성견에 있어서 Cobalt-60 조사가 치수치유 과정에 미치는 영향에 관한 연구

Abstract

[한글]

두경부 방사선 처치 환자에 있어서 근관치료를 시행하는 주요목적은 발치를 하지 않고 보존하거나 발치를 가급한 연기시키기 위한 잠정적인 처치법으로 사용하는 것이 관례이다. 이에 저자는 방사선 조사를 받은 후 치수노출이 되였을 경우 그 치유기전에 관하여 연

구하고자 성견을 사용, cobalt-60을 조사한 군과 방사선 조사를 하지 않은 대조군으로 나누어 각기 직접치수복조술(Dycal**(R) 사용)을 시행한후 치수의 병리조직학적 변화를 관찰하여 다음과 같은 결론을 얻었다.

1. 수복성 상아질(reparative dentin)의 형성은 대조군에서 1주부터, 실험군Ⅰ과 Ⅱ에서는 2주부터 관찰되었다. 상아세관구조(dentinal tubule structure)는 대조군에서만 4주

째에 수가 적었고, 불규칙한 양상으로 나타났으며, 실험군Ⅰ, Ⅱ에서 모두 관찰되지 않았다.

2. 상아질 교(dentin bridge)의 연속성은 대조군, 실험군Ⅰ, Ⅱ 공히 3주부터 관찰되었다.

3. 치수조직내의 충혈 및 출혈은 공히 3주까지 관찰되었고 염증상은 대조군에서는 볼 수 없었으나 실험군Ⅰ, Ⅱ에서는 2주까지 관찰되었고, 실험군Ⅱ에서는 그 정도가 더 심했다.

4. 수산화칼슘이 치수조직내에 깊이 침입된 경우에는 치수조직의 국소적괴사가 관찰되었고 상아질 형성이 현저히 감소하는 양상을 보였다.

[영문]

Irradiation is frequently employed as the sole therapy for oral cancer. These irradiated patients presents peculiar and progressive dental problems. But there is entry scanty informations concerning specific approaches to endodontic treatment for head and neck cancer patients who have been subjected to tumorcidal doses of radiation therapy. The purpose of the present study was to determine the effects of cobalt-60 radiation on the pulpal healing of dogs after the direct pulp capping.

As the experimental animals, 10 dogs (above 7-8 months after birth) were divided into 3 groups (Control, Group Ⅰ,group Ⅱ). The cobalt-60 was irradiated to the group Ⅰ and group Ⅱ each 1,009 and 1,562.5 rads as single dose. As the capping material Dycal**(R) (L.D. Caulk company)was selected. After the direct pulp capping the dogs were sacrified 1, 2, 3, 4, week interval and made the original slides cut with a thickness of 8 microns and stained with hematoxylin and eosin.

After examination and comparision of all specimen, the results of this study were drawn as follows;

1. The formation of reparative dentin was observed from the 1st week in the Control group, the 2nd week in the Group Ⅰ & Ⅱ. The few and irregular table structure was appeared in the 4th week in the Control group only, but foiled in the Group Ⅰ & Ⅱ.

2. The continuity of dentin bridge was appeared in the 3rd neck in all group and the degeneration of odontoblast in the 1st week of the Group Ⅱ.

3. The congestion and hemorrhage in the pulp tissue were observed in all groups until 3rd week. The inflammation was appeared within the 2nd week in the Group Ⅰ and especially marked in the Group Ⅱ, but absent in the Control group.

4. In cases Dycal into the pulp tissue deeply, the local necrosis of pulp and decrease of dentin formation was observed.