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下颌骨和上颌骨结节的不对称性骨重建。

Asymmetric bone remodeling in mandibular and maxillary tori.

机构信息

GEROM Groupe d'Etude Remodelage Osseux et bioMatériaux, Research Group on Bone Remodeling and bioMaterials, LHEA, IRIS-IBS Institut de Biologie en Santé, Université d'Angers, 4 rue Larrey, 49933, Angers Cedex, France.

Department of Maxillo-facial surgery, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France.

出版信息

Clin Oral Investig. 2017 Dec;21(9):2781-2788. doi: 10.1007/s00784-017-2080-8. Epub 2017 Feb 23.

Abstract

OBJECTIVES

Tori are frequent paucisymptomatic bony outgrowths of the oral cavity in three locations: torus palatinus (TP), mandibularis (TM), and maxillaris (TMax). Their usually described histological characteristics are unspecific: normal cortical bone with more or less trabecular bone. The aim of this study was to describe tori's specific morphological and histomorphometric characteristics.

MATERIALS AND METHODS

Histological characteristics in a series of 18 tori collected after surgical removal were analyzed. Microcomputed tomography provided a 3D analysis. Mineral apposition rate (MAR) was measured after double tetracycline labeling. Osteoid tissue was identified by Goldner's trichrome and osteoclasts by the tartrate resistant acid phosphatase identification in undecalcified sections. Iron and aluminum were detected by histochemical staining methods. Osteoid thickness and MAR were determined at the outer surface of the torus and in the Haversian canals.

RESULTS

Tori appeared made of lamellar Haversian bone in 16/18 cases. Osteoid thickness did not differ between the outer surface and within the canals. An asymmetric bone remodeling was observed in the Haversian canals of 15 tori: osteoid seams were deposited on the side close to the free torus surface, and Howship's lacunae with numerous osteoclasts were observed on the opposite side. A high MAR was found at the surface of the tori and within the canals. There was no iron or aluminum deposit.

CONCLUSIONS

Tori may be characterized by a specific asymmetric bone remodeling which seems to determine their shape.

CLINICAL RELEVANCE

This finding could constitute a specific histological feature allowing to differentiate tori from exostoses. Graphical abstract.

摘要

目的

结节通常是口腔中三个部位的轻度症状性骨外生:腭结节(TP)、下颌结节(TM)和上颌结节(TMax)。它们通常描述的组织学特征是非特异性的:正常皮质骨伴或多或少的小梁骨。本研究旨在描述结节的特定形态和组织形态计量学特征。

材料和方法

分析了 18 例经手术切除后收集的结节系列的组织学特征。微计算机断层扫描提供了 3D 分析。在双四环素标记后测量矿化沉积率(MAR)。在未脱钙切片中,通过 Goldner 三色法识别类骨质组织,通过抗酒石酸酸性磷酸酶鉴定破骨细胞。通过组织化学染色方法检测铁和铝。在外表面和哈弗管内测量结节的类骨质厚度和 MAR。

结果

16/18 例结节呈板层哈弗骨样。类骨质厚度在结节外表面和管内没有差异。在 15 例结节的哈弗管中观察到不对称的骨重塑:骨样组织沉积在靠近游离结节表面的一侧,而在另一侧观察到富含破骨细胞的 Howship 陷窝。在结节表面和管内发现高 MAR。没有铁或铝沉积。

结论

结节可能具有特定的不对称骨重塑特征,这似乎决定了它们的形状。

临床相关性

这一发现可能构成一种特定的组织学特征,有助于将结节与外生骨疣区分开来。

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