Cai Jun, Qin Han
Department of Anesthesia, The Maternal and Child Health Hospital of Lianyungang City, Lianyungang 222006, Jiangsu Province, China.
Department of Stomatology, The Lianyungang Affiliated Hospital of Xuzhou Medical University, Lianyungang First People's Hospital, Lianyungang 222002, Jiangsu Province, China.
World J Clin Cases. 2025 Aug 26;13(24):107535. doi: 10.12998/wjcc.v13.i24.107535.
This study analyzed the dental follicle and alveolar bone of two patients with tooth eruption disorders, aiming to provide some reference for exploring the etiology and selecting treatment plans of this disease from the perspective of the influence of extracellular matrix on osteoclasts differentiation in dental follicle.
Collect dental follicle and alveolar bone tissue from one patient with single tooth eruption disorder and one patient with full permanent tooth eruption disorder, respectively. Simultaneously collect the dental follicle and alveolar bone tissue of obstructed teeth that need to be extracted due to orthodontic treatment as the control group. Hematoxylin and eosin (HE) staining was used to observe the morphology of dental follicle cells. Immunohistochemical staining was used to observe the expression of periostin, receptor activator of nuclear factor kappa B ligand (RANKL), and osteoprotegerin (OPG) protein in dental follicle and alveolar bone tissue. And observe the eruption of teeth after removing resistance from the crown of the permanent tooth germ.
HE staining of two cases of dental follicle tissues showed that the volume of dental follicle cells decreased, the nuclei were condensed, and there seemed to be cellular fibrosis. The immunohistochemical staining showed that both the dental follicle and alveolar bone tissue exhibited increased expression of periostin, decreased expression of RANKL and OPG proteins, and decreased RANKL/OPG ratio. After removing resistance, the permanent tooth germ often appears to have normal eruption. Tooth eruption disorders may be accompanied by abnormal remodeling of periostin, which affects the differentiation function of osteoclasts in the dental follicle and leads to metabolic imbalance of alveolar bone, resulting in tooth eruption disorders. Whether it is a single or full permanent tooth eruption disorder, once the coronal resistance is removed, the teeth can often erupt normally.
本研究分析了两名牙齿萌出障碍患者的牙囊和牙槽骨，旨在从细胞外基质对牙囊破骨细胞分化的影响角度，为探索该疾病的病因及选择治疗方案提供参考。
分别采集一名单颗牙齿萌出障碍患者和一名恒牙全萌出障碍患者的牙囊和牙槽骨组织。同时采集因正畸治疗需要拔除的阻生牙的牙囊和牙槽骨组织作为对照组。采用苏木精-伊红（HE）染色观察牙囊细胞形态。采用免疫组织化学染色观察牙囊和牙槽骨组织中骨膜蛋白、核因子κB受体活化因子配体（RANKL）和骨保护素（OPG）蛋白的表达。并观察恒牙胚冠部去除阻力后牙齿的萌出情况。
两例牙囊组织HE染色显示，牙囊细胞体积减小，细胞核浓缩，似乎存在细胞纤维化。免疫组织化学染色显示，牙囊和牙槽骨组织均表现为骨膜蛋白表达增加，RANKL和OPG蛋白表达降低，RANKL/OPG比值降低。去除阻力后，恒牙胚常表现为正常萌出。牙齿萌出障碍可能伴有骨膜蛋白异常重塑，影响牙囊中破骨细胞的分化功能，导致牙槽骨代谢失衡，从而引起牙齿萌出障碍。无论是单颗还是恒牙全萌出障碍，一旦冠部阻力去除，牙齿通常可正常萌出。
