유치의 치근 흡수면 개조에서 반전기와 관련된 세포와 기질의 특성에 관한 연구

Abstract

[한글]

유치치근의 흡수는 파치세포 (odontoclast)를 포함하는 다양한 간엽세포로 구성된 육아조직에 의하여 이루어지며 전체적으로 흡수현상이 두드러지기는 하나 수복현상도 동반되는 것으로 생각되고 있다. 그러나 유치흡수과정에는 골개조 (bone remodeling)에서 거론

되고 있는 반전기의 개념이 아직 정립되지 않은 상태이다. 그러므로 흡수와 형성의 연결 (coupling)이 이루어질 것으로 기대되는 반전기에 관한 골과 유치에서의 비교 연구가 요망되고 있다. 따라서 유치치근의 흡수면에 나타나는 반전선의 형태와 형성과정, 성분 및 그 기능을 알아보기 위하여, 유치치근의 흡수면에 있는 세포와 기질의 미세구조를 반전부위에 초점을 맞추어 광학 및 투과전자현미경으로 관찰하고, 산성 및 염기성 인산분해효소와 proteoglycan에 대한 조직 및 세포 화학적 방법을 시행하여 반전선 과 인접세포를 투과전자현미경으로 관찰하였으며, 반전선의 삼차원적 입체구조와 석회화 여부를 알기 위하여 증류수 및 NaOCl로 처리한 시편의 표면을 주사전자현미경으로 관찰하였고, 반전선이 노출된 흡수면을 포함하는 시편을 토끼 골수 내에 매식하여 반전선이 골형성 촉진 기능을 갖고 있는지 관찰하여 다음과 같은 결과를 얻었다.

1. 유치치근의 흡수면은 흡수기, 흡수-반전기, 반전기, 수복기, 휴지기로 구분되었다.

2. 반전선은 파치세포의 투명대 하방에서 형성되어 주위로 연장되어 있었으며, 반전선은 그 표면이 매우 불규칙하고 긴 유두상 구조들이 돌출 되어 있는 형태를 보였다.

3. 반전선은 p개teoglycan과 염기성 인산분해효소를 포함하고 있었으며, proteoglycan은 파치세포의 주름변연 하방에서도 많이 나타났다.

4. 반전선은 교원섬유를 균일하게 덮는 과립성 막의 형태나 돌출 된 유두상구조의 형태를 보여주었으며, 반전선의 표층은 유기물로 구성되어 있고 내부는 석회화되어 있는 것으로 나타났다.

5. 흡수면을 포함하는 시편을 토끼 골수에 매식한 결과, 반전선이 노출되어있는 경우에 흡수를 동반하지 않는 골형성이 반전선 위에서 나타났다.

이상의 결과를 종합하여 보면 반전선은 부분적으로는 파치세포에 의하여 흡수된 상아질에 proteoglycan이 축적되어 파치세포의 투명대하방에서 형성되며 조백악세포와 밀접한 연관을 갖고 있는 것으로 생각된다. 따라서 골형성 촉진 능력을 갖고 있는 반전선은 신생 교원섬유가 부착되는 매개체로서의 역할을 수행하는 것으로 사료되며, 유치치근의 흡수면 개조시 나타나는 음성적 균형현상 (negative balance)은 조백악세포의 개입 하에서 이루어지는 반전선의 변화 때문인 것으로 추정된다.

A stndy on characteristics of the cells and matrix related to the reversal phase in

the remodeling of the resorption surface of human deciduous teeth

Sun-Koo Lee D.D.S., M.S.D.

Department of Dental Science, The Graduate School, Yonsei University

(Directed by Prof. Jong-Gab Lee, D.D.S., M.S.D., Ph.D.)

The resorption process of deciduous teeth occurs in the granulation tissues

containing the odontoclasts and the other mesenchymal cells. The resorption process

is accompanied by repair phase, although the resorption is predominant to the

repair. However, the concept of reversal has not been established in deciduous root

resorption. Considering the negative balance in the root resorption unlike in the

bone remodeling, the comparative study on the reversal phase in the bone and

deciduous teeth is demanded. Therefore, this study was accomplished to observe the

morphology, formation, and function of the reversal line in the resorption surface

of deciduous teeth. The ultrastructures of cells and matrix in the reversal phase

of the resorption surface were observed by the light and transmission electron

microscope. They were also stained histochemically and cytochemically against the

alkaline, acid phosphatase and proteoglycan and examined by transmission electron

microscope. The surfaces of the matrix exposed by immersion in the distilled water

and NaOCl were observed by scanning electron microcscopy for the three dimensional

structure and the state of calcification of the reversal line. Also the specimens

including the exposed matrix of resorption surface were implanted in the bone

marrow of the rabbit which would show the activity of stimulation of bone formation

in the reversal line.

