Study on the pathological absorption of maxillary bone induced by mechanical stress

为了解决颌骨囊肿中物理力（=机械应力）与骨吸收之间的关系，我们尝试直接测量囊内压和囊液胶体渗透压。用激光多普勒血流仪测定囊壁微循环。以囊壁组织为材料，采用化学发光-高效液相色谱法检测脂质过氧化，ELISA法检测前列腺素和炎症因子。用组织化学方法观察囊壁过氧化脂质和抗氧化酶的定位。结果如下：囊内压平均值为27.4mmHg，与胶体渗透压相关性较好，随囊液变性伴细菌感染或炎症发生变化。压力与颌骨囊肿的组织学分型无相关性。2. 囊肿壁血流量低于健康侧牙龈黏膜。3. 囊壁组织中PGE_2、IL-1betaIL-6、TNF α的含量较高。这些因素的值与颌骨囊肿的炎症程度有关。4.Cu、Zn-SOD定位于囊壁上皮内侧和囊壁结缔组织毛细血管内皮上皮。这一发现与炎症的病理组织学表现和颌囊肿壁过氧化脂质染色的定位一致。本研究结果表明，自由基介导的组织损伤可引起囊内压力升高，同时囊液胶体渗透压升高也可破坏囊壁微循环。这些结果强烈提示微血管损伤是骨吸收因子产生的主要原因。在临床研究中，颌骨囊肿通过灌洗治疗，随着囊内压力的下降，囊肿的大小逐渐减小，定期抽吸囊肿液，更换含抗氧化试剂的生理盐水。少

To solve the relationship between the physical force ( =mechanical stress)and the bone absorption in jaw cysts, we tried to measure directly intracystic pressure and colloid osmotic pressure of cyst fluids. The cyst wall microcirculation was also measured by laser doppler blood flow meter. Using cyst wall tissues as materials, we tried to detect lipid peroxide by chemiluminescence-HPLC method, prostanoid and inflammatory cytokines by ELISA.Furthermore, the localization of lipid peroxide and antioxidant enzyme in cyst wall were investigated by the histochemical method. Results were as follows.1. The average of intracystic pressure was 27.4mmHg, which was a good correlation with the colloid osmotic pressure, and changed with the degeneration of cyst fluid accompanying with bacterial infection or inflammation. No correlation could be found between the pressure and the histological typing of jaw cysts. 2. The blood flow of cyst wall showed lower value than healthy-side gingival mucosa. 3. … More PGE_2, IL-1betaIL-6, TNF alpha were detected in cyst wall. Values of these factors were in propotion to the degree of inflammation in jaw cysts. 4.Cu, Zn-SOD was localized at the inner side of cyst wall epitelium and at the capillary endothelial epithelium in cyst wall connective tissue. This finding was in good accordance with both pathohistological finding of inflammation and the localization of lipid peroxide staining in jaw cyst wall.These results in this study revealed that the increase of intracystic pressure was induced by the free radicals-mediated tissue injury and that the microcirculation in cyst wall was also damaged by the increasing of the colloid osmotic pressure of cyst fluid. These findings strongly suggested that the microvascular injury was responsible for the generation of bone absorbing factor. In clinical study, jaw cyst gradually decreased in size according to the declines of intracystic pressure by the irrigation therapy, which aspirate cyst fluid regularly to change physiological saline including antioxidant reagents. Less