褪黑素促进骨再生机制及在口腔种植中的应用

Mechanism by which melatonin promotes bone regeneration and its application in oral implantation

背景:牙槽骨的缺损会危害患者的口颌功能和身心健康。褪黑素因具有促进骨再生特性,可用于预防和治疗骨缺损疾病,对与口腔种植相关的骨结合及种植体周围炎症也有重要应用。目的:探讨褪黑素促进骨再生机制、褪黑素在口腔种植领域的潜在应用,为在口腔种植中发挥褪黑素促骨生成特性提供新的思路。方法:以“褪黑素,骨缺损,成骨细胞,破骨细胞,活性氧,牙周炎,骨结合,种植体周围炎”为中文检索词,以“melatonin,bone defect,osteoblast,osteoclast,ROS,periodontitis,osseointegration,periimplantitis”为英文检索词,应用计算机检索中国知网、PubMed数据库收录的相关文献。检索时限重点为2019年1月至2024年8月,同时纳入少数经典远期文献。通过阅读文题和摘要进行筛选,最终纳入91篇文献进行综述。结果与结论:①褪黑素促进骨再生,机制是促进成骨细胞、软骨细胞和血管内皮细胞的增殖和分化,抑制骨吸收,限制氧化应激。②褪黑素作为骨形成的促进剂,在口腔种植中起到促进骨结合和预防种植体周围炎的作用。③未来还需要更多的研究完整地揭示褪黑素的成骨机制,并作出褪黑素在骨结合和种植体周围炎方面的最佳给药条件和安全性指南。

BACKGROUND:Alveolar bone defects can jeopardize patients’oral and jaw function and physical and mental health,and reduce their quality of life.Melatonin can be used for the prevention and treatment of bone defect diseases due to its properties of promoting bone regeneration,and also has important applications in osseointegration and peri-implant inflammation related to oral implants.OBJECTIVE:To explore the mechanism by which melatonin promotes bone regeneration,the potential application of melatonin in the field of oral implantation,and to provide new ideas for the utilization of melatonin’s osteogenic properties in oral implantation.METHODS:With“melatonin,bone defect,osteoblast,osteoclast,reactive oxygen species,periodontitis,osseointegration,peri-implantitis”as Chinese and English search terms,the relevant literature was searched in CNKI and PubMed databases.The timeframe of the search was from January 2019 to August 2024,while a few classical early documents were included.Screening was carried out by reading the titles and abstracts,and 91 papers were finally included for review.RESULTS AND CONCLUSION:(1)Melatonin promotes bone regeneration by promoting the proliferation and differentiation of osteoblasts,chondrocytes and vascular endothelial cells,inhibiting bone resorption and limiting oxidative stress.(2)Melatonin,as a promoter of bone formation,plays a role in promoting osseointegration and preventing peri-implantitis in oral implants.(3)More research is needed in the future to completely reveal the osteogenic mechanisms of melatonin and to make guidelines for optimal administration conditions and safety of melatonin in osseointegration and peri-implantitis.