TOOTH MOVEMENT
TOOTH MOVEMENT
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DOI：
10.1177/10454411910020040101
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发表时间：
1991-01-01
期刊：
影响因子：
--
通讯作者：
DAVIDOVITCH, Z
中科院分区：
文献类型：
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作者：
DAVIDOVITCH, Z
本文综述了有关力致牙齿运动的生物学基础的概念演变。19世纪的假说提出了两种机制：对牙周韧带施加压力和张力，以及牙槽骨的弯曲。20世纪早期和中期的组织学研究表明，这两种现象实际上是同时发生的，并且细胞以及PDL和牙槽骨的细胞外成分参与了对施加的机械力的反应，最终导致重塑活动。对培养的分离细胞进行的实验表明，形状扭曲可能通过打开质膜离子通道或通过使细胞骨架细丝结晶而导致细胞活化。另一方面，矿化或非矿化的胶原基质的机械变形可能引起生物电现象（应力产生的电位和流电位）的发展，这些现象能够通过改变细胞膜或流体包膜上的电荷来刺激细胞。在完整的动物中，大约1分钟/天的机械扰动显然足以引起深刻的成骨反应，这可能是由于基质蛋白聚糖相关的“应变记忆”。酶分离的人PDL细胞对机械和化学信号作出生物化学反应。后者包括内分泌、自分泌和旁分泌。组织化学和免疫组织化学研究表明，在牙齿早期移动的地方，PDL液体移位，细胞和基质扭曲。血管活性神经递质从牙周神经末梢释放，导致白细胞从邻近的毛细血管中迁移。这些细胞分泌细胞因子和生长因子，刺激PDL细胞和牙槽骨衬细胞重塑其相关基质。这种重塑活动有助于牙齿移动到骨头被吸收的区域。这些新出现的信息表明，在现存的哺乳动物中，许多类型的细胞都参与了对牙齿和骨骼施加机械应力的生物反应。从本质上讲，神经系统、免疫系统和内分泌系统的细胞参与了PDL和牙槽骨细胞对施加压力的激活和反应。这一事实表明，对牙齿施加力的生物反应领域的研究应该足够广泛，包括探索物理、细胞和分子现象之间可能存在的联系。这一调查领域的目标应该继续阐述基本原则，特别是将新发现外推到临床环境中，在临床环境中，每年有数百万患者长期遭受机械力对牙齿的应用，以努力改善其在口腔中的位置。最近开发的研究工具，如细胞培养技术和免疫探针，是促进这一发展的最大希望。
This article reviews the evolution of concepts regarding the biological foundation of force-induced tooth movement. Nineteenth century hypotheses proposed two mechanisms: application of pressure and tension to the periodontal ligament (PDL), and bending of the alveolar bone. Histologic investigations in the early and middle years of the 20th century revealed that both phenomena actually occur concomitantly, and that cells, as well as extracellular components of the PDL and alveolar bone, participate in the response to applied mechanical forces, which ultimately results in remodeling activities.Experiments with isolated cells in culture demonstrated that shape distortion might lead to cellular activation, either by opening plasma membrane ion channels, or by crystallizing cytoskeletal filaments. Mechanical distortion of collagenous matrices, mineralized or non-mineralized, may, on the other hand, evoke the development of bioelectric phenomena (stress-generated potentials and streaming potentials) that are capable of stimulating cells by altering the electric charge on their membrane or their fluid envelope. In intact animals, mechanical perturbations on the order of about 1 min/d are apparently sufficient to cause profound osteogenic responses, perhaps due to matrix proteoglycan-related "strain memory".Enzymatically isolated human PDL cells respond biochemically to mechanical and chemical signals. The latter include endocrines, autocrines, and paracrines. Histochemical and immunohistochemical studies showed that during the early places of tooth movement, PDL fluids are shifted, and cells and matrix are distorted. Vasoactive neurotransmitters are released from periodontal nerve terminals, causing leukocytes to migrate out of adjacent capillaries. Cytokines and growth factors are secreted by these cells, stimulating PDL cells and alveolar bone lining cells to remodel their related matrices. This remodeling activity facilitates movement of teeth into areas in which bone had been resorbed.This emerging information suggests that in the living mammal, many cell types are involved in the biological response to applied mechanical stress to teeth, and thereby to bone. Essentially, cells of the nervous, immune, and endocrine systems become involved in the activation and response of PDL and alveolar bone cells to applied stresses. This fact implies that research in the area of the biological response to force application to teeth should be sufficiently broad to include explorations of possible associations between physical, cellular, and molecular phenomena. The goals of this investigative field should continue to expound on fundamental principles, particularly on extrapolating new findings to the clinical environment, where millions of patients are subjected annually to applications of mechanical forces to their teeth for long periods of time in an effort to improve their position in the oral cavity. Recently developed research tools such as cell culture techniques and immunologic probes, are the best hope for enhancing this development.