Prognosis and regulation of inflammatory granulation tissue in tooth extraction socket
10.12016/j.issn.2096-1456.202330615
- VernacularTitle:拔牙窝炎性肉芽组织的转归和调控
- Author:
Wuyang ZHANG
1
;
Yang XUE
;
Kaijin HU
Author Information
1. 口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,第四军医大学口腔医院颌面外科,陕西 西安(710032)
- Keywords:
tooth extraction socket;
alveolar bone;
healing process;
inflammatory granulation tissue;
mesen-chymal stem cell;
transformation;
restorative granulation tissue;
inflammatory lesions;
bone regeneration
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2024;32(10):737-745
- CountryChina
- Language:Chinese
-
Abstract:
Periodontitis and periapical periodontitis have a high incidence rate and often result in the progressive ab-sorption of alveolar bone.This is one of the main causes of tooth loosening and loss.Prolonged local inflammation leads to the proliferation of capillaries,fibroblasts,and inflammatory cells such as neutrophils and lymphocytes.This process results in the replacement of surrounding bone tissue with inflammatory granulation tissue.Traditionally,it has been ad-vocated that inflammatory granulation tissue is pathological and should be completely removed from the extraction sock-et to avoid complications such as bleeding,infection,and poor bone healing after tooth extraction.Although the regener-ative capacity of inflammatory granulation tissue is reduced,it can be enhanced by increasing the body's immunity or by eliminating pathogenic stimuli(such as tooth extraction and root canal treatment).As a result,the fibrous components in the inflammatory granulation tissue gradually increase,while infiltrating inflammatory cells gradually decrease.Ulti-mately,this transformation leads to the formation of reparative granulation tissue,followed by ossification.Furthermore,the use of granulation tissue from the tooth extraction socket for immediate implantation to facilitate wound closure or soft tissue reconstruction has yielded favorable clinical outcomes,and histological studies simultaneously confirmed the presence of mesenchymal stem cells within the inflammatory granulation tissue.Therefore,it is necessary to reconsider the traditional belief that inflammatory granulation tissue must be completely removed.Given the potential of inflamma-tory granulation tissue to undergo osteogenic transformation under appropriate interventions,regulating the transforma-tion of inflammatory granulation tissue into reparative granulation tissue with osteogenic potential represents a novel strategy for the regenerative treatment of dental alveolar inflammatory lesions.This approach holds broad clinical appli-cation prospects and is an important research direction for the future.Reactive oxygen species,NOD-like receptor pro-tein 3,and matrix metalloproteinase K are key regulatory factors involved in the transformation of inflammatory granula-tion tissue into reparative granulation tissue.Furthermore,bone morphogenetic protein 2 and vascular endothelial growth factor are key regulatory factors involved in the osteogenic regeneration of reparative granulation tissue.Howev-er,the molecular mechanisms of these regulatory factors remain unclear;therefore,elucidating their molecular mecha-nisms will help identify suitable targets for promoting the regeneration of dental alveolar inflammatory lesions.Further-more,this will contribute to the development of related biological treatment technologies and drugs,which may ultimate-ly provide a more minimally invasive and effective treatment for inflammatory lesions of alveolar bone.However,it is im-portant to note that research in this field is still in its early stages.There is still considerable progress to be made before clinical translation and application can be achieved.
