Dibart Serge, Yee Cynthia, Surmenian Jerome, Sebaoun Jean David, Baloul Susan, Goguet-Surmenian Emilie, Kantarci Alpdogan
**Orthodontics, Henry M. Goldman School of Dental Medicine, Boston University, MA and
**Orthodontics, Henry M. Goldman School of Dental Medicine, Boston University, MA and.
Eur J Orthod. 2014 Aug;36(4):457-64. doi: 10.1093/ejo/cjt079. Epub 2013 Nov 19.
Piezocision is a novel, minimally invasive technique combining micro-incisions and decortications made by a piezotome in order to enhance the rate of orthodontic tooth movement. The combined technique allows simultaneous hard and/or soft tissue grafting via selective tunnelling to correct gingival recessions or bone deficiencies. The present study was designed to evaluate the effects of Piezocision on bone with or without tooth movement on a rat model.
Ninety-four Sprague-Dawley rats were divided into four groups: no treatment (n = 3), TM (tooth movement alone; n = 21), PS (Piezocision alone; n = 35), and PS + TM (Piezocision and tooth movement; n = 35). In each group, seven time points were studied: 1, 3, 7, 14, 28, 42, and 56 days. After sacrifice, the maxillae were removed, defleshed, stained with haematoxylin and eosin for morphometric analyses and tartrate-resistant acid phosphatase for osteoclastic activity.
Three days after the surgery, the bone content decreased significantly in the PS and PS + TM groups compared to baseline (P < 0.01) and the TM group (P < 0.05). This trend continued until Day 28 and was particularly evident in the PS + TM group. At Day 56, alveolar bone returned to its baseline levels in all groups. Osteoclastic activity followed similar change pattern found in the amount of bone, suggesting a strong role for the coupling of the resorptive and formative turnover of the bone. Osteoclastic activity increased as soon as Day 1 in the PS (29.0±3.0, P < 0.05) and PS + TM groups (39.0±6.0, P < 0.01) compared to baseline (22.0±4.0). The highest level of osteoclastic activity in TM group was observed at 3 days (64.3±8.0, P < 0.01) with a steady decrease thereafter. The Piezocision-induced osteoclastic activity showed a steady increase up to 7 days in both PS (39.0±7.0, P < 0.01) and PS + TM (51.8±7.0, P < 0.01) groups and decreased thereafter until Day 56.
Within the limitations of our study (number of animals, duration in time, and limited data on the anabolic activity), our preliminary results suggest that Piezocision-facilitated orthodontic tooth movement increases the rate of movement of the teeth undergoing orthodontic treatment through the coupled remodelling of the alveolar bone. This process is initiated by the osteoclastic activity following surgery and extended via the synergistic relationship between Piezocision and tooth movement.
压电切开术是一种新型的微创技术，它结合了由压电骨刀制作的微小切口和去皮质术，以提高正畸牙齿移动的速率。这种联合技术允许通过选择性隧道技术同时进行硬组织和/或软组织移植，以纠正牙龈退缩或骨缺损。本研究旨在评估压电切开术在大鼠模型中对有或无牙齿移动情况下骨的影响。
94只Sprague-Dawley大鼠被分为四组：未治疗组（n = 3）、单纯牙齿移动组（TM，n = 21）、单纯压电切开术组（PS，n = 35）和压电切开术与牙齿移动组（PS + TM，n = 35）。在每组中，研究了七个时间点：1天、3天、7天、14天、28天、42天和56天。处死后，取出上颌骨，去除肌肉组织，用苏木精和伊红染色进行形态计量分析，并用抗酒石酸酸性磷酸酶染色分析破骨细胞活性。
术后3天，与基线相比（P < 0.01）以及与TM组相比（P < 0.05），PS组和PS + TM组的骨含量显著降低。这种趋势持续到第28天，在PS + TM组中尤为明显。在第56天，所有组的牙槽骨均恢复到基线水平。破骨细胞活性遵循与骨量相似的变化模式，表明骨的吸收和形成转换的耦合起了重要作用。与基线（22.0±4.0）相比，PS组（29.0±3.0，P < 0.05）和PS + TM组（39.0±6.0，P < 0.01）在术后第1天破骨细胞活性就开始增加。TM组破骨细胞活性在第3天达到最高水平（64.3±8.0，P < 0.01），此后稳步下降。压电切开术诱导的破骨细胞活性在PS组（39.0±7.0，P < 0.01）和PS + TM组（51.8±7.0，P < 0.01）中均持续增加至第7天，此后下降直至第56天。
在我们研究的局限性（动物数量、时间持续以及关于合成代谢活性的数据有限）范围内，我们的初步结果表明，压电切开术辅助的正畸牙齿移动通过牙槽骨的耦合重塑增加了接受正畸治疗牙齿的移动速率。这个过程由术后的破骨细胞活性启动，并通过压电切开术与牙齿移动之间的协同关系得以扩展。
