正畸力作用轻度牙周炎患牙后龈沟液中RANKL、OPG的表达

Expression of RANKL and OPG in gingival crevicular fluid of teeth with mild periodontitis under orthodontic force

目的检测正畸力作用轻度牙周炎患牙后龈沟液中核因子κB受体活化子配体(receptor activator for NF-κB ligand,RANKL)、骨保护素(Osteoprotegerin,OPG)的浓度变化,探讨正畸力是否加重患牙的牙周损伤。方法选择20例无牙周炎病史正畸患者和20例伴有轻度牙周炎但炎症已被控制的正畸患者;分别在正畸加力后0 h、1 h、24 h、7 d、14 d、21 d收集上颌双侧尖牙远中龈沟液;应用酶联免疫吸附(enzyme-linked immune sorbent assay,ELISA)实验测定龈沟液中RANKL、OPG浓度;分析正畸过程中RANKL、OPG的变化趋势及两者比值。结果在正畸加力后各时间点,两组患者龈沟液中RANKL、OPG浓度无明显差异(P>0.05),除加力后7 d外,其他时间点龈沟液中RANKL/OPG比值无差异(P>0.05);以加力后0 h作对照,各时间点组内患者龈沟液中RANKL浓度均升高(P<0.05),在加力后7 d达到最大值;而各时间点组内患者龈沟液中OPG浓度均降低(P<0.01),在加力后7 d,OPG浓度最低;此外,RANKL/OPG比值均增加,同样在加力后7 d达到最大值。结论在相同正畸力作用下,伴牙周炎患牙牙周组织骨改建活动无明显异常;因此,恰当的正畸力不会引起轻度牙周炎患牙牙周病变加重。

Objective To evaluate the effect of orthodontic force on teeth with mild periodontitis by detecting levels of receptor activator of nuclear factorκB ligand （ RANKL） and osteoprotegerin （ OPG） in gingival crevicular fluid （ GCF） . Methods 20 cases without a history of periodontitis and 20 orthodontic patients with mild periodontitis whose inflammation was under the control were selected. The distal gingival crevicular fluid of the bilateral maxillary teeth after orthodontic force was collected for 0 h、1 h、24 h、7 d、14 d、21 d. Then the concentrations of RANKL and OPG in gingival crevicular fluid were determined by ELISA assays. The change trend of RANKL, OPG and the ratio of RANKL/OPG in the process of orthodontics were analyzed. Results At each time point with orthodontic force, there was no significant difference in RANKL and OPG concentrations in the gingival crevicular fluid between the two groups （ P〉 0.05） . The ratio of RANKL/OPG in the gingiva crevicular fluid had no difference at every time point （ P〉 0.05） , except for the 7 d. Using the 0 h as control, the concentrations of RANKL in gingival crevicular fluid elevated in the two groups at all time points （ P〈0.05） ,and the highest expression under orthodontic force was at the 7 d. However, the concentrations of OPG in gingival crevicular fluid decreased（ P〈0.01） , and the lowest expression under orthodontic force was at the 7 d. Furthermore, the RANKL/ OPG ratios also increased, and reached maximum at 7 d under orthodontic force. Conclusion Under the same orthodontic force, the bone reconstructed activities have no obvious distinction with or without periodontitis. Therefore, appropriate orthodontic force does not aggravate the proceeding of the mild periodontitis.