PAOO微创术式与传统术式促进正畸牙移动效果及生物学机制研究

doi:10.13591/j.cnki.kqyx.2025.11.003

摘要/Abstract

摘要：

目的比较翻瓣骨皮质切开与仅骨皮质切开术下牙周加速成骨正畸(PAOO)对加速正畸牙移动的影响。方法选取健康雄性SD大鼠60只(体质量180~200 g),将大鼠随机分为对照组、翻瓣骨皮质切开组和仅骨皮质切开(非翻瓣)组各20只,正畸加力后分别在牙移动0、1、3、7 d过量麻醉处死手术组及对照组大鼠各5只,统计对照组与实验组大鼠牙移动距离,同时进行免疫组化染色观察相应分子生物学变化。结果翻瓣骨皮质切开术与仅骨皮质切开加速正畸牙移动方面未见显著差异;相比传统正畸牙移动,翻瓣骨皮质切开术与仅骨皮质切开均可引起牙周受压力侧RANKL表达增加;翻瓣骨皮质切开术与非翻瓣骨皮质切开术均能够增加张力区组织生成面积,但两种术式之间不存在显著差异;相比传统正畸牙移动,翻瓣骨皮质切开术与仅骨皮质切开均可引起牙周受张力侧ALP、OCN、OPN表达增加,两术式间未见显著差异。结论翻瓣骨皮质切开及仅骨皮质切开在早期加速正畸牙移动及促进牙槽骨形成方面均发挥显著作用。两种PAOO术式的骨皮质切开均能为正畸治疗提供更为高效、稳定的生物学支持。

关键词: PAOO, 骨皮质切开, 加速正畸牙移动, 骨改建

Abstract:

Objective To compare the periodontally accelerated osteogenic orthodontics(PAOO) effects of corticotomy with full mucoperiosteal flap(flapped corticotomy) and corticotomy-only on accelerating orthodontic tooth movement. Methods A total of 60 healthy male SD rats(weighing 180-200 g)were selected and randomly divided into three groups. There were 20 rats each in the flapped corticotomy group, the corticotomy-only group, and the control group. After applying orthodontic instruments, 5 rats each in the surgical group and the control group were killed by excessive anesthesia on 0, 1, 3, and 7 days after tooth movement. The tooth movement distances of the rats in the control group and the experimental group were counted, and immunohistochemical staining was performed to observe the corresponding molecular biological changes. Results There was no significant difference in accelerating orthodontic tooth movement between the flapped corticotomy group and the corticotomy-only group. Compared with traditional orthodontic tooth movement, both the flapped corticotomygroup and the corticotomy-only group could bring an increase in the expression of RANKL on the pressed periodontal side while there was no significant difference between the two experimental groups. Both the flapped corticotomy and non-flapped corticotomy could enlarge the area of tissue formation in the periodontal tension zone, and still there was no significant difference between the two surgical methods. Compared with traditional orthodontic tooth movement, both the flapped corticotomy group and the corticotomy-only group could lead to an increase in ALP, OCN and OPN expression on the periodontal tension zone. Conclusion Both flapped corticotomy and corticotomy play a significant role in accelerating orthodontic tooth movement and promoting alveolar bone formation in the early stage. Both surgical methods of PAOO can provide more efficient and stable biological support for orthodontic treatment.

Key words: PAOO, corticotomy, accelerated orthodontics, bone remodeling

中图分类号:

R783.5

刘浩, 彭文静, 高秋颖, 胥加斌, 刘刚, 朱绍跃. PAOO微创术式与传统术式促进正畸牙移动效果及生物学机制研究[J]. 口腔医学, 2025, 45(11): 813-818.

LIU Hao, PENG Wenjing, GAO Qiuying, XU Jiabin, LIU Gang, ZHU Shaoyue. The study on PAOO minimally invasive versus traditional surgery in accelerating orthodontic tooth movement and its mechanisms[J]. Stomatology, 2025, 45(11): 813-818.

