Single-tooth extraction site bone loss ---- functional disuse or overuse?

单牙拔除部位骨质流失----功能废用还是过度使用？

基本信息

批准号：
8032444
负责人：
Zongyang Sun
金额：
$ 11.44万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-02-18 至 2013-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8032444
关键词：
Affect Alveolar Alveolar ridge Anatomy Animal Model Biological Bite Force Bone Resorption Bone remodeling Cell Proliferation Clinical Contralateral Data Dental Implants Dentistry Disease Disuse Atrophy Edentulous Mouth Environment Etiology Family suidae Goals Grant Growth Harvest Homeostasis Human Implantation procedure Inflammation Jaw Mandible Mastication Measurement Measures Mechanics Methods Mixed Dentition Modeling Molecular Oral cavity Pathogenesis Phase Prevention Prevention strategy Relative (related person)Research Research Personnel Residual state Resistance Reverse Transcriptase Polymerase Chain Reaction Role Sampling Side Signal Transduction Site Staining method Stains Stimulus Structure TNFSF11 gene Techniques Testing Time Tissues Tooth Extraction Tooth Loss Tooth root structure Tooth structure Trauma Western Blotting alveolar bone base bone bone cell bone lead bone loss bone metabolism design in vivo medical specialties osteoclastogenesis permanent tooth prevent public health relevance restoration theories

项目摘要

DESCRIPTION (provided by applicant): The alveolar ridge at an extraction site is characterized by progressive bone loss, a common and serious clinical problem termed residual ridge resorption (RRR). The pathogenesis of RRR is not clear, but disuse (lack of functional stimulation) has been widely considered a cause. The in vivo mechanical environment of the extraction site, however, has never been characterized. While it is likely true that multiple extractions reduce masticatory stimulation to the bone, this may not be the case for a single-tooth extraction. Masticatory loading, as reflected by bone strain at a single-tooth extraction site, may be increased rather than decreased because 1) occlusal force is not necessarily reduced with a single extraction, and 2) the structural resistance of alveolar bone to occlusal force is compromised due to trauma and the loss of tooth root support. Using a pig model, we propose to measure and compare masticatory strain at the buccal alveolar bone of an extraction site and a contralateral non-extraction (control) site immediately (baseline control) and 6 weeks (experimental) after the extraction (Aim 1). These studies will provide the first direct recordings of functional mechanics surrounding a single-tooth extraction site. Further, we will investigate the post-extraction change of the alveolar bone as compared to the control side and correlated with mechanical strains (Aim 2). Alveolar bone structure and remodeling will be examined using histomorphometric methods. Cellular features including proliferation and osteoclastogenesis will be examined by immunohistochemical methods. Expression of bone remodeling (OPG, RANKL and RANK) and differentiation (Runx2) regulators will be examined using real-time RT-PCR and Western blot techniques. Overall, we hypothesize that alveolar bone at a single-extraction site will be overstrained during mastication due to its compromised structural resistance to loading, which will stimulate alveolar bone remodeling and lead to bone loss (RRR). This study features a direct characterization of the mechanical environment at a single-tooth extraction site and clarifies the relationship between functional mechanics and RRR. The findings of this study will contribute in directing the course of future research on the pathogenesis and prevention of this severe clinical entity affecting millions. Public Health Relevance: Tooth loss, a clinical entity affecting millions, leaves a residual alveolar ridge undergoing progressive bone resorption. Restoring an absorbed edentulous ridge is challenging and costly. The proposed research will characterize functional (masticatory) mechanics, a critical factor for bone metabolism, at a single-tooth extraction site alveolar ridge and examine its relationship with bone change. The results will guide researchers and clinicians in seeking effective preventive strategies for this disease.

描述（由申请人提供）：提取部位的肺泡脊的特征是进行性骨质流失，这是一个常见且严重的临床问题，称为残留脊（RRR）。 RRR的发病机理尚不清楚，但是被普遍认为是原因（缺乏功能刺激）。然而，从未表征提取位点的体内机械环境。虽然多种提取可能会减少骨骼刺激对骨骼的确的确，但单齿提取可能并非如此。通过单齿提取部位的骨骼应变反映的咀嚼负荷可能会增加而不是减少，因为1）咬合力不一定会随着单个提取而减小，而2）肺泡骨对咬合力的结构耐药性因创伤和牙齿根部支撑的损失而损害。使用猪模型，我们建议在提取位点的颊肺肺骨和对侧非萃取（对照）位点（基线对照）（基线对照）和6周（实验）（AIM 1）立即测量和比较咀嚼菌株（AIM 1）。这些研究将提供围绕单齿提取部位的功能力学的第一个直接记录。此外，我们将研究与对照侧相比，肺泡骨的萃取后变化，并与机械菌株相关（AIM 2）。牙槽骨结构和重塑将使用组织形态计量学方法进行检查。细胞特征包括增殖和破骨细胞生成，将通过免疫组织化学方法检查。将使用实时RT-PCR和Western印迹技术检查骨骼重塑（OPG，RANKL和RANK）和分化调节剂的表达。总体而言，我们假设单次萃取部位的肺泡骨在咀嚼期间由于其损坏的结构耐药性而被过度处理，这将刺激肺泡骨重塑并导致骨质流失（RRR）。这项研究以单齿提取地点的机械环境进行了直接表征，并阐明了功能力学与RRR之间的关系。这项研究的结果将在指导未来研究的对该严重临床实体的发病机理和预防数百万的研究过程中做出贡献。公共卫生相关性：牙齿丧失，一种影响数百万的临床实体，留下了一个残留的肺泡脊，进行了进行性骨吸收。恢复一个被吸收的厌恶山脊是具有挑战性且昂贵的。拟议的研究将在单齿提取部位肺泡脊中表征功能（咀嚼）力学，这是骨代谢的关键因素，并检查其与骨变化的关系。结果将指导研究人员和临床医生为这种疾病寻求有效的预防策略。