女性正畸患者不同月经周期加力后相关骨代谢因子变化的表达研究
发布时间：2019-06-24 23:55
【摘要】：研究背景和目的：随着对美观与功能的意识进一步增强，正畸治疗中成年患者的比例正在逐渐升高，但相对处于生长发育期的青少年患者，成人患者代谢速率与牙齿移动都较为缓慢，治疗周期明显延长。较长的矫治时间易带来美观、疼痛及牙周问题，造成患者不必要的困扰。而缩短疗程最直接的方法，就是加速正畸牙的移动，而目前临床使用的方法费用高风险大，找到一种绿色健康的加速正畸牙移动的方法显得十分紧迫。 牙齿移动的生理基础是骨组织的改建，包括骨的吸收和形成两个方面，是一系列分子所参与调节的循环过程，主要参与细胞包括骨细胞、成骨细胞、破骨细胞等，分别发挥启动骨改建、骨基质形成、骨吸收等作用，而研究表明骨细胞、成骨细胞、破骨细又作为雌激素的靶细胞，受到雌激素直接或者间接调节。核因子κB受体活化因子配体（RANKL）、骨保护素（OPG）、骨钙素（OCN）等骨代谢因子也受雌激素影响。 女性体内雌激素水平随着生理周期的改变而呈现波动性变化，因此本研究通过在成年女性月经周期中的不同时期对正畸牙加力，研究龈沟液内雌激素（雌二醇E2）、OCN、RANKL、OPG的时效性表达及与牙齿自身移动的周期节律的相互作用。从而为临床选择最佳加力时机提供理论依据。 方法： 1.选取18-28周岁双侧对称拔除第一恒前磨牙青年女性恒牙合患者24人。随机选取其中12人为月经期加力组，12人为排卵期加力组。 2.右侧尖牙使用NITI拉簧施加水平向150g正畸力使之远中移动。 3.使用牙周滤纸分别于加力前(T0)，加力后14天(T1),28天（T2），42天（T3）取右侧尖牙远中（压力侧）龈沟液样本。 4.电化学发光法测定龈沟液中E2,OCN的活性水平。使用ELISA酶联免疫法检测龈沟液中RANKL及OPG的活性水平。 结果： 1.月经期加力组E2水平在加力后28天水平最低，加力后42天达到高峰。排卵期加力组E2水平在加力后14天水平最低，在加力后28天达到高峰，然后呈下降趋势。总体水平上排卵期加力组E2水平显著高于月经期加力组（F=15.242, P＜0.05）；加力前后不同时间之间有显著差异（F=3.049, P＜0.05）；加力后42天龈沟液内E2水平显著高于未加力时龈沟液内E2水平（P＜0.05）。 2.不同生理周期加力对女性龈沟液内骨钙素OCN水平的影响：月经期加力组及排卵期加力组龈沟液OCN水平皆于加力后逐渐升高，于加力后28天水平达到峰值，后呈回落趋势。总水平上排卵期加力组OCN水平显著高于月经期加力组（F=15.67, P＜0.05）；加力前后不同时间之间有显著差异（F=5.75, P＜0.05）;加力后14天、28天、42天后龈沟液内OCN水平显著高于加力前水平（P＜0.05），加力后14天、28天、42天互相之间无显著差异（P＞0.05）。 3.女性月经周期中不同时期加力，龈沟液中RANKL水平未产生显著差异（P＞0.05）；女性月经周期中不同时期加力，也不对龈沟液中OPG水平产生显著影响(P＞0.05)。龈沟液中RANKL水平于加力后即呈现升高趋势，加力后平均水平高于未加力时。而OPG于加力后呈现降低趋势，加力后平均水平低于未加力时水平，提示加力后骨保护趋势的减弱。RANKL/OPG比值并不受不同加力时期的影响，但加力后数值呈现上升趋势。 结论： 1.在成年女性月经周期中不同阶段进行正畸加力，牙周微环境中的雌激素E2水平有差异，排卵期加力组E2水平高于月经期加力组水平。提示女性正畸患者在月经期加力，牙周微环境中较低的雌激素水平有利于牙齿的快速移动。 2.在成年女性月经周期中不同阶段进行正畸加力，牙周局部OCN水平有显著差异，其总体水平可能受到E2水平变化的影响。 3.在成年女性月经周期中不同阶段进行正畸加力，牙周微环境中RANKL、OPG水平并无体现出显著差异，但加力后水平与未加力水平有显著差异，提示RANKL、OPG受月经周期激素水平波动影响不大，但受到较多加力的影响。RANKL/OPG比值结果与RANKL、OPG结果一致，提示加力后破骨活动的增强。 4.女性正畸拔牙患者于雌激素水平较高的排卵期施加正畸力，骨保护因子E2，OCN表达增强，不利于牙槽骨改建，牙齿移动较为缓慢。而于月经期加力，上述因子表达减弱，，可能有助于牙齿快速移动。
[Abstract]:The research background and purpose: With the further enhancement of the consciousness and function, the proportion of adult patients in the orthodontic treatment is increasing, but the metabolic rate of adult patients and the movement of the teeth are slow, and the treatment period is obviously prolonged. The long treatment time is easy to bring beauty, pain and periodontal problems, and causes unnecessary trouble of the patient. And the most direct method for shortening the course of treatment is to accelerate the movement of the orthodontic tooth, and the current method for clinical use is high in risk, and a green and healthy method for accelerating the orthodontic tooth movement is very urgent. The physiological basis of tooth movement is the remodeling of bone tissue, including the absorption and formation of bone. It is a circulating process involved in the regulation of a series of molecules. The effects of bone resorption, etc., show that the bone cells, osteoblasts, osteoclasts, and the target cells of the estrogen are directly or indirectly modulated by an estrogen. The bone metabolism factors such as the nuclear factor B receptor activating factor ligand (RANKL), the osteoprotegerin (OPG), the osteocalcin (OCN), and the like are also reflected by the estrogen In response to the change of the estrogen level in the female body with the change of the physiological period, this study is to study the estrogen (Estradiol E2), OCN, and RA in the gingival crevicular fluid by applying a force to the orthodontic tooth during different periods of the menstrual cycle of the adult female. The time-sensitive expression of NKL and OPG and the phase of the periodic rhythm with the movement of the teeth Mutual action. It provides the best time for clinical selection. On the Basis of Methods:1.1 1-28-year-old two-sided symmetrical extraction of the first permanent premolar young female 24 of the patients with occlusion were randomly selected,12 of which were of the menstrual period of the menstrual period,12 for the ovulatory force group.2. Right-hand cusp use the NITI tension spring to apply a level of 150 g 3. Use the periodontal filter paper before the application (T0),14 days after the application (T1),28 days (T2) and 42 days (T3) to take the right sharp tooth far. Middle (pressure side) gingival crevicular fluid sample.4. Electrochemical luminescence method to measure the gingival sulcus The activity level of E2 and OCN in the liquid was measured by ELISA. ANK The activity level of L and OPG. Results:1. The E2 level in the menstrual cycle of the menstrual period was 2% after the application of the force. The 8-day level is the lowest, and the peak is reached 42 days after the application of force. The E2 level of the booster group in the ovulatory period is the lowest at 14 days after the application of the force, and at the same time, the level of E2 in the The level of E2 was significantly higher than that of the group (F = 15.242, P <0.05). There was a significant difference between the different time before and after the application (F = 3.049, P <0.05). 