

目的:观察新型激光光敏根管消毒剂、甲苯胺蓝和亚甲基蓝在牙本质中的渗透效果,评价三种光敏剂在牙本质中的渗透性。方法:收集新鲜拔除的离体单根管牙90颗,根管预备后随机分为三组。每组30颗。A组为新型激光光敏根管消毒剂组;B组为甲苯胺蓝组;C组为亚甲基蓝组。A、B、C三组实验根管内分别用浸有饱和的新型激光光敏根管消毒剂、甲苯胺蓝和亚甲基蓝的棉捻在根管内停留60秒。沿牙体长轴颊舌纵向劈开,倒置荧光显微镜下观察并拍照,用Photoshop8.01软件测量三种光敏剂渗透入牙本质的平均深度。结果:新型激光光敏根管消毒剂在牙本质内的渗透平均深度为553.25μm,甲苯胺蓝在牙本质内的渗透平均深度为350.75μm,亚甲基蓝在牙本质内的渗透平均深度为168.25μm。结论:新型激光光敏根管消毒剂在牙本质渗透性明显优于甲苯胺蓝和亚甲基蓝,具有良好的牙本质渗透性。     

不同赋形剂调制氢氧化钙对粪肠球菌消毒效果影响的体外评价

目的通过应用离体牙根管模型进行根管消毒模拟试验,就应用不同赋形剂调制的氢氧化钙糊剂对根管的消毒作用进行评价。方法选取因正畸拔除的单根管下颌第一前磨牙并进行根管预备,自釉牙骨质界处将离体牙截去牙冠,在距截冠处5 mm去除根尖,仅留5 mm长牙根,筛选获得经制备的模拟根管120个,随机分为4个试验组和2个对照组(空白对照组和阳性对照组),每组各20颗牙齿。将4个试验组及阳性对照组共100个根管建立粪肠球菌根管感染模型,4个试验组根管内分别放置使用生理盐水、甘油、葡萄糖酸氯己定、樟脑苯酚等4种赋形剂调制的氢氧化钙糊剂,阳性对照组20个感染根管中仅放置生理盐水,而空白对照组20个根管不接种细菌,仅置入无菌生理盐水。所有标本牙置5%CO2,95%N2,37℃环境下培养,每组分别于第3、7天取10个根管使用G钻均匀磨取根管内层牙本质粉末,置BHI液体培养基中培养72 h后,测定并分析各根管中残留细菌量。结果使用氢氧化钙糊剂消毒3 d时,4个试验组根管中残留细菌量均较阳性对照组有明显减少(P<0.01),葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组;使用氢氧化钙糊剂7 d时,试验各组均有消毒效果,但生理盐水-氢氧化钙组牙本质小管中有少量均残留细菌,葡萄糖酸氯己定组、樟脑苯酚组的消毒效果差异无统计学意义。结论在离体牙根管消毒实验中,使用4种赋形剂调制的氢氧化钙糊剂均能有效抑制粪肠球菌生长,葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组。     

基于光学相干层析图像的离体牙三维重建

利用shear-warp算法对离体牙的光学相干层析图像进行三维重建,通过不透明度传递函数的合理设置及光照模型的引入实现牙齿内部组织结构的可视化,便于医生在早期龋齿诊断中定位病变.介绍了shear-warp算法的原理、用于龋齿检测的全光纤光学相干层析成像系统及其二维层析图,以及利用离体牙牙冠的二维层析图重建获得三维结构图.     

结合薄层CT技术建立下颌第一前磨牙三维有限元模型

目的结合薄层CT技术建立下颌第一前磨牙三维有限元模型。方法对正常人下颌第一前磨牙进行薄层CT扫描及图像处理,通过Matlab和ANSYS软件建立三维有限元模型,并加载验证模型力学分析的可行性。结果建立了包含髓腔的下颌第一前磨牙的三维有限元模型,得到101564个单元,144053个节点。载荷后的应力分布主要集中在颊尖部位和根尖部位,牙颈部受力较小。结论薄层CT技术与Matlab和ANSYS软件相结合,建立包含髓腔的下颌第一前磨牙的三维有限元模型,精度高、速度快,使用灵活,为后期的楔缺模型建立和分析奠定了基础。     

