Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan.
Clin Oral Investig. 2013 Jan;17(1):131-7. doi: 10.1007/s00784-012-0686-4. Epub 2012 Feb 29.
Clinicians occasionally face the challenge of moving a tooth through the maxillary sinus. The objective of this study was to evaluate tissue remodeling during tooth movement into the maxillary sinus, more specifically as regards to bone formation.
The maxillary first molar of 20 male mice was moved toward the palatal side by a nickel-titanium super elastic wire for 1 to 14 days, and the bone remodeling around the root was evaluated using histomorphometry and immunodetection of bone-restricted Ifitm-like (Bril) protein, a novel marker of active bone formation.
When mechanical stress was applied to the tooth, the periodontal ligament on the palatal side was immediately compressed to approximately half of its original width by the tipping movement of the tooth. At the same time, osteoblasts deposited new bone on the wall of the maxillary sinus prior to bone resorption by osteoclasts on the periodontal side, as evidenced by the high level of expression of Bril at this site. As a result of these sequential processes, bone on the sinus side maintained a consistent thickness during the entire observation period. No root resorption was observed.
Bone formation on the surface of the maxillary sinus was evoked by mechanotransduction of mechanical stress applied to a tooth over a 2-week period, and was induced ahead of bone resorption on the periodontal ligament side.
Mechanical stress can be exploited to induce bone formation in the maxillary sinus so that teeth can be moved into the sinus without losing bone or causing root damage.
临床医生偶尔会面临将牙齿移入上颌窦的挑战。本研究的目的是评估牙齿移入上颌窦过程中的组织重塑,特别是骨形成。
通过镍钛超弹性丝将 20 只雄性小鼠的上颌第一磨牙向腭侧移动 1 至 14 天,并用组织形态计量学和骨特异性 Ifitm 样(Bril)蛋白的免疫检测评估根周围的骨重塑,Bril 蛋白是一种新的活跃骨形成的标志物。
当对牙齿施加机械应力时,牙齿的倾斜运动立即将腭侧牙周韧带压缩至原始宽度的约一半。与此同时,在破骨细胞对牙周侧进行骨吸收之前,成骨细胞在上颌窦壁上沉积新骨,这一点可通过该部位 Bril 的高表达得到证实。由于这些连续的过程,窦侧的骨在整个观察期间保持一致的厚度。未观察到牙根吸收。
在 2 周的时间内,通过对牙齿施加机械应力的机械转导,在上颌窦表面引发了骨形成,并且在牙周韧带侧的骨吸收之前诱导了骨形成。
可以利用机械应力在上颌窦中诱导骨形成,以便可以将牙齿移入窦内而不会失去骨或造成牙根损伤。