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牙槽骨的近期临床治疗与基础研究

Recent Clinical Treatment and Basic Research on the Alveolar Bone.

作者信息

Tsuchida Sachio, Nakayama Tomohiro

机构信息

Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan.

出版信息

Biomedicines. 2023 Mar 10;11(3):843. doi: 10.3390/biomedicines11030843.

Abstract

The periodontal ligament is located between the bone (alveolar bone) and the cementum of the tooth, and it is connected by tough fibers called Sharpey's fibers. To maintain healthy teeth, the foundation supporting the teeth must be healthy. Periodontal diseases, also known as tooth loss, cause the alveolar bone to dissolve. The alveolar bone, similar to the bones in other body parts, is repeatedly resorbed by osteoclasts and renewed by osteogenic cells. This means that an old bone is constantly being resorbed and replaced by a new bone. In periodontal diseases, the alveolar bone around the teeth is absorbed, and as the disease progresses, the alveolar bone shrinks gradually. In most cases, the resorbed alveolar bone does not return to its original form even after periodontal disease is cured. Gum covers the tooth surface so that it matches the shape of the resorbed alveolar bone, exposing more of the tooth surface than before, making the teeth look longer, leaving gaps between the teeth, and in some cases causing teeth to sting. Previously, the only treatment for periodontal diseases was to stop the disease from progressing further before the teeth fell out, and restoration to the original condition was almost impossible. However, a treatment method that can help in the regeneration of the supporting tissues of the teeth destroyed by periodontal diseases and the restoration of the teeth to their original healthy state as much as possible is introduced. Recently, with improvements in implant material properties, implant therapy has become an indispensable treatment method in dentistry and an important prosthetic option. Treatment methods and techniques, which are mainly based on experience, have gradually accumulated scientific evidence, and the number of indications for treatment has increased. The development of bone augmentation methods has contributed remarkably to the expansion of indications, and this has been made possible by various advances in materials science. The induced pluripotent stem cell (iPS) cell technology for regenerating periodontal tissues, including alveolar bone, is expected to be applied in the treatment of diseases, such as tooth loss and periodontitis. This review focuses on the alveolar bone and describes clinical practice, techniques, and the latest basic research.

摘要

牙周韧带位于牙齿的骨质(牙槽骨)和牙骨质之间,并通过称为沙比纤维的坚韧纤维相连。为保持牙齿健康,支撑牙齿的基础必须健康。牙周疾病,也称为牙齿脱落,会导致牙槽骨溶解。牙槽骨与身体其他部位的骨骼相似,会被破骨细胞反复吸收,并由成骨细胞更新。这意味着旧骨不断被吸收并被新骨取代。在牙周疾病中,牙齿周围的牙槽骨会被吸收,随着疾病进展,牙槽骨会逐渐萎缩。在大多数情况下,即使牙周疾病治愈后,被吸收的牙槽骨也不会恢复到原来的形态。牙龈覆盖牙齿表面,使其与吸收后的牙槽骨形状相匹配,从而使牙齿表面暴露得比以前更多,使牙齿看起来更长,牙齿之间出现间隙,在某些情况下还会导致牙齿刺痛。以前,牙周疾病的唯一治疗方法是在牙齿脱落前阻止疾病进一步发展,几乎不可能恢复到原来的状态。然而,现在引入了一种治疗方法,它有助于牙周疾病破坏的牙齿支持组织再生,并尽可能使牙齿恢复到原来的健康状态。最近,随着种植材料性能的提高,种植治疗已成为牙科不可或缺的治疗方法和重要的修复选择。主要基于经验的治疗方法和技术逐渐积累了科学证据,治疗适应证的数量也有所增加。骨增量方法的发展对适应证的扩大做出了显著贡献,这得益于材料科学的各种进步。用于再生包括牙槽骨在内的牙周组织的诱导多能干细胞(iPS)技术有望应用于牙齿脱落和牙周炎等疾病的治疗。本综述聚焦于牙槽骨,并描述临床实践、技术和最新的基础研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7db5/10044990/06faf09c83bd/biomedicines-11-00843-g001.jpg

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