骨皮质切开术对Beagle犬前磨牙加速压低的实验研究
发布时间：2018-03-01 06:29
本文关键词： 骨皮质切开术 微种植体支抗 磨牙压低 免疫组化染色 出处：《重庆医科大学》2016年硕士论文 论文类型：学位论文
【摘要】：磨牙的压低移动是正畸临床中常见的牙移动方式,但也是最难实现的牙移动方式之一。微种植体支抗(Mini-implant anchorage MIA)的应用为正畸医生提供了新思路,操作简单、舒适度高、力量可控等优势,使临床医生更愿意选择采用MIA对磨牙进行压低。然而很多研究发现,磨牙的压低与其他牙移动方式相比,更易出现根尖及根分叉区域的牙根吸收。同时由于磨牙的压低耗时较长,出现龋齿、牙周病的风险更高。因此,缩短压低磨牙的时间,有利于降低上述风险的发生。有系统评价通过文献分析各种加速牙移动的方法,明确指出骨皮质切开术应用于正畸治疗安全并且明显加速牙移动。骨皮质切开术是通过外科手术的手段在牙周围的骨皮质行切口,以使牙移动的早期出现活跃的骨吸收和骨形成,从而加速正畸牙移动。目前,骨皮质切开术辅助正畸牙移动的文献报道主要集中于临床病例的效果评价,基础研究证据尚不充足;特别是在牙齿垂直向移动方面,相关研究较为匮乏。因此,本研究建立骨皮质切开术辅助MIA快速压低磨牙的动物模型,并且评估其在压低过程中的牙根吸收及牙周组织改建情况。目的:评价骨皮质切开术对磨牙压低移动过程中的加速机制,同时探讨骨皮质切开术对磨牙压低过程中的牙周组织改建及牙根吸收的影响。方法:本实验选择8只成年雄性beagle犬为实验对象,通过自身对照的原则,利用mia为支抗,并用镍钛螺旋拉簧加力,同时压低实验动物下颌的双侧第三前磨牙(thethirdpremolar,p3)、第四前磨牙(thefourthpremolar,p4)。实验侧,在p3的近中、p4的远中和根尖下方行骨皮质切开术,联合mia同时压低p3、p4;而对照侧直接用mia压低实验牙,不施加骨皮质切开术。在建立骨皮质切开术联合mia快速压低磨牙的动物模型之后,通过组织学、免疫组织化学等观察实验牙压低过程中在组织学基础上的牙周组织改建情况、根尖区域牙根的吸收情况及牙周组织中骨钙素(osteocalcin,ocn)和破骨细胞分化因子(receptoractivatorfornuclearfactor-κbligand,rankl)的表达。结果:1、实验侧根尖区域的牙周组织出现的破骨细胞始终更多,牙槽骨表面出现的骨吸收陷窝更多,提示实验侧的骨吸收活动始终比对照侧活跃。2、在加力后的第2周,对照侧的牙周膜中出现了玻璃样变性,对照侧牙周膜中的玻璃样变性在加力后的第4周消失,然而在实验侧并没有出现。在没有进行骨皮质切开术组,加力早期牙周膜中便出现玻璃样变性,以致于减慢牙齿压低的速度。3、he染色显示在同一时间点,施加骨皮质切开术的根尖区域牙根吸收严重程度比对照侧要轻。4、骨皮质切开术辅助牙齿压低过程中,OCN的表达在第2周时明显增强,在第4周时达到高峰,随后逐渐降低,到12周时最弱。未施加骨皮质切开术的牙齿压低过程中,OCN的随时间的变化规律与实验侧相似,但均低于实验侧的表达(P0.05)。5、骨皮质切开术辅助牙齿压低过程中,RANKL的表达水平在第2周时达到高峰,在第4周、8周、12周逐渐降低。未施加骨皮质切开术的牙齿压低过程中,RANKL的表达在第4周时达到高峰,随后逐渐降低,但均低于实验侧的表达(P0.05)。综上所述,本实验可以得出以下结论:1、骨皮质切开术对正畸牙的压低移动过程中,可以促进成骨细胞和破骨细胞的活跃性,从而加快压低过程中的骨吸收和骨形成过程,实验侧的破骨活动和成骨活动更活跃是加速牙压低移动的关键原因之一。2、骨皮质切开术能降低Beagle犬前磨牙压低移动过程中出现的牙根吸收的严重程度。因此骨皮质切开术可以作为一种潜在的、有效的方法对磨牙进行辅助压低。
[Abstract]:Molar intrusion is a common way of orthodontic tooth movement, but one of the tooth movement is the most difficult to achieve. The micro implant anchorage (Mini-implant anchorage MIA) application provides a new idea for orthodontic doctors, simple operation, high comfort, power control and other advantages, so that clinicians prefer to use MIA on the left were down. However, many studies have found that, compared with other lower molar tooth movement, more prone to root and root resorption of the bifurcated region. At the same time due to low pressure when the molar teeth appear longer, dental caries, periodontal risk is higher. Therefore, shortening the molar down time, help to reduce the risk evaluation system. Through the analysis of various methods accelerated tooth movement, clearly pointed out that the cortical incision used in orthodontic treatment and safety significantly accelerated tooth movement. Incision of bone cortex The surgical methods in the cortical bone around dental incision, so that early tooth movement has active bone resorption and bone formation, thus accelerate the orthodontic tooth movement. At present, the effect evaluation of the corticotomy assisted surgery reported orthodontic tooth movement mainly focused on the basic research of clinical cases, the evidence is not enough; especially in the teeth of vertical movement, relevant research is scarce. Therefore, this study established the animal model of corticotomy assisted MIA fast down molars, and evaluate the depression in the process of root resorption and periodontal tissue remodeling. Objective: To evaluate the cortical incision on molar intrusion mobile acceleration mechanism in the process, and to explore the effect of corticotomy on periodontal tissue remodeling and root molar intrusion during the absorption. Methods: in this experiment, 8 adult male beagle dogs to Like, through its own control principle, the use of MIA for anchorage, and nickel titanium spiral spring force, bilateral third premolars and suppress experimental animal mandible (thethirdpremolar, P3), fourth premolars (thefourthpremolar, P4). In the experimental side, near P3, P4 and apical incision far below for the bone cortex, combined with Mia and P4; down P3, while the control side directly with MIA down the experimental teeth, without cortical incision. After setting up the animal model of cortical bone incision surgery combined with MIA fast down molars, by histology, immunohistochemistry and observation of experimental tooth down in the process of histological basis the periodontal tissue remodeling, apical root resorption area of osteocalcin and periodontal tissues (osteocalcin, OCN) and osteoclast differentiation factor (receptoractivatorfornuclearfactor- kappa bligand, RANKL) expression. Results: 1, the root tip region 鍩熺殑鐗欏懆缁勭粐鍑虹幇鐨勭牬楠ㄧ粏鑳炲缁堟洿澶，
本文编号：1550824
本文链接：https://www.wllwen.com/yixuelunwen/kouq/1550824.html
最近更新
教材专著
