Functional Tooth Mobility

描述(申请人提供)：移动性是牙齿生物力学的一个基本特征，允许牙齿在其窝内移动以分散和减轻负荷。牙齿的活动性在结构上由牙周组织(韧带、牙龈、细胞外基质以及与牙骨质和骨的附着物)决定，在功能上由咬合力和肌力决定，是最广泛使用的牙周参数之一，用来决定个体牙齿的预后。然而，过度的机动性可能不是提取的有效指标，因为机动性也是一种内在的保护性和适应性反应。有效的治疗计划需要了解功能过程中牙齿活动的正常范围。令人惊讶的是，功能牙齿的活动性从来没有被直接测量过，因此我们既不知道正常的活动范围，也不知道“过度”活动的阈值。因此，不稳定牙齿的临床治疗指南并不存在。缺乏这些数据反映了在正常功能期间进行口腔内测量的困难，以及不可能对人类受试者进行侵入性研究，更不用说临床患者了。因此，我们建议开发一个小型猪模型。这个物种是最被接受和最好描述的类似于人类咀嚼的动物，它的多根后牙与人类的牙齿非常相似。通过创新结合植入式微型换能器技术来测量牙根在牙槽窝内的位移以及伴随的牙槽弯曲和间质液体压力，我们计划检测上颌第一磨牙近中牙根功能活动的正常范围(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的影响(目标2)。这项工作将为所涉及的工程方法建立原则证明，并为计划中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。这项拟议研究的成果将是第一次在体内确定咀嚼如何取代牙齿，潜在的翻译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.