Functional Tooth Mobility

描述（由申请人提供）：可移动性是牙齿生物力学的基本特征，允许牙齿在牙槽内移动以传播和减轻负荷。牙齿的活动度在结构上是由牙周组织（韧带、牙龈、细胞外基质和牙骨质的附着物）决定的，在功能上是由咬合力和肌肉力决定的，是决定个体牙齿预后的最广泛使用的牙周参数之一。然而，过度移动可能不是提取的有效指标，因为移动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正常的牙齿活动范围。令人惊讶的是，功能性牙齿的活动从未被直接测量过，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，临床指南的管理不稳定的牙齿不存在。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，以及对人类受试者进行侵入性研究的不可能性，更不用说临床患者了。因此，我们建议开发一个迷你猪模型。这一物种是最被接受和描述良好的动物模拟人类咀嚼，其多根后牙与人类非常相似。通过可植入微型传感器技术的创新组合来测量牙槽内的三维牙根位移以及随之产生的牙槽弯曲和间质流体压力，我们计划检查上颌第一磨牙近中根的正常功能活动范围（Aim 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（Aim 2）。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提供基线数据，这些研究将调查由于牙槽骨丢失而导致的牙齿移动的预后。提出的研究成果将是首次在体内确定咀嚼如何置换牙齿，潜在的转化回报将是制定更好的临床策略来保护受损牙齿。

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.