レーザードップラー血流計を用いた外傷後の永久中切歯歯髄血流の解析 Analysis of the Fluctuation of Pulpal Blood Flow in Luxated Permanent Incisors Measured by a Laser Doppler Flowmeter

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著者

    • 菊入 崇 KIKUIRI Takashi
    • 北海道大学大学院歯学研究科口腔機能学講座小児・障害者歯科学教室 Dentistry for Children and Disabled People, Department of Oral Functional Science, Hokkaido University Graduate School of Dental Medicine
    • 阿部 倫子 ABE Michiko
    • 北海道大学大学院歯学研究科口腔機能学講座小児・障害者歯科学教室 Dentistry for Children and Disabled People, Department of Oral Functional Science, Hokkaido University Graduate School of Dental Medicine
    • 樋口 かさね HIGUCHI Kasane
    • 北海道大学大学院歯学研究科口腔機能学講座小児・障害者歯科学教室 Dentistry for Children and Disabled People, Department of Oral Functional Science, Hokkaido University Graduate School of Dental Medicine

抄録

著者らはこれまでに,レーザードップラー血流計による小児および成人の永久切歯の歯髄血流測定,ならびに外傷後の幼若永久歯の歯髄診断へのレーザードップラー血流計の応用について報告した。<BR>本研究では,1年を超える永久中切歯の外傷の治癒経過と歯髄血流変動についてレーザードップラー血流計を用いて検討した。健全歯ならびに生活歯であることが判明した外傷歯において,歯髄血流に脈拍と同期した拍動成分とともに0.01-0.05Hzの低周波成分が存在することが明らかになった。これらの周期的変動成分の検出は,エックス線写真上で歯髄腔の確認が困難な歯についても可能であった。軽度の脱臼を認めた7歳児の上顎中切歯外傷の1例では,受傷8日後に測定された歯髄血流値は,対照群の小児の上顎中切歯の歯髄血流値に比べ約2倍の値を示した。歯根破折があり固定を必要とした上顎中切歯外傷の1例にお受いて,傷約5年後の診査で歯髄腔の狭窄とともに歯髄血流値の低下を認めた。<BR>これらの結果は,外傷後の歯髄の回復過程の評価ならびに歯髄診断に,レーザードップラー血流計による歯髄血流測定が有用であることを示している。

A laser Doppler flowmeter (LDF) was adopted to assess pulpal vitality in luxated teeth. Identification of heartbeat synchronous fluctuations in the flowmetric signal was shown to be particularly important for the diagnosis of luxated non-sensitive teeth. In our method, a LDF probe was positioned at the buccal surface of each tooth at least 2 mm apart from the gingival margin, and the pulpal blood flow was non-invasively measured. The mean flowmetric value in the luxated tooth and the periodic fluctuation in each flowmetric signal were compared with those in control teeth of either healthy adults or healthy children. Low-frequency fluctuations (<0.1 Hz) as well as fluctuations synchronous with the heartbeat were observed in the flowmetric signals of vital teeth. Here we demonstrate that vitality in luxated teeth can be assessed more precisely by introducing power spectral analysis (maximum entropy method) into detection of both heartbeat synchronous and low-frequency fluctuations.<BR>Flowmetric signals from luxated upper incisors of three patients in which the pulp s had survived the trauma showed prominent low-frequency (0.01-0.05 Hz) and heartbeat synchronous fluctuations after injury. These fluctuations were detectable even when the pulp chamber of the measured tooth was obscure and could not be confirmed on the X-ray film. Among the injured teeth, one incisor of a 7-year old patient showed a blood flow value nearly twice as high as the control value when it was measured 8 days after injury. A pulp chamber in an another injured tooth that accompanied root fracture was gradually narrowed and the blood flow value was decreased during 5-year observation after trauma. These results indicate that both low-frequency and heartbeat synchronous fluctuations are useful for the early diagnosis of pulpal vitality and that the LDF is a powerful tool for the evaluation of pulpal recovery after trauma.

収録刊行物

  • 小児歯科学雑誌

    小児歯科学雑誌 42(4), 580-589, 2004-09-25

    The Japanese Society of Pediatric Dentistry

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各種コード

  • NII論文ID(NAID)
    10013571199
  • NII書誌ID(NCID)
    AN00116228
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    05831199
  • データ提供元
    CJP書誌  J-STAGE 
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