2. The effect of different physiological cycles on the level of OCN of the gingival crevicular fluid in the gingival crevicular fluid was the same as that of the gingival crevicular fluid (P <0.05). The level of OCN was significantly higher than that of the group (F = 15.67, P <0.05). There was a significant difference (F = 5.75, P <0.05) between the different time before and after the application. The OCN in the gingival crevicular fluid was 14 days,28 days and 42 days after the application. The level is significantly higher than the pre-applied level (P <0.05),14 days after application,28 days,4 There was no significant difference between 2 days (P> 0.05).3. There was no significant difference in the level of RANKL in the gingival crevicular fluid during the different period of the female's menstrual cycle (P> 0.05). The level of OPG in the gingival crevicular fluid was significantly affected (P> 0.05). In other words, the rising trend is presented, the average level of the post-stress is higher than that of the non-applied force, and the OPG shows a lower trend after the application of the force, and the average level of the post-application is low The RANKL/ OPG ratio is not affected by a decrease in the trend of bone protection after stress augmentation when no stress is applied. same force Conclusion:1. In the different stages of the menstrual cycle of the adult female, the effects of orthodontics, estrogen and E2 in the periodontal micro-environment The level of E2 in the stage of ovulatory period is higher than the level of the force group in the menstrual period. It is suggested that the female orthodontics should be applied to the menstrual period. And the lower estrogen level in the periodontal micro-environment is beneficial to the rapid movement of the teeth. 3. The level of RANKL and OPG in the periodontal micro-environment did not show a significant difference in the level of RANKL and OPG during the different stages of the menstrual cycle of the adult female, but there was a significant difference in the post-stress level and the unstressed level. the difference, prompting the ran kl, OPG was not significantly affected by menstrual cycle hormone levels but was affected by more stress. RANKL/ OPG ratio Results The results were consistent with the results of RANKL and OPG. The expression of the protective factor E2 and OCN is enhanced, which is not conducive to the reconstruction of the alveolar bone, and the movement of the teeth is more
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5
本文编号：2505470
[Abstract]:The research background and purpose: With the further enhancement of the consciousness and function, the proportion of adult patients in the orthodontic treatment is increasing, but the metabolic rate of adult patients and the movement of the teeth are slow, and the treatment period is obviously prolonged. The long treatment time is easy to bring beauty, pain and periodontal problems, and causes unnecessary trouble of the patient. And the most direct method for shortening the course of treatment is to accelerate the movement of the orthodontic tooth, and the current method for clinical use is high in risk, and a green and healthy method for accelerating the orthodontic tooth movement is very urgent. The physiological basis of tooth movement is the remodeling of bone tissue, including the absorption and formation of bone. It is a circulating process involved in the regulation of a series of molecules. The effects of bone resorption, etc., show that the bone cells, osteoblasts, osteoclasts, and the target cells of the estrogen are directly or indirectly modulated by an estrogen. The bone metabolism factors such as the nuclear factor B receptor activating factor ligand (RANKL), the osteoprotegerin (OPG), the osteocalcin (OCN), and the like are also reflected by the estrogen In response to the change of the estrogen level in the female