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参考文献 19

[1]	Han SH, Park WJ, Park JB. Comparative efficacy of traditional corticotomy and flapless piezotomy in facilitating orthodontic tooth movement: A systematic review and meta-analysis[J]. Medicina (Kaunas), 2023, 59(10): 1804.
[2]	Bukhari OM, Sohrabi K, Tavares M. Factors affecting patients’ adherence to orthodontic appointments[J]. Am J Orthod Dentofacial Orthop, 2016, 149(3): 319-324. doi: 10.1016/j.ajodo.2015.07.040
[3]	Sameshima GT, Iglesias-Linares A. Orthodontic root resorption[J]. J World Fed Orthod, 2021, 10(4): 135-143. doi: 10.1016/j.ejwf.2021.09.003 pmid: 34785166
[4]	Kole H. Surgical operations on the alveolar ridge to correct occlusal abnormalities[J]. Oral Surg Oral Med Oral Pathol, 1959, 12(5): 515-529concl. doi: 10.1016/0030-4220(59)90153-7
[5]	Wilcko WM, Wilcko T, Bouquot JE, et al. Rapid orthodontics with alveolar reshaping: Two case reports of decrowding[J]. Int J Periodontics Restorative Dent, 2001, 21(1): 9-19.
[6]	Kim SH, Kim I, Jeong DM, et al. Corticotomy-assisted decompensation for augmentation of the mandibular anterior ridge[J]. Am J Orthod Dentofacial Orthop, 2011, 140(5): 720-731. doi: 10.1016/j.ajodo.2009.12.040
[7]	Cassetta M, Di Carlo S, Giansanti M, et al. The impact of osteotomy technique for corticotomy-assisted orthodontic treatment (CAOT) on oral health-related quality of life[J]. Eur Rev Med Pharmacol Sci, 2012, 16(12): 1735-1740.
[8]	Dibart S. Piezocision^TM: Accelerating orthodontic tooth movement while correcting hard and soft tissue deficiencies[J]. Front Oral Biol, 2016, 18: 102-108. doi: 10.1159/000351903 pmid: 26599123
[9]	Gibreal O, Hajeer MY, Brad B. Efficacy of piezocision-based flapless corticotomy in the orthodontic correction of severely crowded lower anterior teeth: A randomized controlled trial[J]. Eur J Orthod, 2019, 41(2): 188-195. doi: 10.1093/ejo/cjy042
[10]	Mheissen S, Khan H, Samawi S. Is Piezocision effective in accelerating orthodontic tooth movement: A systematic review and meta-analysis[J]. PLoS One, 2020, 15(4): e0231492. doi: 10.1371/journal.pone.0231492
[11]	Al-Naoum F, Hajeer MY, Al-Jundi A. Does alveolar corticotomy accelerate orthodontic tooth movement when retracting upper canines? A split-mouth design randomized controlled trial[J]. J Oral Maxillofac Surg, 2014, 72(10): 1880-1889. doi: 10.1016/j.joms.2014.05.003
[12]	Lin Y, Fu ML, Harb I, et al. Functional biomaterials for local control of orthodontic tooth movement[J]. J Funct Biomater, 2023, 14(6): 294. doi: 10.3390/jfb14060294
[13]	Singh A, Gill G, Kaur H, et al. Role of osteopontin in bone remodeling and orthodontic tooth movement: A review[J]. Prog Orthod, 2018, 19(1): 18. doi: 10.1186/s40510-018-0216-2 pmid: 29938297
[14]	Komori T. Functions of osteocalcin in bone, pancreas, testis, and muscle[J]. Int J Mol Sci, 2020, 21(20): 7513. doi: 10.3390/ijms21207513
[15]	Kim JY, Kim BI, Jue SS, et al. Localization of osteopontin and osterix in periodontal tissue during orthodontic tooth movement in rats[J]. Angle Orthod, 2012, 82(1): 107-114. doi: 10.2319/030911-173.1
[16]	Ferron M, Hinoi E, Karsenty G, et al. Osteocalcin differentially regulates beta cell and adipocyte gene expression and affects the development of metabolic diseases in wild-type mice[J]. Proc Natl Acad Sci USA, 2008, 105(13): 5266-5270. doi: 10.1073/pnas.0711119105 pmid: 18362359
[17]	Chellaiah MA, Kizer N, Biswas R, et al. Osteopontin deficiency produces osteoclast dysfunction due to reduced CD44 surface expression[J]. Mol Biol Cell, 2003, 14(1): 173-189. doi: 10.1091/mbc.e02-06-0354 pmid: 12529435
[18]	Feng JQ, Clinkenbeard EL, Yuan BZ, et al. Osteocyte regulation of phosphate homeostasis and bone mineralization underlies the pathophysiology of the heritable disorders of rickets and osteomalacia[J]. Bone, 2013, 54(2): 213-221. doi: 10.1016/j.bone.2013.01.046 pmid: 23403405
[19]	Meikle MC. The tissue, cellular, and molecular regulation of orthodontic tooth movement: 100 years after Carl Sandstedt[J]. Eur J Orthod, 2006, 28(3): 221-240. doi: 10.1093/ejo/cjl001