【作者】 莫水学；

【导师】 陈扬熙；

【作者基本信息】 四川大学 ， 口腔临床医学， 2006， 博士

【摘要】 近年来，我国要求正畸治疗的成年患者以每年5％的比率递增，其中多为处于育龄阶段的年轻女性。临床上常有在正畸治疗期间怀孕或想怀孕的患者，亦有已怀孕的女性想寻求正畸治疗的情况。但正畸治疗对妊娠会有何影响?在不同孕期进行正畸施力，对牙移动效应和牙周组织改建的影响有何不同?对这些方面的研究目前还较少。因此，探索在孕周期的不同阶段正畸施力是否影响牙周组织的改建、牙移动效应有何不同，以及正畸施力是否反馈影响正常妊娠以及胎儿发育等，已经成为正畸医生必须面对的临床问题。 正常妊娠的维持有赖于卵巢及胎盘中性激素的节律性分泌，并受到大脑皮层—下丘脑—垂体的调控，最后通过与靶器官上的性激素受体结合而实现生殖与生理的变化。受孕后，孕酮对维持正常妊娠起到主要作用，其分泌具有近年节律的特性。近期研究发现，在牙周组织中也存在性激素受体，骨改建、胶原的合成和降解等都受性激素的影响。那么，妊娠状态下的牙周组织中，其骨改建相关因子的表达是否也具有某种变化规律呢?在不同的时间断层(不同的孕期)加力矫治牙齿，所获得的牙移动效应会怎样?正畸力对正常妊娠有何影响?其影响信号传导的因子和通道有哪些?这些都是亟待探讨的问题。 此外，正畸力引起牙周骨改建的机理十分复杂。应力、时间、一系列的神经、体液因素和细胞因子、生长因子等都参与其中。近期研究发现，在骨的细胞外基质中有含有一类叫SIBLING(Small Integrin-Binding Ligand，N-linked Glycoprotein)的蛋白家族，包括骨桥蛋白(osteopontin OPN)和牙本质基质蛋白1(dentin matrix protein 1 DMP1)，在骨的矿化、改建过程更多还原

【Abstract】 Background and Objective: Among the adult orthodontic patients, there are a lot of young females who are at the reproductive age. In orthodontic practice, it is very usual that an orthodontist would face some female patients, who are conceiving children or want to do that during the treatment period. There also are some pregnant women who intend to seek orthodontic treatment. But what is the influence that the orthodontic treatment would exert on the human pregnancy? Is it safe to perform the orthodontic treatment during the gestational period? Could the orthodontic force impair the development of the fetus? Is it having different effects on tooth movement velocity when moving tooth at different trimesters of pregnancy? Meanwhile, during the gestational period, what are the effects of the orthodontic tooth movement on the periodontal tissue remodeling? What is the expression pattern of the bone remodeling factors in the periodontal tissue during the pregnacy? To date, there seldom exist any researches about these concerns. For the pregnant patients’ sake, investigation into these questions is invaluable.The maintenance of normal pregnancy depends on the rhythmic secretion of progesterone by ovaries and placenta, which are controlled by cortex-hypothalamus-pituitary axis. Recently, it was found that progesterone receptors exist in the periodontal tissue, and the bone remodeling, the degradation更多还原