牙齿生长线——解人类演化及生活历史的新方法

绝大多数哺乳动物的牙齿分为门齿、犬齿、前臼齿和臼齿。从外部观察,牙体由牙冠、牙根及牙颈三部分组成,从牙体的纵剖面可见牙体由牙釉质、牙本质、牙髓和牙根组成。在牙齿表面和内部保留着周期性的发育记录称为牙齿生长线,代表牙齿硬组织分泌的时间间隔,     

不同材料充填修复下颌第一前磨牙楔状缺损的应力分析

目的研究三种材料对两种角度下颌第一前磨牙楔状缺损的修复效果。方法在下颌第一前磨牙颊颈部深度为1mm,夹角分别为30°、90°的楔状缺损有限元模型上用银汞合金、复合树脂和玻璃离子粘固粉三种材料进行缺损修复,以未修复的楔模型为对照,加载100N轴向力后,利用三维有限元方法进行牙颈部应力分析。结果三种材料修复均改善了缺损牙体的应力集中。银汞合金修复体较其他两种材料承受了更大的应力,使缺损局部牙体应力集中状况得以更多缓解,在角度增加时作用更明显。复合树脂最有效降低牙体内部区域的应力集中。结论楔状缺损充填修复可缓解缺损区牙体硬组织的应力集中,复合树脂相对理想。     

不同嵌体修复MOD洞型的三维有限元分析

目的：建立近中-合面-远中（MOD）洞型嵌体修复下颌第一磨牙的计算机三维实体和有限元模型,并进行初步应力分析。方法：通过螺旋CT扫描,利用Mimics、GeomagicStudio7等图像处理软件建立第一恒磨牙的云纹点模型,通过UG软件建立下颌第一恒牙的三维几何模型,通过有限元软件ABAQUS进行网格划分,并在MSC．MARC有限元软件中建立下颌第一磨牙三维有限元模型。结果：建立起包含牙釉质、本质、髓腔以及牙槽骨的精细下颌第一磨牙三维有限元模型。结论：将CT扫描技术、数字图像处理技术与有限元方法结合起来,建立出高精度的下颌第一磨牙MOD洞型的三维有限元模型,为MOD洞型采用嵌体修复提供了研究手段．     

A procedure for splitting human teeth to obtain intact pulp tissue, enamel and dentin

Calcified human permanent and primary teeth are often split to obtain pulp tissue for histochemical studies as well as unaltered dentin and surfaces for scanning electron microscopy. Various procedures have been used to cleave teeth, with different degrees of consistency. For rapid and fairly consistent splitting, a vise to the jaws of which triangular metal files have been welded has been found useful. The apices of the files were ground by an electric drill to the shape of typical teeth. Teeth to be split were grooved on their opposing external surfaces and were then cracked open between the file blades upon application of pressure by the vise. Teeth usually split lengthwise, exposing the entire pulp organ in one section and an empty pulp chamber-root canal in the other. This facilitated rapid penetration of fixative into pulp, and easier removal of pulp tissue in toto, as well as providing fresh enamel and dentin surfaces suitable for scanning electron microscopy.     

A Procedure for Splitting Human Teeth to Obtain Intact Pulp Tissue, Enamel and Dentin

Calcified human permanent and primary teeth are often split to obtain pulp tissue for histochemical studies as well as unaltered dentin and surfaces for scanning electron microscopy. Various procedures have been used to cleave teeth, with different degrees of consistency. For rapid and fairly consistent splitting, a vise to the jaws of which triangular metal files have been welded has been found useful. The apices of the files were ground by an electric drill to the shape of typical teeth. Teeth to be split were grooved on their opposing external surfaces and were then cracked open between the file blades upon application of pressure by the vise. Teeth usually split lengthwise, exposing the entire pulp organ in one section and an empty pulp chamber-root canal in the other. This facilitated rapid penetration of fixative into pulp, and easier removal of pulp tissue in toto, as well as providing fresh enamel and dentin surfaces suitable for scanning electron microscopy.     

