Berkün Onur, Fındık Yavuz, Akpınar Orhan, Ay Zuhal Yetkin, Baykul Timuçin
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey.
J Maxillofac Oral Surg. 2022 Jun;21(2):487-492. doi: 10.1007/s12663-020-01481-1. Epub 2021 Jan 4.
Maxillary transverse deficiency is one of the most common skeletal problems. Patients who have completed skeletal maturity, maxillary transverse deficiency can be treated with surgically assisted rapid maxillary expansion. Orthodontic forces affect the cells in the periodontium to form biologically active substances responsible for remodeling. These substances can be detected in the content of the gingival crevicular fluid (GCF). This study aimed to investigate changes in RANK, RANKL and OPG in the gingival crevicular fluid after surgically assisted rapid maxillary expansion.
A total of 16 patients with a maxillary transverse deficiency were included in the study. Gingival crevicular fluid samples were collected from the mesiobuccal regions of the upper left central, lateral incisors, first and second premolar teeth before the operation (T0), after activation period (T1) and at the 4th month (T2) after the retention period. Changes in RANK, RANKL and OPG levels of gingival crevicular fluid samples were investigated.
RANK and RANKL amounts were found to be significantly increased in the first and second premolar teeth after expansion, and OPG amounts were significantly decreased in central incisor and first premolar teeth. RANKL was also significantly higher in the first premolar teeth than in the second premolar after retention.
According to the results of the study, RANK, RANKL and OPG levels are changed in the gingival crevicular fluid after surgically assisted rapid maxillary expansion.
Using tooth-borne appliances for SARME operations alters the biological content of the GCF. For avoiding these interactions, bone-borne appliances may be used for SARME procedures.
上颌横向发育不足是最常见的骨骼问题之一。对于骨骼发育成熟的上颌横向发育不足患者,可采用外科辅助快速上颌扩弓治疗。正畸力作用于牙周组织中的细胞,使其形成负责重塑的生物活性物质。这些物质可在龈沟液(GCF)中检测到。本研究旨在探讨外科辅助快速上颌扩弓后龈沟液中RANK、RANKL和OPG的变化。
本研究共纳入16例上颌横向发育不足患者。在术前(T0)、激活期后(T1)和保持期后第4个月(T2),从左上中切牙、侧切牙、第一和第二前磨牙的近中颊侧区域采集龈沟液样本。研究龈沟液样本中RANK、RANKL和OPG水平的变化。
扩弓后第一和第二前磨牙的RANK和RANKL含量显著增加,中切牙和第一前磨牙的OPG含量显著降低。保持期后,第一前磨牙的RANKL也显著高于第二前磨牙。
根据本研究结果,外科辅助快速上颌扩弓后龈沟液中RANK、RANKL和OPG水平发生了变化。
在外科辅助快速上颌扩弓手术中使用牙支持式矫治器会改变龈沟液的生物学成分。为避免这些相互作用,在外科辅助快速上颌扩弓手术中可使用骨支持式矫治器。