Promene na pulpi i dentinu nakon direktnog i indirektnog prekrivanja alkalnim cementom

Lj. Šubarić ,
Lj. Šubarić
A. Mitić ,
A. Mitić
V. Matvijenko ,
V. Matvijenko
M. Živković ,
M. Živković
D. Živković ,
D. Živković
R. Jovanović ,
R. Jovanović
D. Perić ,
D. Perić
A. Mitić ,
A. Mitić
J. Veselinović
J. Veselinović

Published: 15.01.2014.

Volume 42, Issue 3 (2013)

pp. 23-30;

Abstract

Suštinu biološkog lečenja caries profunda čini proces 'ozdravljenja' koji se zasniva na stimulaciji dentinogenetske funkcije pulpe, što omogućava stvaranje mineralizovanog tkiva. U eksperimentalnom istraživanju postavljen je cilj da se skening elektronskom mikroskopijom i polarizacionom mikroskopijom: Analiziraju promene na celularnim i ekstracelularnim komponentama zubne pulpe posle direktnog i indirektnog prekrivanja alkalnim cementom (Dycal), Utvrdi izgled dentinske površine posle direktnog i indirektnog prekrivanja pulpe i Formira predlog za kliničku primenu preparata Dycal ukoliko obezbeđuje dobru i efikasnu dentinogenezu. Ispitivanje je izvršeno na eksperimentalnim životinjama (domaća svinja). Za ovo istraživanje korišćen je alkalni cement Dycal. Na zubima eksperimentalne grupe uradjene su preparacije V klase sa vestibularne strane. Na jedanaest zuba je uradjeno indirektno, a na jedanaest zuba direktno prekrivanje pulpe. Nakon završene preparacije dentin je direktno prekriven alkalnim cementom Dycal. Preko Dycal-a je postavljena podloga cink fosfatnog cementa i materijal za definitivno zatvaranje kaviteta (amalgam). Na zubima gde je urađena perforacija komore pulpe Dycal je ubacivan direktno u komoru pulpe, a preko toga je postavljena podloga cink fosfatnog cementa i kavitet je definitivno zatvaran amalgamom. Adekvatno pripremljeni zubi i pulpa posmatrani su SEM i polarizacionim mikroskopom. Rezultati: Posmatranjem i analizom dobijenih rezultata, na polarizacionom i skening elektronskom mikroskopu u poređenju sa kontrolnom grupom, dobijeni su rezultati koji mogu imati značajnu kliničku implikaciju u biološkom lečenju pulpe. Dycal direktno apliciran u komoru pulpe: uočava se granica između novostvorenog reparativnog dentina u normalnu dentinsku strukturu, sreću se degradirane smežurane ćelije, zapažaju se jezgra kalcifikacije, mladi krvni sudovi i ćelije (fibrociti, histiociti i fibroblasti). Indirektno aplikovan Dycal: uočava se normalna dentinska struktura , jasno su vidljivi dentinski kanalići, a sreće se i atubulusna dentinska struktura, vidi se slika dentinske strukture koja prožima acelularno pulpno tkivo, hipercelularnost na granici stvaranja novog dentina i brojni krvni sudovi. Prisustvo amorfnog kalcifikata dentinske strukture govori o početnom stvaranju barijere od čvrstog tkiva što je cilj eksperimenta. Dobijeni rezultati eksperimentalnim istraživanjem sugerišu Dycal kao dobar materijal za direktno i indirektno prekrivanje pulpe.

Keywords

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