National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand.
J Appl Oral Sci. 2020;28:e20190690. doi: 10.1590/1678-7757-2019-0690. Epub 2020 Apr 27.
Objective To investigate the effects of intro-oral injection of parathyroid hormone (PTH) on tooth extraction wound healing in hyperglycemic rats. Methodology 60 male Sprague-Dawley rats were randomly divided into the normal group (n=30) and DM group (n=30). Type 1 diabetes mellitus (DM) was induced by streptozotocin. After extracting the left first molar of all rats, each group was further divided into 3 subgroups (n=10 per subgroup), receiving the administration of intermittent PTH, continuous PTH and saline (control), respectively. The intermittent-PTH group received intra-oral injection of PTH three times per week for two weeks. A thermosensitive controlled-release hydrogel was synthesized for continuous-PTH administration. The serum chemistry was determined to evaluate the systemic condition. All animals were sacrificed after 14 days. Micro-computed tomography (Micro-CT) and histological analyses were used to evaluate the healing of extraction sockets. Results The level of serum glucose in the DM groups was significantly higher than that in the non-DM groups (p<0.05); the level of serum calcium was similar in all groups (p>0.05). Micro-CT analysis showed that the DM group had a significantly lower alveolar bone trabecular number (Tb.N) and higher trabecular separation (Tb.Sp) than the normal group (p<0.05). The histological analyses showed that no significant difference in the amount of new bone (hard tissue) formation was found between the PTH and non-PTH groups (p>0.05). Conclusions Bone formation in the extraction socket of the type 1 diabetic rats was reduced. PTH did not improve the healing of hard and soft tissues. The different PTH administration regimes (continuous vs. intermittent) had similar effect on tissue healing. These results demonstrated that the metabolic characteristics of the hyperglycemic rats produced a condition that was unable to respond to PTH treatment.
目的 研究甲状旁腺激素(PTH)经口内注射对糖尿病大鼠拔牙创愈合的影响。
方法 将 60 只雄性 Sprague-Dawley 大鼠随机分为正常组(n=30)和糖尿病组(n=30)。采用链脲佐菌素诱导 1 型糖尿病模型。所有大鼠拔除左侧第一磨牙后,每组进一步分为 3 个亚组(n=10),分别给予间歇 PTH、持续 PTH 和生理盐水(对照组)治疗。间歇 PTH 组每周经口内注射 PTH 3 次,共 2 周。合成一种热敏性控释水凝胶用于持续 PTH 给药。通过血清化学分析评估系统状态。所有动物于 14 天后处死。采用微计算机断层扫描(Micro-CT)和组织学分析评估拔牙窝的愈合情况。
结果 糖尿病组大鼠血清葡萄糖水平明显高于非糖尿病组(p<0.05);各组血清钙水平相似(p>0.05)。Micro-CT 分析显示,糖尿病组大鼠牙槽骨小梁数量(Tb.N)明显低于正常组,而小梁间隔(Tb.Sp)明显高于正常组(p<0.05)。组织学分析显示,PTH 组和非 PTH 组新生骨(硬组织)形成量无显著差异(p>0.05)。
结论 1 型糖尿病大鼠拔牙窝骨形成减少。PTH 不能改善软硬组织的愈合。不同的 PTH 给药方案(连续与间歇)对组织愈合的效果相似。这些结果表明,高血糖大鼠的代谢特征导致其无法对 PTH 治疗产生反应。