【摘要】 背景:上颌骨横向发育不足是临床上常见的错牙合畸形,种植体支抗辅助上颌快速扩弓等新兴上颌骨扩弓方法为成人上颌骨扩弓提供了新的可能。目的:综述上颌骨扩弓机制的研究进展,从而更好地寻找骨缝间骨再生的方法,获得满足临床需要的扩弓量以及扩弓效果的稳定性。方法:检索万方、中国期刊全文数据库(CNKI)、Pub Med、Web of Science等数据库2010年1月至2020年9月期间关于上颌骨扩弓机制的文章,检索词为"maxillary expansion, craniofacial suture, suture growth, mechanical force, bone remodeling, immunity cells, mesenchymal stemcells,craniosynostosis"及"上颌骨扩弓,颅面骨骨缝,骨缝生长,机械应力,骨重建,免疫细胞,间充质干细胞,颅缝早闭",排除陈旧以及重复的观点,将检索到的文献进行整理,纳入69篇文献进行分析。结果与结论:上颌骨扩弓可以通过不同临床手段对腭中缝施加机械力从而完成骨缝的开展及上颌骨的增宽,此过程不仅需要成骨细胞和破骨细胞参与,也同间充质干细胞和免疫细胞的增殖分化和调节密切相关。在机械力作用下,多种细胞借助细胞因子通过不同信号通路彼此调节共同完成骨改建。对于扩弓机制的认识,特别是借鉴颅缝早闭治疗方法的研究进展,通过抑制生长发育末期骨缝的闭合,或者使融合的骨缝重新打开为上颌骨扩弓提供了新的治疗思路。更多还原

【Abstract】 BACKGROUND: Maxillary transverse deficiency is a common malocclusion deformity encountered in clinical practice. Rapid maxillary expansion assisted with implant anchorage provides a new possibility for maxillary expansion in adults.OBJECTIVE: To review the research progress in the mechanism of maxillary expansion, providing ideas for bone remodeling between palatal sutures, obtaining the expansion volume and stability that meet the clinical needs.METHODS: We searched for relevant articles published from January 2010 to September 2020 in WanFang, CNKI, PubMed, and Web of Science with the keywords of "maxillary expansion, craniofacial suture, suture growth, mechanical force, bone remodeling, immunity cells, mesenchymal stem cells, craniosynostosis" in Chinese and English respectively. Finally, 69 articles met the criteria for review.RESULTS AND CONCLUSION: Maxillary expansion exerts mechanical force on the palatal suture by different clinical means to expand bone sutures and widen the constricted maxillary. This process not only requires the participation of osteoblasts and osteoclasts, but also involves the proliferation, differentiation and regulation of mesenchymal stem cells as well as immune cells. Under the action of mechanical force, a variety of cells interact with each other via cytokines, to complete bone remodeling through different signaling pathways. Referring to advances in the treatment of craniosynostosis, it provides a new idea for maxillary expansion by inhibiting the closure of bone suture at the end of growth and development, or reopening the fused suture.更多还原