咬合性外傷における歯肉の形態変化について

Morphological changes of gums in occlusal trauma.

抄録

研究目的:

咬合性外傷は、歯根膜に大きな変化をもたらし、その変化は歯科組織に影響を及ぼす。本研究の目的は、咬合性外傷を受けた歯の周囲に存在する辺縁歯根膜に生じる形態的変化を評価することである。

AIM: Occlusal trauma causes major modifications of the coverage periodontium, which in turn reflect on the dental unit. The aim of the present study is to evaluate some of the morphological modifications occurred in the marginal periodontium surrounding teeth affected by occlusal trauma.

材料と方法:

咬合性外傷を受けた51名の患者から採取した辺縁歯周組織片を古典的組織学的手法（ホルマリン固定、パラフィン包埋）で処理し、歯肉粘膜の上皮および結合組織の変化を強調するために、Hematoxylin-Eosin (HE), Massonの三色染色と抗CD34抗体免疫染色で染色を行なった。上皮と結合組織の形態学的パラメータのセットは、患歯に関する3つの局所的な基準に基づいて個別に評価された。

MATERIALS AND METHODS: Fragments of marginal periodontium coming from 51 patients with occlusal trauma were processed using classical histological techniques (formalin fixation and paraffin embedment) and stained with Hematoxylin-Eosin (HE), Masson's trichrome and anti-CD34 antibody immunostaining, in order to highlight the epithelial and connective tissue changes of gingival mucosa. A set of epithelial and connective tissue morphological parameters were assessed individually and based on three topographical criteria concerning the affected tooth.

結果:

上皮、特にその表層部は、歯の種類と歯列弓に依存して変化していた。上皮の厚さは，両層の線維化，深層の血管密度が増加するにつれて減少する傾向を示した．白板症は歯牙の種類に関係なく，表層上皮が厚く，角層乳頭部の線維化が少ないほど顕著であった．血管密度は，角層の線維化が進行すると減少した．

RESULTS: The epithelium and especially its superficial compartment presented changes depending on the tooth type and the dental arch. Epithelial thickness had the tendency to decrease as the fibrosis in both corium compartments and vascular density in the deep corium compartment were increasing. Leukoplakia present around the affected teeth but not always was related with the tooth type and was more obvious as the superficial compartment of the epithelium was thicker and as fibrosis was more reduced in the papillary compartment of the corium. Vascular density reduced when fibrosis process increased in the corium.

結論:

咬合性外傷による病変とそのトポグラフィーは、周囲の歯周組織の様々な構造に局所的に影響を及ぼす可能性があり、また影響を及ぼしている。

CONCLUSIONS: Lesions determined by occlusal trauma and their topography can and are influencing locally the different structures of the surrounding periodontium.