Tohar Ran, Alali Hen, Ansbacher Tamar, Brosh Tamar, Sher Inbal, Gafni Yossi, Weinberg Evgeny, Gal Maayan
Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Hadassah Academic College, Jerusalem 91010, Israel.
J Funct Biomater. 2022 Jun 8;13(2):76. doi: 10.3390/jfb13020076.
Minimally invasive exodontia is among the long-sought-for development aims of safe dental medicine. In this paper, we aim, for the first time, to examine whether the enzymatic disruption of the periodontal ligament fibers reduces the force required for tooth extraction. To this end, recombinantly expressed clostridial collagenase G variant purified from Escherichia coli was injected into the periodontal ligament of mesial and distal roots of the first and second split porcine mandibular premolars. The vehicle solution was injected into the corresponding roots on the contralateral side. Following sixteen hours, the treated mandibles were mounted on a loading machine to measure the extraction force. In addition, the effect of the enzyme on the viability of different cell types was evaluated. An average reduction of 20% in the applied force (albeit with a large variability of 50 to 370 newton) was observed for the enzymatically treated roots, reaching up to 50% reduction in some cases. Importantly, the enzyme showed only a minor and transient effect on cellular viability, without any signs of toxicity. Using an innovative model enabling the analytical measurement of extraction forces, we show, for the first time, that the enzymatic disruption of periodontal ligament fibers substantially reduces the force required for tooth extraction. This novel technique brings us closer to atraumatic exodontia, potentially reducing intra- and post-operative complications and facilitating subsequent implant placement. The development of novel enzymes with enhanced activity may further simplify the tooth extraction process and present additional clinical relevance for the broad range of implications in the oral cavity.
微创拔牙术是安全牙科医学长期以来追求的发展目标之一。在本文中，我们首次旨在研究牙周韧带纤维的酶促破坏是否能降低拔牙所需的力量。为此，将从大肠杆菌中纯化的重组表达的梭菌胶原酶G变体注射到第一和第二颗劈开的猪下颌前磨牙近中根和远中根的牙周韧带中。将载体溶液注射到对侧相应的牙根中。16小时后，将处理过的下颌骨安装在加载机器上以测量拔牙力。此外，评估了该酶对不同细胞类型活力的影响。对于经酶处理的牙根，观察到施加力平均降低了20%（尽管变化范围很大，为50至370牛顿），在某些情况下降低幅度高达50%。重要的是，该酶对细胞活力仅表现出轻微且短暂的影响，没有任何毒性迹象。使用一种能够分析测量拔牙力的创新模型，我们首次表明牙周韧带纤维的酶促破坏可显著降低拔牙所需的力量。这项新技术使我们更接近无创拔牙，有可能减少术中及术后并发症，并便于后续种植体植入。开发具有更高活性的新型酶可能会进一步简化拔牙过程，并在口腔领域的广泛应用中具有更多临床意义。
