# 成牙本质细胞坏死（Odontoblast Necrosis）

- 器官 / 系统：牙齿 / 消化系统（tooth / alimentary-system）
- NTP 数据编号：ntp-0251
- 规范 URL：https://www.labsmart.cn/ntp/tooth-odontoblast-necrosis.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#tooth-odontoblast-necrosis
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/alimentary-system/tooth/Odontoblast-Necrosis
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
成牙本质细胞坏死（Odontoblast necrosis）的特征是成牙本质细胞丢失，以及成牙本质细胞胞质呈强嗜酸性、细胞核皱缩和/或淡染（Figure 1、Figure 2、Figure 3、Figure 4，箭头）。

## 病变描述（中文）
成牙本质细胞坏死（Odontoblast necrosis）的特征是成牙本质细胞丢失，以及成牙本质细胞胞质呈强嗜酸性、细胞核皱缩和/或淡染（Figure 1、Figure 2、Figure 3、Figure 4，箭头）。NTP 研究中已观察到化学暴露所致的成牙本质细胞坏死。所提出的坏死机制为牙髓血管血栓形成继发的梗死。牙髓内的炎症也可导致缺血性坏死，原因是牙本质限制范围内组织肿胀使牙髓内压力升高，而牙本质限制了可发生的肿胀程度。此外，牙髓内 collateral 血供的发育受限，因为供应牙髓的血管必须经牙根尖进入牙齿。伴有成牙本质细胞坏死的牙髓炎症在啮齿类动物中可为偶发性病变。

## 诊断与分级建议（NTP 共识，中文）
成牙本质细胞坏死应当根据病变范围进行诊断和分级。如果成牙本质细胞坏死继发于牙髓血管血栓形成，应当诊断坏死（而非梗死），并应在病理学描述中充分讨论可疑的发病机制。相关炎症不应单独诊断，除非其严重程度足以需要单独诊断。如果炎症是原发病变且为成牙本质细胞坏死的原因，应当诊断炎症，病理学家需运用其判断力决定是否也应诊断成牙本质细胞坏死。如果未诊断成牙本质细胞坏死，则应在病理学描述中予以描述。

## 英文原文 · Comment
Odontoblast necrosis is characterized by loss of odontoblasts and odontoblasts with highly eosinophilic cytoplasm and shrunken and/or faded nuclei ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 , arrows). Odontoblast necrosis due to chemical exposure has been observed in NTP studies. The proposed mechanism of necrosis was infarction secondary to thrombosis of pulp vessels. Inflammation in the pulp can also result in ischemic necrosis due to increased pressure in the tooth pulp from tissue swelling within the confines of the dentin, which limits the degree of swelling that can occur. In addition, the development of collateral blood supply within the pulp is limited because blood vessels supplying the pulp must enter the tooth through the apex of the tooth. Inflammation of the tooth pulp with odontoblast necrosis can be an incidental lesion in rodents.

## 英文原文 · Recommendation
Odontoblast necrosis should be diagnosed and graded based on the extent of the lesion. If the odontoblast necrosis is secondary to thrombosis of vessels in the tooth pulp, necrosis should be diagnosed (as opposed to infarct), and the suspected pathogenesis should be thoroughly discussed in the pathology narrative. Associated inflammation should not be diagnosed separately unless it is severe enough to warrant a separate diagnosis. If the inflammation is the primary lesion and the cause of the odontoblast necrosis, the inflammation should be diagnosed, and the pathologist will need to use his or her judgment in determining whether the odontoblast necrosis should also be diagnosed. If the odontoblast necrosis is not diagnosed, it should be described in the pathology narrative.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0208.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0206.jpg

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