下牙槽神经离断对下颌骨骨质和拔牙创愈合的影响研究  

Effects of inferior alveolar nerve denervation on mandibular bone development and healing of tooth extraction sockets

作　　者：程凯远 张美子 刘中宁[1] 姜婷[1] CHENG Kai-yuan;ZHANG Mei-zi;LIU Zhong-ning;JIANG Ting(Department of Prosthodontics,Peking University School and Hospital of Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院修复科、国家口腔医学中心、国家口腔疾病临床医学研究中心、口腔生物材料和数字、诊疗装备国家工程研究中心,北京100081

出　　处：《口腔颌面修复学杂志》2025年第2期105-115,共11页Chinese Journal of Prosthodontics

基　　金：国家自然科学基金面上项目(项目编号:82170928);北京市科技新星计划资助(项目编号:Z1911000001119096)。

摘　　要：目的:本研究探索失神经支配对下颌骨骨质和拔牙创愈合的影响,并利用神经肽逆转失神经对下颌骨的负面影响,为深入探讨神经支配对骨发育骨再生的重要意义及构建神经化骨组织工程打下基础。方法:本研究通过下牙槽神经离断模型探究失神经支配对于大鼠髁突软骨内成骨,皮质骨骨膜下成骨及拔牙创骨愈合的影响。60只雄性Sprague Dawley大鼠拔除右侧下颌磨牙后随机分为三组,分别为Sham组(假手术)、IANS组(右侧下牙槽神经离断)以及CGRP组[右侧下牙槽神经离断+降钙素基因相关肽(CGRP)注射]。CGRP组分别在右侧髁突、拔牙窝以及下颌骨体周围注射CGRP(100 nmol/L,0.2 mL)。术后间隔2周分别注射钙黄绿素、茜素红、盐酸四环素以观察皮质骨沉积。术后2周、4周、6周收集下颌骨样本,通过micro-CT及组织学切片分析骨质骨量变化情况。结果:大鼠右侧下牙槽神经离断后,与Sham组相比,IANS组髁突软骨变薄,软骨细胞分层紊乱,骨小梁稀疏;拔牙窝骨质愈合欠佳,骨小梁稀疏,骨密度较低;下颌皮质骨骨沉积缓慢等。同时,CGRP组相较IANS组,髁突软骨层更厚,软骨细胞分层有序;拔牙窝骨质愈合良好,骨小梁致密,骨密度更高;下颌骨骨皮质骨沉积速率更快。CGRP组获得了和Sham组相似的骨发育和骨再生效果。结论:大鼠下牙槽神经离断会抑制下颌骨髁突软骨内成骨、骨缺损骨再生和膜内成骨。局部注射降钙素基因相关肽CGRP可以修复失神经对下颌骨新骨形成和拔牙创愈合影响。研究提示下牙槽神经对于下颌骨骨质和拔牙创愈合具有重要作用和影响。Objective:In the repair of significant bone tissue defects,nerve regeneration is crucial to promote bone regeneration.To explore the influence of innervation on the jaw bone,this study used the inferior alveolar nerve transection model to investigate the impact of denervation on new bone formation and healing of tooth extraction sockets in the mandible.Neuropeptides were used to reverse the adverse effects of denervation on the jaw bone.This study laid a foundation for further discussion on the significance of nerve innervation on bone development and bone regeneration and the construction of neutralizedbone tissue engineering.Methods:In this study,the effect of denervation on intraoral osteogenesis of the condyle,subperiosteal osteogenesis of cortical bone and healing of tooth extraction trauma in rats were investigated by constructing the model of inferior alveolar nerve transection surgery model 60 SD rats were randomly divided into three groups after proper mandibular molar extraction:Sham group,right inferior alveolar nerve transection surgery group(IANS group),and right inferior alveolar nerve transection surgery+calcitonin gene-related peptide injection group(CGRP group).In the CGRP group,CGRP(100 nmol/L,0.2 mL)was injected into the right condyle,tooth extraction fossa and around the mandibular body every three days.The experimental animals were injected with calcein,alizarin red and tetracycline hydrochloride on the day of surgery,2 weeks and 4 weeks after surgery,respectively.The rats were euthanized at 2,4 and 6 weeks after surgery,and the mandibular samples were collected for follow-up micro-CT analysis and histological section analysis.Results:After the right inferior alveolar nerve was severed,compared with the Sham group,the condylar cartilage in the IANS group was thinner,the stratification of chondrocytes was disorganized,and the bone trabecula was sparse.The bone healing of the extraction fossa was poor,the trabecula bone was sparser,and the bone density was low.The bone deposition of the mandibu

关 键 词：下牙槽神经离断 髁突 拔牙窝 骨膜下成骨 降钙素基因相关肽 

分 类 号：R782.1[医药卫生—口腔医学]