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目的通过观察破骨细胞核因子k B受体活化因子配体(receptor activator nuclear factor kappa B ligand,RANKL)和骨保护因子(osteoprotegerin,OPG)在不同骨移植材料拔牙位点保存时骨构建过程中表达变化,探讨破骨细胞对不同骨移植材料植入拔牙窝内在引导骨再生中的作用。方法选取6只12月龄雄性beagle犬,微创拔除上下颌双侧第一侧切牙,将4个位点随机做不同处理,A组填入富血小板纤维蛋白(platelet-rich fibrin,PRF),B组填入骨诱导活性材料(osteoinduction active material,OAM),C组填入羟基磷灰石生物陶瓷(coralline hydroxyapatite,CHA),D组空置(对照)。6只犬随机分别于术后4周和12周各处死3只,制作牙槽骨标本。免疫组化检测24个拔牙位点保存制作的犬牙槽骨标本中RANKL与OPG的表达变化。结果术后4周骨组织中OPG的表达A组高于B组、C组和D组(P<0.05),RANKL的表达D组高于C组、B组和A组(P<0.05)。术后12周骨组织中OPG的表达D组高于C组、B组和A组(P<0.05),RANKL的表达C组高于B组、A组和D组(P<0.05)。结论骨移植材料在骨改建过程中通过促进成骨细胞分化成熟而刺激OPG表达升高,抑制破骨细胞。提示骨移植材料通过调控RANKL和OPG在拔牙窝新骨形成过程中发挥作用。
OBJECTIVE: To observe the expression of osteoclast activators nuclear factor kappa B ligand (RANKL) and osteoprotegerin (osteoprotegerin, osteoprotegerin, osteoprotegerin) during osteosynthesis in the preservation of different bone graft materials To investigate the role of osteoclasts in guiding the regeneration of different bone graft materials into the socket of tooth extraction. Methods Six male 12-month-old beagle dogs were selected. The bilateral first maxillary and lateral mandibular incisors were removed by microinvasion. The four sites were randomly divided into two groups. Group A was filled with platelet-rich fibrin (PRF) Group B was filled with osteoinduction active material (OAM), group C was filled with coralline hydroxyapatite (CHA), group D was vacant (control). Six dogs were randomly sacrificed at 4 and 12 weeks postoperatively to produce alveolar bone specimens. Immunohistochemistry was used to detect the expression of RANKL and OPG in alveolar bone specimens prepared from 24 tooth extraction sites. Results The expression of OPG in bone tissue at 4 weeks after operation was higher in group A than in group B, C and D (P <0.05). The expression of RANKL in group D was higher than that in group C, B and group A (P <0.05). The expression of OPG in bone tissue at 12 weeks after operation was higher in group D than in group C, group B and group A (P <0.05). The expression of RANKL in group C was higher than that in group B, group A and group D (P <0.05). Conclusion In bone remodeling process, bone graft material stimulated OPG expression and inhibited osteoclasts by promoting the differentiation and maturation of osteoblasts. Prompted bone graft material through the regulation of RANKL and OPG play a new role in the process of new bone formation in the extraction socket.