Lechner Johann, von Baehr Volker
Clinic for Integrative Dentistry, Gruenwalder Str. 10A, 81547 Munich, Germany.
Compartment of Immunology and Allergology, Institute for Medical Diagnostics, MVZ GbR, Nicolaistrasse 22, 12247 Berlin, Germany.
EPMA J. 2015 May 6;6(1):10. doi: 10.1186/s13167-015-0032-4. eCollection 2015.
This research elucidates the question of whether common and widespread dental procedures (DP) like root filling (RF) and the removal of wisdom teeth (WT) contribute to chronic inflammation in the jawbone. Dentists, in carrying out these DP, can set off defective wound healing in the jawbone in ignorance of its connection to inflammatory mediators and the possibility of it being a hidden cause of chronic systemic diseases (SYD).
We examined samples of the jawbone for seven cytokines by multiplex analysis in three groups of jawbone areas. In order to clarify systemic interrelations, specimens from 16 patients were analyzed in areas of former surgery in the retromolar wisdom tooth area; specimens from 16 patients were analyzed in the jawbone, apically of teeth with RF; and specimens from 19 patients were of the healthy jawbone. Each of the retromolar and the apical jawbone samples showed clinically fatty degenerated and osteonecrotic medullary changes.
All fatty necrotic and osteolytic jawbone (FDOJ) samples showed regulated on activation, normal T-cell expressed and secreted (RANTES) and fibroblast growth factor (FGF)-2 as the only extremely overexpressed cytokines. FDOJ cohorts showed a 30-fold mean overexpression of RANTES and a 20-fold overexpressed level of FGF-2 when compared to healthy controls.
As RANTES is discussed in the literature as a possible contributor to inflammatory diseases, and though it might have oncogenic effects, we hypothesize that FDOJ in areas of improper and incomplete wound healing in the jawbone might act as hyperactivated signaling pathways, while serving as an unknown source of "silent inflammation". Because of the wide range of RANTES in immune diseases, treating FDOJ can cover many potential prediction or prognosis of individual outcomes.
本研究阐明了诸如根管充填（RF）和智齿拔除（WT）等常见且广泛实施的牙科手术（DP）是否会导致颌骨慢性炎症这一问题。牙医在实施这些牙科手术时，可能会引发颌骨伤口愈合不良，却忽视了其与炎症介质的关联以及它可能是慢性全身性疾病（SYD）潜在病因的可能性。
我们通过多重分析在三组颌骨区域检测了颌骨样本中的七种细胞因子。为了阐明全身的相互关系，对16例患者在磨牙后智齿区域先前手术部位的样本进行了分析；对16例患者在有根管充填的牙齿根尖处的颌骨样本进行了分析；对19例患者的健康颌骨样本进行了分析。每个磨牙后和根尖颌骨样本均显示出临床上脂肪变性和骨坏死的骨髓改变。
所有脂肪坏死性和溶骨性颌骨（FDOJ）样本均显示，作为唯一极度过度表达的细胞因子，活化调节正常T细胞表达和分泌因子（RANTES）和成纤维细胞生长因子（FGF）-2出现了上调。与健康对照组相比，FDOJ队列中RANTES的平均过表达水平为30倍，FGF-2的过表达水平为20倍。
由于文献中讨论RANTES可能是炎症性疾病的一个促成因素，并且尽管它可能具有致癌作用，但我们推测，颌骨伤口愈合不当和不完全区域的FDOJ可能作为过度激活的信号通路，同时作为“沉默炎症”的未知来源。鉴于RANTES在免疫疾病中的广泛作用，治疗FDOJ可以涵盖许多个体结果的潜在预测或预后。
