Publication: Deneysel diş replantasyonunda farklı materyallerin periodantal doku iyleşmesindeki etkisinin biyokimyasal ve histolojik incelenmesi
Abstract
Avülsiyon olgularında tedavi yaklaşımı erken ya da geç sürelerde dişin replante edilmesidir. Replante dişin prognozunu, periodontal ligamentteki hasar belirler. Fibrin yapıştırıcı cerrahide kullanılan hemostatik bir ajandır ve sütur, ligatür gibi standart cerrahi tekniklere ek olarak kullanılmaktadır. Adipoz kök hücreler kemik, kıkırdak, yağ dokusu ve nöronlar gibi çeşitli dokulara farklılaşabilir. Adipoz kök hücrelerin periodontal doku rejenerasyonunu da artırdığı bildirilmiştir. Çalışmamızın amacı fibrin yapıştırıcı ve fibrin yapıştırıcı+adipoz kök hücrelerin diş replantasyonu sonrası periodontal doku iyileşmesine etkisini araştırmaktır. Çalışmamızda ağırlıkları 250-350 g arasında değişen 27 adet Sprague Dawley cinsi erkek sıçan kullanıldı. Diş çekiminden 60 dakika sonra maksiller santral kesici dişler fibrin yapıştırıcı (n=14), fibrin yapıştırıcı+adipoz kök hücreler (n=16) ve hiçbir materyal kullanılmadan (kontrol) (n=8) replante edildi. Kanal tedavisi gerçekleştirilen dişler kalsiyum hidroksit patı ile dolduruldu. Replantasyondan 60 gün sonra sıçanlar sakrifiye edildi ve hemimaksilla kesitleri histolojik ve biyokimyasal inceleme için çıkarıldı. Fibrin yapıştırıcı, fibrin yapıştırıcı+adipoz kök hücreler ve kontrol grupları arasında inflamatuar rezorpsiyon ve normal periodontal ligament ile iyileşme düzeyleri açısından ileri derecede anlamlı fark bulundu (p<0.01). Tüm gruplar arasında ankiloz düzeyleri açısından anlamlılık saptanırken (p<0.05), yüzeyel rezorpsiyon düzeyleri açısından fark bulunmadı (p>0.05). Fibrin yapıştırıcının tek başına kullanımı periodontal dokularda orta derecede iyileşmeyle sonuçlanırken, fibrin yapıştırıcı+adipoz kök hücreler, düzgün periodontal ligament formasyonu ve iyileşme göstermiştir. Çalışmamızda adipoz kök hücrelerin diş replantasyonu sonrası dokuların iyileşmesinde ve avülsiyon tedavisinde önemli rol oynayabileceği sonucuna varılmıştır. poz kök hücreler, avülse diş, fibrin yapıştırıcı, periodontal doku iyileşmesi, replantasyon.
Histological and Biochemical Analysis of Different Materials’ Effect on Periodontal Tissue Healing in Experimental Tooth Replantation Treatment option in avulsion cases is early or late replantation of the traumatized teeth. Prognosis of the replanted tooth depends on the level of periodontal injury. Fibrin sealant is a hemostatic agent used in surgery and it is indicated as an adjunct to standard surgical techniques (such as suture and ligature). Adipose tissue stem cells can differentiate into bone, cartilage, adipose and neurogenic tissue. Literature has reported that adipose stem cells can improve periodontal tissue regeneration. The aim of our study is to evaluate the effects of fibrin sealant and fibrin sealant+adipose stem cells on healing of periodontal tissues after tooth replantation. Twenty-seven male Sprague Dawley rats, weighing 250 to 350 g were used in this study. After 60 minutes of extraction, maxillary central incisor teeth were replanted with fibrin sealant (n=14), fibrin sealant+adipose stem cells (n=16) and no material (control) (n=8). Calcium hydroxide dressing was applied following pulp extirpation. Sixty days after the replantation, rats were sacrificed and hemimaxillablocks were dissected out for histological and biochemical analysis. Inflammatory resorption and healing with normal PDL levels were significantly different between fibrin sealant, fibrin sealant+adipose stem cells and control groups (p<0.01). Ankylosis levels were statistically different in all groups (p<0.05) whereas surface resorption levels were similar (p>0.05). Although singular use of fibrin sealant could improve periodontal tissue healing moderately, fibrin sealant+adipose stem cells provided a prominent periodontal ligament formation and healing. Our results suggest that adipose stem cells can play an important role in the healing after tooth replantation and it might have a therapeutic potential in treatment of avulsion cases.
Histological and Biochemical Analysis of Different Materials’ Effect on Periodontal Tissue Healing in Experimental Tooth Replantation Treatment option in avulsion cases is early or late replantation of the traumatized teeth. Prognosis of the replanted tooth depends on the level of periodontal injury. Fibrin sealant is a hemostatic agent used in surgery and it is indicated as an adjunct to standard surgical techniques (such as suture and ligature). Adipose tissue stem cells can differentiate into bone, cartilage, adipose and neurogenic tissue. Literature has reported that adipose stem cells can improve periodontal tissue regeneration. The aim of our study is to evaluate the effects of fibrin sealant and fibrin sealant+adipose stem cells on healing of periodontal tissues after tooth replantation. Twenty-seven male Sprague Dawley rats, weighing 250 to 350 g were used in this study. After 60 minutes of extraction, maxillary central incisor teeth were replanted with fibrin sealant (n=14), fibrin sealant+adipose stem cells (n=16) and no material (control) (n=8). Calcium hydroxide dressing was applied following pulp extirpation. Sixty days after the replantation, rats were sacrificed and hemimaxillablocks were dissected out for histological and biochemical analysis. Inflammatory resorption and healing with normal PDL levels were significantly different between fibrin sealant, fibrin sealant+adipose stem cells and control groups (p<0.01). Ankylosis levels were statistically different in all groups (p<0.05) whereas surface resorption levels were similar (p>0.05). Although singular use of fibrin sealant could improve periodontal tissue healing moderately, fibrin sealant+adipose stem cells provided a prominent periodontal ligament formation and healing. Our results suggest that adipose stem cells can play an important role in the healing after tooth replantation and it might have a therapeutic potential in treatment of avulsion cases.