body with the change of the physiological period, this study is to study the estrogen (Estradiol E2), OCN, and RA in the gingival crevicular fluid by applying a force to the orthodontic tooth during different periods of the menstrual cycle of the adult female. The time-sensitive expression of NKL and OPG and the phase of the periodic rhythm with the movement of the teeth Mutual action. It provides the best time for clinical selection. On the Basis of Methods:1.1 1-28-year-old two-sided symmetrical extraction of the first permanent premolar young female 24 of the patients with occlusion were randomly selected,12 of which were of the menstrual period of the menstrual period,12 for the ovulatory force group.2. Right-hand cusp use the NITI tension spring to apply a level of 150 g 3. Use the periodontal filter paper before the application (T0),14 days after the application (T1),28 days (T2) and 42 days (T3) to take the right sharp tooth far. Middle (pressure side) gingival crevicular fluid sample.4. Electrochemical luminescence method to measure the gingival sulcus The activity level of E2 and OCN in the liquid was measured by ELISA. ANK The activity level of L and OPG. Results:1. The E2 level in the menstrual cycle of the menstrual period was 2% after the application of the force. The 8-day level is the lowest, and the peak is reached 42 days after the application of force. The E2 level of the booster group in the ovulatory period is the lowest at 14 days after the application of the force, and at the same time, the level of E2 in the The level of E2 was significantly higher than that of the group (F = 15.242, P <0.05). There was a significant difference between the different time before and after the application (F = 3.049, P <0.05). 2. The effect of different physiological cycles on the level of OCN of the gingival crevicular fluid in the gingival crevicular fluid was the same as that of the gingival crevicular fluid (P <0.05). The level of OCN was significantly higher than that of the group (F = 15.67, P <0.05). There was a significant difference (F = 5.75, P <0.05) between the different time before and after the application. The OCN in the gingival crevicular fluid was 14 days,28 days and 42 days after the application. The level is significantly higher than the pre-applied level (P <0.05),14 days after application,28 days,4 There was no significant difference between 2 days (P> 0.05).3. There was no significant difference in the level of RANKL in the gingival crevicular fluid during the different period of the female's menstrual cycle (P> 0.05). The level of OPG in the gingival crevicular fluid was significantly affected (P> 0.05). In other words, the rising trend is presented, the average level of the post-stress is higher than that of the non-applied force, and the OPG shows a lower trend after the application of the force, and the average level of the post-application is low The RANKL/ OPG ratio is not affected by a decrease in the trend of bone protection after stress augmentation when no stress is applied. same force Conclusion:1. In the different stages of the menstrual cycle of the adult female, the effects of orthodontics, estrogen and E2 in the periodontal micro-environment The level of E2 in the stage of ovulatory period is higher than the level of the force group in the menstrual period. It is suggested that the female orthodontics should be applied to the menstrual period. And the lower estrogen level in the periodontal micro-environment is beneficial to the rapid movement of the teeth. 3. The level of RANKL and OPG in the periodontal micro-environment did not show a significant difference in the level of RANKL and OPG during the different stages of the menstrual cycle of the adult female, but there was a significant difference in the post-stress level and the unstressed level. the difference, prompting the ran kl, OPG was not significantly affected by menstrual cycle hormone levels but was affected by more stress. RANKL/ OPG ratio Results The results were consistent with the results of RANKL and OPG. The expression of the protective factor E2 and OCN is enhanced, which is not conducive to the reconstruction of the alveolar bone, and the movement of the teeth is more
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5
【参考文献】
相关期刊论文 前1条
1 郭洪敏,杜靖远;维生素K_2对成骨细胞增殖和分化的影响[J];中华老年医学杂志;1998年02期
本文编号：2505470
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