Following results Were obtained :

1. In the light microscopic view, the resorption surface could be classified into

the resorption resorption-reversal, reversal, repair, resting phase.

2. The reversal line was formed under the clear zone of odontoclast and extended

beyond the odonlsclast in the transmission electron microscopic view of the

resorption-reversal phase. The reversal line was very irregular in surface and

consisted of the long papillary protrusions.

3. Proteog1ycan and alikaline phosphatase were included in the reversal line.

Proteoglycans were also stained under the ruffled border of odontoclast.

4. In the scanning electron microscope view, the reversal ]ines were observed as

a granular membrane covering the collagen fibers or a series of papillary

protrusions. The reversal line consists of organic superficial layer and calcific

deep layer.

5. After implantation of dentin stick including the resorption surface, the bone

formation without accompanying the resorption occurred upon the reversal line.

Taken all together, the reversal line is formed under the 치ear zone of

odontoclast, at least in part, by the accumulation of proteoglycan released from

the dentin matrix during the resorption, and is intimately related to the

cementoblast. The reversal line, with the ability to stimulate the direct bone

formation, is supposed to have a role as a medium for the attachment of new

collagen fiber. On the base of base result, we hypothesize that the negative

balance in the remodeling of the deciduous root resorption may be attributed, at

least in part, to the modification of reversal line under the cementoblast.

[영문]

The resorption process of deciduous teeth occurs in the granulation tissues containing the odontoclasts and the other mesenchymal cells. The resorption process is accompanied by repair phase, although the resorption is predominant to the

repair. However, the concept of reversal has not been established in deciduous root resorption. Considering the negative balance in the root resorption unlike in the bone remodeling, the comparative study on the reversal phase in the bone and deciduous teeth is demanded. Therefore, this study was accomplished to observe the morphology, formation, and function of the reversal line in the resorption surface of deciduous teeth. The ultrastructures of cells and matrix in the reversal phase of the resorption surface were observed by the light and transmission electron microscope. They were also stained histochemically and cytochemically against the alkaline, acid phosphatase and proteoglycan and examined by transmission electron microscope. The surfaces of the matrix exposed by immersion in the distilled water and NaOCl were observed by scanning electron microcscopy for the three dimensional structure and the state of calcification of the reversal line. Also the specimens

including the exposed matrix of resorption surface were implanted in the bone marrow of the rabbit which would show the activity of stimulation of bone formation in the reversal line.

Following results Were obtained :

1. In the light microscopic view, the resorption surface could be classified into the resorption resorption-reversal, reversal, repair, resting phase.

2. The reversal line was formed under the clear zone of odontoclast and extended beyond the odonlsclast in the transmission electron microscopic view of the resorption-reversal phase. The reversal line was very irregular in surface and

consisted of the long papillary protrusions.

3. Proteog1ycan and alikaline phosphatase were included in the reversal line. Proteoglycans were also stained under the ruffled border of odontoclast.

4. In the scanning electron microscope view, the reversal ]ines were observed as a granular membrane covering the collagen fibers or a series of papillary protrusions. The reversal line consists of organic superficial layer and calcific deep layer.

5. After implantation of dentin stick including the resorption surface, the bone formation without accompanying the resorption occurred upon the reversal line.

Taken all together, the reversal line is formed under the 치ear zone of odontoclast, at least in part, by the accumulation of proteoglycan released from the dentin matrix during the resorption, and is intimately related to the cementoblast. The reversal line, with the ability to stimulate the direct bone

formation, is supposed to have a role as a medium for the attachment of new collagen fiber. On the base of base result, we hypothesize that the negative balance in the remodeling of the deciduous root resorption may be attributed, at least in part, to the modification of reversal line under the cementoblast.