本文選題：牙周炎 + 降鈣素�。� 參考：《天津醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：本實驗通過建立大鼠牙周炎模型并對其應(yīng)用1,25維生素D及降鈣素后,觀察牙周探診深度(probing depth, PD)、牙槽骨喪失水平,檢測血清中的骨堿性磷酸酶(bone alkaline phosphatase, BALP)及骨鈣素(osteocalcin, OC)的濃度的變化情況。以探討降鈣素與1,25維生素D對牙周炎導(dǎo)致大鼠牙槽骨喪失的影響,從而為牙周炎的輔助治療探索一種新的可行方法。 方法：清潔級健康成年雄性Wistar大鼠125只,隨機分為A、B、C、D、E5組(n=25只／組),即A組為空白對照組,B組為牙周炎對照組,C組為降鈣素治療組,D組為1,25維生素D治療組,E組為降鈣素和1,25維生素D聯(lián)合治療組。B、C、D、E組用正畸結(jié)扎絲結(jié)扎雙側(cè)上頜第一磨牙牙頸部加高糖軟食的方法建立牙周炎大鼠模型。A組麻醉后不作處理。用正畸結(jié)扎絲結(jié)扎上頜磨牙牙頸部加高糖軟食的方法建立牙周炎大鼠模型后,給予藥物治療,降鈣素治療組(C組,降鈣素溶于生理鹽水,2μg/kg,皮下注射)、1,25維生素D治療組(D組,維生素D溶于花生油中,2μg/kg,灌胃)、降鈣素和1,25維生素D聯(lián)合治療組(E組)。觀察各組大鼠的一般指標(biāo)：體質(zhì)量變化,活動情況,毛色等。在第2周、4周、6周和8周末各組處死5只大鼠,測量雙側(cè)上頜第一磨牙牙周探診深度,觀察牙槽骨喪失水平；第8周末各組采取10只大鼠腹部降主動脈血,用酶聯(lián)免疫吸附試驗法(Enzyme-linked immunosorbent assay, ELISA)檢測血清中的骨堿性磷酸酶(Bone alkaline phosphatase, BALP)以及骨鈣素(Osteocalcin,OC)的濃度。留取大鼠上頜骨,經(jīng)10%甲醛固定后,15%的EDTA脫鈣,常規(guī)石蠟包埋切片HE染色觀察牙周組織的病理變化,包括牙周膜纖維排列和炎細胞浸潤程度以及牙槽骨情況。應(yīng)用SPSS17.0統(tǒng)計軟件包分析實驗數(shù)據(jù),符合正態(tài)分布和方差齊性計量資料采用均數(shù)±標(biāo)準差(x±s)表示。多組資料間均數(shù)比較采用單因素方差分析,組間多重比較采用LSD-t檢驗。P0.05為差異有統(tǒng)計學(xué)意義。 結(jié)果：A組大鼠活潑好動,形體均勻,反應(yīng)敏捷,每日飲量少且尿量少,毛色光滑,體質(zhì)量隨著周齡的增長而穩(wěn)步的增長。B、C、D、E組大鼠于結(jié)扎術(shù)3天后,表現(xiàn)為食欲下降,唾液量增多,生長基本良好,每日飲量少且尿量少,隨后食欲逐漸如常,體質(zhì)量隨著周齡的增長而穩(wěn)步的增長。通過對A組和B組大鼠雙側(cè)上頜第一磨牙PD的比較可以發(fā)現(xiàn),用藥2周,B組大鼠的PD高于A組大鼠(P0.05)。B組與C、D、E組PD差異無統(tǒng)計學(xué)意義(P0.05)；用藥后4周、6周和8周,B組PD均高于C、D、E組(P0.05),且E組PD低于C組和D組。通過對A組和B組大鼠雙側(cè)上頜第一磨牙牙槽骨喪失水平的比較可以發(fā)現(xiàn),用藥2周,B組大鼠牙槽骨喪失水平高于A組(P0.05)。B組大鼠與C、D、E組大鼠牙槽骨喪失水平差異無統(tǒng)計學(xué)意義(P0.05)；用藥4周時,B組與C、D、E組牙槽骨喪失水平差異無統(tǒng)計學(xué)意義(P0.05)；用藥6周和8周時,B組牙槽骨喪失水平高于C、D、E組(P0.05),且E組低于C組和D組；在第8周末進行血清中BALP及OC的檢測。8周時,A組BALP、OC均高于B組(P0.05)；且B、C、D、E組間BALP和OC的水平差異均有統(tǒng)計學(xué)意義(P0.05)。8wk時組織病理學(xué)觀察發(fā)現(xiàn)差異,HE染色顯示A組牙齦上皮完整,結(jié)合上皮位于釉牙骨質(zhì)界,牙槽嵴頂無吸收。B組牙周袋形成,牙齦乳頭喪失,牙齦上皮表面糜爛,牙周膜纖維排列紊亂炎癥細胞浸潤牙槽骨吸收嚴重。E組大鼠牙周膜纖維排列較整齊,牙槽峭頂有新骨及新生牙骨質(zhì)形成。結(jié)論： 1.維生素D缺乏,鈣、磷的缺乏或不平衡可引起牙槽骨成骨能力的降低。 2.降鈣素和1,25維生素D均能部分拮抗牙周炎導(dǎo)致的牙槽骨喪失,二者聯(lián)合應(yīng)用效果更佳。
[Abstract]:Objective: To observe the changes of the concentration of bone alkaline phosphatase (bone alkaline phosphatase, BALP) and Osteocalcin (osteocalcin, OC) in the serum by establishing a rat model of periodontitis and using 1,25 vitamin D and calcitonin, and observing the level of probing depth (PD), the loss of alveolar bone, and the changes of the concentration of the serum alkaline phosphatase (bone alkaline phosphatase, BALP) and Osteocalcin (osteocalcin, OC) in the serum. The effects of calcium and 1,25 vitamin D on alveolar bone loss in rats with periodontitis, so as to explore a new feasible method for adjuvant treatment of periodontitis.
