歯肉陥没の治療における結合組織移植片の血管形成と神経伝達。組織学的および免疫組織化学的研究

Vascularization and Innervation of Connective Tissue Grafts in the Treatment of Gingival Recessions: A Histologic and Immunohistochemical Study.

抄録

本研究の目的は，ヒトにおける上皮下結合組織グラフトの治癒過程を組織学的に評価することである．MillerクラスIまたはIIの局所的な歯肉退縮欠損を有する16名の患者を対象に，バイラミナー法を用いて連続的に治療を行った．ベースライン時と2ヵ月後に，ドナー部位とレシピエント部位から組織を採取した．ヘマトキシリン・エオジンと免疫組織化学的手法を用いて、移植片の血行再建と再神経支配を調べた。治癒2ヵ月後、移植組織の統合が明らかになり、結合組織は内層と表層にそれぞれレシピエント部位（細胞成分）とドナー部位（細胞外マトリックス）に属する特徴を発現していた。これは、新生血管の増加と、上皮内遊離神経終末の減少を伴っていた。

The goal of this study was to histologically evaluate the healing process of subepithelial connective tissue graft in humans. A sample of 16 patients with Miller Class I or II localized gingival recession defects were consecutively treated with a bilaminar technique. At baseline and after 2 months, tissue samples were taken from the donor and recipient sites. The revascularization and reinnervation of the graft were examined by means of hematoxylin-eosin and immunohistochemical techniques. After 2 months of healing, the integration of the grafted tissue was evident with the connective tissue expressing features belonging to both the recipient (cellular component) and the donor site (extracellular matrix) in the inner and superficial layers, respectively. This was accompanied by increased neovascularization and reduction in intraepithelial free nerve endings.