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

为解决颌骨囊肿中的物理力（即机械应力）与骨吸收之间的关系，我们尝试直接测量囊肿内压力和囊液胶体渗透压。用激光多普勒血流仪测定囊壁微循环。以囊壁组织为材料，采用荧光定量-HPLC法检测脂质过氧化物，ELISA法检测前列腺素和炎性细胞因子，并采用组织化学方法研究脂质过氧化物和抗氧化酶在囊壁中的定位。结果如下：1.囊内压平均为27.4mmHg，与胶体渗透压有较好的相关性，随囊液变性伴细菌感染或炎症而变化。压力与颌骨囊肿的组织学类型无相关性。2.囊肿壁血流量明显低于健侧牙龈粘膜。3. ...更多信息 囊壁中检测到PGE_2、IL-1 β、IL-6、TNF α。这些因素的值与颌骨囊肿的炎症程度成正比。4.Cu，Zn-SOD定位于囊壁上皮内侧及囊壁结缔组织内的毛细血管内皮上皮。这一结果与病理组织学所见的炎症反应和囊壁脂质过氧化物染色的定位一致，提示自由基介导的组织损伤引起囊内压增高，囊液胶体渗透压增高也损害囊壁微循环。这些发现强烈表明微血管损伤是骨吸收因子产生的原因。在临床研究中，颌骨囊肿通过定期抽吸囊液，更换含抗氧化剂的生理盐水的冲洗治疗，随着囊内压力的下降，囊肿逐渐缩小。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