Functional Tooth Mobility

描述（由申请人提供）：移动性是牙齿生物力学的基本特征，允许牙齿在其牙槽内移动以分散和减轻负荷。牙齿移动性在结构上由牙周组织（韧带、牙龈、细胞外基质以及牙骨质和骨的附着物）决定，在功能上由咬合力和肌肉力决定，并且已经是用于确定个体牙齿预后的最广泛使用的牙周参数之一。然而，过度的流动性可能不是提取的有效指标，因为流动性也是一种内在的保护和适应性反应。有效的治疗计划需要了解功能期间牙齿移动的正常范围。令人惊讶的是，功能性牙齿移动从未被直接测量，因此我们既不知道正常的移动范围，也不知道“过度”移动的阈值。因此，不存在治疗不稳定牙齿的临床指南。这些数据的缺乏反映了在正常功能期间进行口内测量的困难，以及对人类受试者（更不用说临床患者）进行侵入性研究的不可能性。因此，我们建议建立一个小型猪模型。该物种是最被接受和描述的类似于人类咀嚼的动物，其多根后牙与人类非常相似。通过植入式微型传感器技术的创新组合，用于测量其插槽内的3D牙根位移以及伴随的牙槽弯曲和间质液压力，我们计划检查上颌第一磨牙近中牙根的正常功能活动范围（目标1），并评估这些生理动力学如何受到不同程度的牙槽骨丢失（目标2）的影响。这项工作将为所涉及的工程方法建立原理证明，并为计划的未来研究建立基线数据，这些研究将调查因牙槽骨丢失而移动的牙齿的预后。拟议研究的可交付成果将是第一次在体内确定咀嚼如何使牙齿移位，潜在的转化回报将是开发更好的临床策略来保护受损的牙齿。

DESCRIPTION (provided by applicant): Mobility is a fundamental characteristic of dental biomechanics, allowing the tooth to move within its socket to disseminate and relieve loads. Tooth mobility is determined structurally by periodontal tissues (ligament, gingiva, extracellular matrix and attachments to cementum and bone) and functionally by occlusal and muscular forces, and has been one of the most widely used periodontal parameters to determine individual tooth prognosis. However, excessive mobility may not be a valid indicator for extraction, because mobility is also an intrinsic protective and adaptive response. Effective treatment planning requires an understanding of the normal range of tooth mobility during function. Surprisingly, functional tooth mobility has never been directly measured, thus we know neither the normal range of movement nor the threshold for "excessive" mobility. Consequently, clinical guidelines for the management of unstable teeth do not exist. The lack of such data reflects the difficulty of making intraoral measurements during normal function as well as the impossibility of performing invasive studies on human subjects, much less clinical patients. Hence, we propose to develop a minipig model. This species is the most accepted and well-described animal analogue to human mastication and its multi-rooted posterior teeth are quite similar to those of humans. Through the innovative combination of implantable miniature transducer technology for measuring 3D tooth root displacement within its socket and accompanying alveolar bending and interstitial fluid pressure, we plan to examine the normal range of functional mobility of mesial roots of the maxillary first molar (Aim 1), and to assess how these physiological kinetics are affected by various degrees of alveolar bone loss (Aim 2). The work will establish proof-of-principle for the engineering methods involved and baseline data for planned future studies that will investigate the prognosis for teeth that are mobile because of loss of alveolar bone. The deliverables of the proposed study will be the first in vivo determinations of how chewing displaces teeth, and the potential translational payoffs will be to develop better clinical strategies to preserve compromised teeth.