Esthetic reconstruction of teeth in patient with dentinogenesis imperfecta--a case report

Dentinogenesis imperfecta (DI) is the result of a dominant genetic defect and affects both the deciduous and permanent dentitions. It is characterized by opalescent teeth composed of irregularly formed and undemineralized dentin which obliterates pulp chamber and root canal. DI can appear as a separate disorder or with osteogenesis imperfecta (OI). The teeth with DI show a grayish-blue to brown hue with dislodged enamel, dysplastic dentine with irregular dentinal tubules and interglobular dentine, short roots and pulpal obliteration, which all may lead to rapid and extensive attrition which require adequate crown reconstruction. The aim of this study was to show a reconstruction of frontal teeth in upper jaw with direct composite veneers in young adult patient with DI.     

Mechanical vulnerability of lower second premolar utilising visco-elastic dynamic stress analysis

Stress analysis determines vulnerability of dental tissues to external loads. Stress values depend on loading conditions, mechanical properties and constrains of structural components. The critical stress levels lead to tissue damage. The aim of this study is to analyse dynamic stress distribution of lower second premolar due to physiological cyclic loading, and dependency of pulsatile stress characteristics to visco-elastic property of dental components by finite element modelling. Results show that visco-elastic property markedly influences stress determinants in major anatomical sites including dentin, cementum–enamel and dentin–enamel junctions. Reduction of visco-elastic parameter leads to mechanical vulnerability through elevation of stress pulse amplitude, maximum stress value; and reduction of stress phase shift as a determinant of stress wave propagation. The results may be applied in situations in which visco-elasticity is reduced such as root canal therapy and post and core restoration in which teeth are more vulnerable to fracture.     

Tusk abnormalities in wild boar (<Emphasis Type="Italic">Sus scrofa</Emphasis> L.)

This paper describes pathological alterations in the permanent canines (tusks) of four male wild boars. The mandibular tusks of all individuals, and also some of the maxillary tusks, exhibited an extended enamel hypoplasia in their apical portion, denoting an impairment of secretory ameloblast function. Moreover, the pulp cavities of the mandibular tusks were exposed through cleft-like openings in the wear (whetting) surfaces of the teeth. Presence of a plug of reparative dentine within the pulp cavity was observed in a split mandibular tusk of one individual. In a second boar, the presence of a plug of reparative dentine within the pulp cavity of the mandibular tusks was indicated radiographically. These findings suggested a reparation process attempting to demarcate a vital, apical pulp portion from a necrotic, incisal portion. The enamel hypoplasias observed in the teeth are regarded to be sequelae of the pulp inflammation caused by bacterial invasion in the mandibular tusks. Most likely, bacterial invasion of the dental pulp occurred through the cleft-like openings in the tusks whetting surfaces, the openings resulting from insufficient formation of secondary dentine. It is, however, also conceivable that pulp inflammation and partial necrosis occurred as a consequence of bacterial invasion of patent dentinal tubules, and that the openings in the whetting surface developed secondarily as a consequence of the pulp changes. One mandibular tusk showed marked signs of resorption apically, suggesting a spread of the inflammation from the pulp into the periodontium.     

Tooth development in a scincid lizard, Chalcides viridanus (Squamata), with particular attention to enamel formation

