Department of Paediatric Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang, China.
Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
BMC Oral Health. 2024 Jun 5;24(1):658. doi: 10.1186/s12903-024-04394-4.
Tooth avulsion represents the most severe form of dental trauma, necessitating tooth replantation as the primary treatment. However, the risk of replacement root resorption (RRR) poses a significant threat to tooth retention following replantation. This study preliminarily aimed to investigate the effect of physiological occlusal force on RRR after the replantation of avulsed teeth and to explore the potential underlying mechanisms.
Thirty-six 4-week-old male Sprague-Dawley rats underwent extraction and immediate replantation of their left maxillary molars. The rats were randomly divided into two major groups: the occluded (n = 18) group, where the opposite mandibular teeth were preserved; non-occluded (n = 18) group, where the opposite mandibular teeth were extracted. Within each major group, there were three subgroups corresponding to 7 days, 14 days, and 2 months, resulting in a total of six subgroups, (n = 6 per subgroup). The right maxillary first molars served as the normal control. Various periodontal characteristics were assessed using haematoxylin-eosin (H&E), tartrate-resistant acid phosphatase (TRAP) staining, and micro-computed tomography (micro-CT).
Histological staining revealed that under occlusal force, the early stage (day 7) after tooth replantation mainly manifested as root surface resorption, especially in the non-occluded group, which gradually diminished over time. Cementum and periodontal ligament (PDL) repair was observed on day 14. Micro-CT analysis indicated a significant decrease in PDL width in the non-occluded group two months after replantation, consistent with the histological findings, signifying severe RRR in the non-occluded group.
This study provides preliminary evidence that physiological occlusal force may attenuate osteoclastogenesis during the early stage of tooth replantation, thereby reducing the occurrence of RRR and promoting periodontal healing.
牙脱位代表了最严重的牙齿创伤形式，需要进行牙再植作为主要治疗方法。然而，再植后替换根吸收（RRR）的风险对牙齿保留构成了重大威胁。本研究初步旨在探讨生理咬合对再植后牙 RRR 的影响，并探讨潜在的潜在机制。
36 只 4 周龄雄性 Sprague-Dawley 大鼠进行了左上颌磨牙的拔除和即刻再植。大鼠随机分为两大组：咬合组（n=18），保留对颌下颌牙齿；非咬合组（n=18），拔除对颌下颌牙齿。在每个主要组中，有三个亚组对应于 7 天、14 天和 2 个月，总共有六个亚组，（每组 n=6）。右侧上颌第一磨牙作为正常对照。使用苏木精-伊红（H&E）、抗酒石酸酸性磷酸酶（TRAP）染色和微计算机断层扫描（micro-CT）评估各种牙周特征。
组织学染色显示，在咬合力作用下，再植后早期（第 7 天）主要表现为牙根表面吸收，尤其是在非咬合组中，随着时间的推移逐渐减少。第 14 天观察到牙骨质和牙周韧带（PDL）修复。微 CT 分析表明，再植后两个月非咬合组 PDL 宽度明显减少，与组织学发现一致，表明非咬合组发生严重 RRR。
本研究初步证明生理咬合力可能在牙再植的早期阶段减弱破骨细胞生成，从而减少 RRR 的发生，促进牙周愈合。
