血清"生長激素/類胰島素生長因素系統"於初期矯 於初期矯正治療之骨生成反應的表現

矯正治療時，牙齒在骨頭中重塑形，一邊進行骨吸收，一邊進行骨生成反應。『生長激素類/胰島素生長因素系統』已被證實為骨生成反應的指標，卻尚未應用於牙醫學領域中。本研究試圖在矯正初期治療中，測量相關血清指標的濃度變化，協助瞭解其中骨調節機轉。全口固定式矯正裝置治療共23人（男6女17），平均年齡23歲1月（12歲7月至31歲5月）。測量血清中生長激素、類胰島素生長因素-1、類胰島素生長因素結合蛋白—3、鹼性磷酸酶以及肌酸激酶，依序分五次測量。血清一，抽取治療前的血清。隨後，馬上放置矯正分離橡皮圈。血清二，放置矯正分離橡皮圈二天後。血清三，置入全口固定式矯正裝置，開始施予矯正力二天後。血清四，開始施予矯正力二週後。血清五，矯正力四週後。樣本採重複試驗，統計方法為單因子變異數分析以及Bonferroni事後檢定。矯正裝置施力二天後，生長激素、類胰島素生長因素-1、以及類胰島素生長因素結合蛋白—3先降至最低而在四週內逐漸升高，有顯著差異，此結果顯示，這些指標的確是骨生成因子，而其中以類胰島素生長因素結合蛋白—3的反應最靈敏。肌酸激酶在施力後二天濃度提升，代表肌肉受到了暫時性的傷害，而鹼性磷酸酶的變化沒有統計上的差異。所有指標變化都在正常值範圍內，因此矯正治療並不影響內分泌系統的恆定性。

關鍵字

生長激素；類胰島素生長因素-1 ；類胰島素生長因素結合蛋白-3 ；鹼性磷酸酶肌酸激酶矯正治療；重塑形；骨生成反應

並列摘要

Tooth movement during orthodontic treatment is associated with bone remodeling. Bone formation occurs on the tension side far away the dental root due to osteoblastic activity and bone resorption happens on the compression side respectively. GH/IGF axis has been in proof as a bone formation indicator, but never mentioned among dental treatments. The current study is focused to the orthodontic bone modulation in terms of the serum GH/IGF axis and some associated indexes (hGH, IGF-1, IGFBP-3, alkaline phosphatase and creatine kinase). 23 volunteers（6 males, 17 females）were chosen from 12Y7M to 31Y5M (mean, 23Y1M). There are five sampling points: the day and 2 days after separation, as well as 2 days, 2 weeks, and 4 weeks after full mouthing bracketing. The samples of each patient were then aliquot in duplicity. One-Way-ANOVA and Bonferroni test were used as statistical methods. The results show that the hGH, IGF-1 and IGFBP-3 decreased at 2 days after full mouth bracketing (p ﹤0.05) and increased gradually within four weeks. It is implicated that theses important indicators are actually modulating local alveolar bone formation in orthodontic tooth movement. Creatine kinase was temporarily ascending at 2 days after full mouth bracketing. It might demonstrate some muscle damage occurred. All serum changes in this study are in normal range. Thus, orthodontic treatment is no harm for systemic hormone homeostasis.

並列關鍵字

GH ； IGF-1 ； IGFBP-3 ； alkaline phosphatase ； creatine kinase ； orthodontic treatment ； remodeling ； bone formation

參考文獻

1. Ammann p, Rizzoli R, Meyer JM, Slosman D, Bonjour JP (1993) IGF-I and palmidronate increase bone miner density in ovariectomized adult rats. Am J Physiol 265:E770-E776

2. Andress DL (1991) A novel human insulin-like growth factor (IGF) binding protein secreted by human osteoblast-like cells. Biochem Biophys Res Commun 176: 213-218

4. Andress DL, Loop SM, Zapf J, Kiefer MC (1992) Caboxy-truncated insulin-like growth factor binding-5 stimulates mitogenesis in ostoeoblastic -like cells. Biochem Biophys Res Commun 195:25-30

5. Andress DL (1995) Heparin modulates the binding of insulin-like growth factor (IGF) binding protein-5 to a membrane protein in osteoblastic cells. J Bio Chem 270:28289-28296

6. Bagi CM, Bromagge R, Deleon L, Adams S, Rosen D, Sommer A (1994) Benefit of systemically adminstered rh IGF-I and rhIGF-1/IGFBP-3 on cancellous bone in ovariectomized rats. J Bone Miner Res 9:1031-1312

國際替代計量

血清"生長激素/類胰島素生長因素系統"於初期矯於初期矯正治療之骨生成反應的表現

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