Methods: 125 healthy adult male Wistar rats were randomly divided into A, B, C, D, E5 group (n=25 only / group), that is, group A as the blank control group, the B group was the control group of periodontitis, the C group was the calcitonin treatment group, the D group was the 1,25 vitamin treatment group, and the group was ligated with orthodontic ligature and ligature. The.A group of the rat model of periodontitis was not treated with the method of high sugar soft food in the neck of the first molar of the maxillary first molar to establish a rat model of periodontitis with orthodontic ligation of the maxillary molar and high sugar and soft food. The treatment group (group C, calcitonin soluble in physiological saline, 2 u g/kg, subcutaneous injection), 1,25 Vitamin D group (group D, vitamin D dissolved in peanut oil, 2 mu g/kg, gavage), calcitonin and 1,25 vitamin D combined treatment group (group E). Observe the general indexes of rats in each group: body mass change, activity condition, hair color and so on. 5 rats were killed in each group at 4 weeks, 6 weeks and 8 weekends in each group, and the depth of the periodontal detection of the bilateral maxillary first molar was measured. The level of alveolar bone loss was observed, and the blood of abdominal descending aorta in 10 rats was taken at the end of eighth weeks. The concentrations of bone alkaline phosphatase (Bone alkaline phosphatase, BALP) and Osteocalcin (Osteocalcin, OC) in the serum were detected by Enzyme-linked immunosorbent assay (ELISA) in each group. The maxillofacial bone was retained in the rat and 10% formaldehyde was obtained. After fixation, 15% of EDTA decalcification and routine paraffin embedded HE staining were used to observe the pathological changes of periodontal tissue, including periodontal ligament fiber arrangement, infiltration degree of inflammatory cells and alveolar bone. The SPSS17.0 statistical package was used to analyze the experimental data, which accorded with the normal distribution and variance homogeneity measurement data with mean mean + standard deviation (x + s). Comparison of data between groups was conducted by one-way ANOVA. Multiple comparisons between groups were performed by LSD-t test,.P0.05 was statistically significant.
Results: the rats in group A were active and active, with a uniform body, quick reaction, less daily drink and less urine and smooth hair color. The body mass increased steadily with the age of.B, C, D, E, 3 days after ligation, showing a decline in appetite, increased saliva, good base, less daily drink and less urine, and the appetite gradually as usual, body and body gradually as usual, body gradually, body gradually as usual, body then gradually as usual, body appetite gradually as usual, body After 2 weeks of drug use, the PD of group B rats was higher than that of A group (P0.05).B group and C, D, E group, and there was no significant difference between the A group and the C group (P0.05).B group, and the 4 weeks, 6 weeks and 8 weeks after the drug use were higher than those of the group of A and group A. In group A and group D, by comparing the loss of alveolar bone in the bilateral maxillary first molar of rats in group A and B, the loss of alveolar bone in group B rats was higher than that of group A (P0.05).B group and C, and there was no significant difference in the loss level of alveolar bone in the group of D and E group (P0.05). The difference of the loss of alveolar bone in the B group was different from that of the E group (P0.05). There was no statistical significance (P0.05). At 6 and 8 weeks, the loss of alveolar bone in group B was higher than that of C, D, E group (P0.05), and the E group was lower than the C and D groups. The HE staining showed that the gingival epithelium was intact in group A, the epithelium was located in the glazed cementum boundary, the top of the alveolar ridge was not absorbed by the.B group, the papilla was lost, the surface of the gingiva was erosive, the periodontal ligament was arranged in disorder, and the inflammatory cells infiltrated the alveolar bone, and the periodontal ligament of the alveolar bone was neatly arranged and the alveolar crest was on the top. The formation of new bone and new cementum. Conclusion:
1. vitamin D deficiency, calcium or phosphorus deficiency or imbalance can cause osteogenesis of alveolar bone.
2. calcitonin and 1,25 vitamin D can partly antagonize the alveolar bone loss caused by periodontitis, and the combined application of the two is better.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.42

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