- 學位論文
以動物實驗模型探討低能量雷射治療對矯正牙齒移動的影響
The effect of low level laser therapy on orthodontic tooth movement in a rat model
摘要
近幾年來，有矯正需求的患者有與日俱增的趨勢；不論是恢復顏面美觀、重建咬合功能，或是因牙周或補綴需求而輔助的協同性治療，矯正治療都是不可或缺的一環。但就大部分患者而言，動輒一、兩年冗長的治療時間往往是其對矯正治療卻步的主因；也因此近十年來，學者們對於加速矯正牙齒移動方面有廣泛性的諸多嘗試嚐試與實驗。本研究建立一大鼠的矯正牙齒移動模型，期能以此模型探究各種影響牙齒移動速率因子的效果，並利用波長970nm的低能量二極體雷射，在兩周的實驗周間內探討其對牙齒移動速率之影響。在實驗組及對照組均在其上顎左側裝置關閉空間彈簧，並在實驗組的第0、1、4、7、11天的時間點進行雷射照射，於實驗開始後第14天進行動物犧牲。在牙齒移動速率以印模材在第4、7、11、14天分別取模後，倒出石膏模型並分別測量其牙齒移動距離；在組織學方面以免疫組織化學染色標定基質金屬蛋白酶-3 (MMP-3)、TRAP、以及osteocalcin三種蛋白質；在犧牲後的大鼠頭顱骨並利用顯微斷層掃描，分析其骨量比率與骨礦物質密度於實驗組及對照組間變化。實驗結果在牙齒移動距離方面，實驗組均高於對照組，並在第14天達到統計上顯著；在免疫組織化學染色方面在osteocalcin蛋白質的標定在實驗組有明顯高於對照組，顯示其骨生成量較多，而在MMP-3及TRAP的標定上兩組則沒有明顯差異；在顯微斷層掃描部分，骨量比率與骨礦物質密度均在實驗組略低於對照組，顯示其骨代謝量較為增加，但差異並沒有達到統計上顯著。本研究結果顯示970nm之低能量雷射治療於兩周的大鼠實驗中能顯著增加牙齒移動速率，並在骨生成量與骨代謝量有略高於對照組，此結果尚待進一步的動物與人體實驗來證實其療效與制定最佳治療效果的照射劑量範圍。
並列摘要
There are increasing needs orthodontic demands upon fororthodontic treatment recently. Among them are needs of better estheticss、needs of , occlusal functionsrehabilitation、, and/or needs of preparation for future implant / prosthetic treatments. Although there are evident benefits for from orthodontic treatmenttooth movement (OTM), patients in face of it usually hesitate try to avoid the due to prolonged long treatment time associated with it. In this study, we used rat model to demonstrate the effect of 970nm low level laser therapy (LLLT) to on orthodontic tooth movement rateOTM. There were 13 rats divided to: 7 for experimental group (n=7) and 6 for control group (n=6). , and Ni-Ti closed coil springs were used to perform orthodontic tooth movement over L’t side of maxilla from incisors to first molars of both groups. LLLT was done in experimental group for 14 day OTMonly on day 0, 1, 4, 7, 11 under general anesthesia, and the experiment duration was 14 days. Silicon impressions material and pour up models was used for rat maxilla impression were taken on day 4, 7, 11, 14; then stone casts were made and . Tmeasurement of tooth movement was donemeasured between the first and second molars with enlarged photos taken on the dental models. Immnohistochemistry Immnohistochemical analysis for MMP-3、, TRAP、, and osteocalcin expression was done on paraffin sections, and m. MicroCT analysis of rat maxilla after sacrifice was used to measure done to demonstrate differences of bone minereal density and bone volume/ total volume in the furcation areas of the maxillary first molars.. The results showed that tooth movement distance was higher in the experimental group than in control group, with day 14 reached statistical significance on day 14. The immunohistochemistry showed the levels of osteocalcin expressed morehigher in experimental group than in control group, with while other two proteins (MMP-3 and TRAP) showed no significant difference. The microCT results showed slightly lower BMD and BV/TV in experimental group than in control group, but both of them though it didn’t reach statistical significant levelce. The results suggested that the 970nm LLLT used in this study may increase orthodontic tooth movement rate, but . However, further more animal and human studies would be needed for further determination of its optimal timing and doseage.
參考文獻
延伸閱讀
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