Paek J, Oh Y, Kim J, Lee J-H
Department of Prosthodontics, Kyung Hee University Dental Hospital, Seoul, Korea.
Gene Expr. 2015;16(3):137-44. doi: 10.3727/105221615X14181440065490.
Tooth extraction is a routine surgical procedure in dental treatment. As a wound healing process after tooth extraction, a saddle-shaped residual ridge forms due to bone formation in the extraction socket and localized bone resorption on the external surface of the jawbone. The residual ridge is subjected to continuous bone resorption with substantial differences among individuals. In some cases, it results in excessive bone atrophy, which complicates dental restorative treatment. This unique oral wound healing process may be influenced by factors that are specific to oral tissue. HIF expression is different in oral wound healing compared to that of skin wounds. The objective of this study was to examine a genetic association between SNP of the HIF-1α gene, which is known to have high genetic diversity, and the residual ridge resorption (RRR). Two hundred and two Korean subjects (70.80 ± 9.40 years) with partially or completely edentulous mandible were recruited, and edentulous mandibular bone height was measured following the protocol of the American College of Prosthodontists. The HIF-1α allele was directly sequenced in 24 subjects resulting in the variants over 5% frequency in 95% likelihood, whereas tag-SNPs were selected to perform analysis for the remaining population. Student's t-test and ANOVA were used for statistical analysis to examine the association between the SNPs and the RRR. Four novel variants were discovered, and a minor allele of rs11549467 was associated with the RRR of the subjects (p = 0.028). rs11549467 increases HIF-1α transactivity, enhancing angiogenesis and increasing new vessel formation. Thus, rs11549467 may play an important role in the disturbed bone remodeling balance resulting in RRR. Results of this study may be useful in developing novel genetic diagnostic tests and identifying Koreans susceptible to developing excessive jawbone atrophy after dental extraction. Most importantly, early screening using genetic information will rescue susceptible patients from the vulnerable situation of excessive jawbone atrophy where no effective prosthetic treatment is available.
拔牙是牙科治疗中的常规外科手术。作为拔牙后的伤口愈合过程,拔牙窝内的骨形成以及颌骨外表面的局部骨吸收会形成鞍状的残余牙槽嵴。残余牙槽嵴会持续发生骨吸收,个体之间存在显著差异。在某些情况下,会导致过度的骨萎缩,使牙齿修复治疗变得复杂。这种独特的口腔伤口愈合过程可能受口腔组织特有的因素影响。与皮肤伤口相比,低氧诱导因子(HIF)在口腔伤口愈合中的表达有所不同。本研究的目的是检查已知具有高遗传多样性的HIF-1α基因单核苷酸多态性(SNP)与残余牙槽嵴吸收(RRR)之间的遗传关联。招募了202名韩国受试者(年龄70.80 ± 9.40岁),其下颌部分或完全无牙,按照美国口腔修复医师学会的方案测量无牙下颌骨高度。对24名受试者的HIF-1α等位基因进行直接测序,得到95%可能性下频率超过5%的变体,而其余人群则选择标签SNP进行分析。采用学生t检验和方差分析进行统计分析,以检查SNP与RRR之间的关联。发现了四个新变体,rs11549467的一个次要等位基因与受试者的RRR相关(p = 0.028)。rs11549467增加HIF-1α的转录活性,增强血管生成并增加新血管形成。因此,rs11549467可能在导致RRR的骨重塑平衡紊乱中起重要作用。本研究结果可能有助于开发新的基因诊断测试,并识别拔牙后易发生过度颌骨萎缩的韩国人。最重要的是,利用遗传信息进行早期筛查将使易感患者避免处于没有有效修复治疗的过度颌骨萎缩的脆弱状况。