Comparative analysis of tooth development in the main vertebrate lineages is needed to determine the various evolutionary routes leading to current dentition in living vertebrates. We have used light, scanning and transmission electron microscopy to study tooth morphology and the main stages of tooth development in the scincid lizard, Chalcides viridanus, viz., from late embryos to 6-year-old specimens of a laboratory-bred colony, and from early initiation stages to complete differentiation and attachment, including resorption and enamel formation. In C. viridanus, all teeth of a jaw have a similar morphology but tooth shape, size and orientation change during ontogeny, with a constant number of tooth positions. Tooth morphology changes from a simple smooth cone in the late embryo to the typical adult aspect of two cusps and several ridges via successive tooth replacement at every position. First-generation teeth are initiated by interaction between the oral epithelium and subjacent mesenchyme. The dental lamina of these teeth directly branches from the basal layer of the oral epithelium. On replacement-tooth initiation, the dental lamina spreads from the enamel organ of the previous tooth. The epithelial cell population, at the dental lamina extremity and near the bone support surface, proliferates and differentiates into the enamel organ, the inner (IDE) and outer dental epithelium being separated by stellate reticulum. IDE differentiates into ameloblasts, which produce enamel matrix components. In the region facing differentiating IDE, mesenchymal cells differentiate into dental papilla and give rise to odontoblasts, which first deposit a layer of predentin matrix. The first elements of the enamel matrix are then synthesised by ameloblasts. Matrix mineralisation starts in the upper region of the tooth (dentin then enamel). Enamel maturation begins once the enamel matrix layer is complete. Concomitantly, dental matrices are deposited towards the base of the dentin cone. Maturation of the enamel matrix progresses from top to base; dentin mineralisation proceeds centripetally from the dentin–enamel junction towards the pulp cavity. Tooth attachment is pleurodont and tooth replacement occurs from the lingual side from which the dentin cone of the functional teeth is resorbed. Resorption starts from a deeper region in adults than in juveniles. Our results lead us to conclude that tooth morphogenesis and differentiation in this lizard are similar to those described for mammalian teeth. However, Tomes processes and enamel prisms are absent.     

Immunodetection of osteoadherin in murine tooth extracellular matrices

An antiserum was generated from synthetic peptides highly conserved between different mammalian species to immunolocalise the small leucine-rich proteoglycan osteoadherin (OSAD) in murine teeth. In 19-day-old embryos of rats and mice, a positive staining was found in incisor predentin and alveolar bone surrounding developing incisors and molars. In newborns, OSAD was detected at the tip of the first molar cusp where it accumulated in predentin concomitantly with odontoblast differentiation. In 2-day-old rats and mice, in the first molar, immunostaining revealed positive predentin, enamel matrix close to the apical pole of ameloblasts and a strong signal in dentin. At this stage, OSAD was detected in predentin in the second molar. Ultrastructural immunocytochemistry showed gold particles associated with collagen fibres in predentin and in foci at the dentin mineralisation front. Gold particles were also detected near the secretory pole of ameloblasts where enamel crystallites elongate. No staining was detected in pulp tissue and dental follicle. Restriction of OSAD expression to the extracellular matrix of bone, dentin and enamel suggests a role of this proteoglycan in the organisation of mineralised tissues.     

Enamel defects and ameloblast-specific expression in Enam knock-out/lacz knock-in mice

Enamelin is critical for proper dental enamel formation, and defects in the human enamelin gene cause autosomal dominant amelogenesis imperfecta. We used gene targeting to generate a knock-in mouse carrying a null allele of enamelin (Enam) that has a lacZ reporter gene replacing the Enam translation initiation site and gene sequences through exon 7. Correct targeting of the transgene was confirmed by Southern blotting and PCR analyses. No enamelin protein could be detected by Western blotting in the Enam-null mice. Histochemical 5-bromo-4-chloro-3-indolyl-beta-d-galactopyranoside (X-gal) staining demonstrated ameloblast-specific expression of enamelin. The enamel of the Enam(+/-) mice was nearly normal in the maxillary incisors, but the mandibular incisors were discolored and tended to wear rapidly where they contacted the maxillary incisors. The Enam(-/-) mice showed no true enamel. Radiography, microcomputed tomography, and light and scanning electron microscopy were used to document changes in the enamel of Enam(-/-) mice but did not discern any perturbations of bone, dentin, or any other tissue besides the enamel layer. Although a thick layer of enamel proteins covered normal-appearing dentin of unerupted teeth, von Kossa staining revealed almost a complete absence of mineral formation in this protein layer. However, a thin, highly irregular, mineralized crust covered the dentin on erupted teeth, apparently arising from the formation and fusion of small mineralization foci (calcospherites) in the deeper part of the accumulated enamel protein layer. These results demonstrate ameloblast-specific expression of enamelin and reveal that enamelin is essential for proper enamel matrix organization and mineralization.