上海口腔医学

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (4): 359-369.doi: 10.19439/j.sjos.2026.04.003

• 论著 • 上一篇    下一篇

Er,Cr:YSGG 激光联合引导骨再生技术对牙周炎大鼠拔牙位点成骨的影响及相关机制探讨

郭延伟1, 张广德1, 孔令斌2, 杨世茂3   

  1. 1.济宁口腔医院 口腔颌面外科,山东 济宁 272002;
    2.济宁医学院临床医学院 教研室,山东 济宁 272067;
    3.济南市口腔医院 口腔颌面外科,济南市口腔疾病与组织修复再生医学重点实验室,山东 济南 250013
  • 收稿日期:2025-07-31 修回日期:2025-09-30 出版日期:2026-08-25 发布日期:2026-09-01
  • 通讯作者: 杨世茂,E-mail: yangshimao1986@163.com
  • 作者简介:郭延伟（1985—）,男,硕士,主治医师,E-mail: guoweikq@126.com
  • 基金资助:
    国家自然科学基金（81170935）; 山东省医药卫生科技项目（202308020962; 202408020544）

Effect of Er,Cr:YSGG laser combined with guided bone regeneration technique on osteogenesis at the extraction site of periodontitis rats and its regulatory mechanism via the Wnt/β-catenin pathway

Guo Yanwei1, Zhang Guangde1, Kong Lingbin2, Yang Shimao3   

  1. 1. Department of Oral and Maxillofacial Surgery, Jining Stomatological Hospital. Jining 272002;
    2. Teaching and Research Section, School of Clinical Medicine, Jining Medical University. Jining 272067;
    3. Department of Oral and Maxillofacial Surgery, Jinan Stomatological Hospital; Jinan Key Laboratory of Oral Diseases and Tissue Repair and Regeneration Medicine. Jinan 250013, Shandong Province, China
  • Received:2025-07-31 Revised:2025-09-30 Online:2026-08-25 Published:2026-09-01

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摘要： 目的: 探讨铒铬钇钪镓石榴石（Er,Cr:YSGG）激光联合引导骨再生技术（guided bone regeneration,GBR）对重度牙周炎大鼠拔牙位点成骨的协同效应,以及对Wnt/β-catenin信号通路的调控机制。方法: 选择60只SD大鼠构建重度牙周炎模型,最终50只建模成功。随机分为以下5组（n=10）,即A组（单纯拔牙）、B组（拔牙+Er,Cr:YSGG 激光）、C组（拔牙+骨粉+屏障膜）、D组（拔牙+激光+骨粉）和E组（拔牙+激光+GBR）。术后4、8 周时,每组各取5只处死,采用CBCT检测拔牙位点骨密度（bone mineral density, BMD）及骨体积分数（bone volume/total volume, BV/TV）,并进行组织学观察。采用酶联免疫吸附试验、实时荧光定量PCR检测β-catenin、Runx2等的表达水平。利用多因子检测技术（meso scale discovery, MSD）检测 GSK-3β磷酸化水平。结果: CBCT 结果显示,术后 4 周,A、B 组拔牙窝内可见大面积低密度影,C、D组可观察到少量纤维骨痂,E 组纤维骨痂密度更高,且出现局部高密度影。术后8周,A、B 组骨缺损仍占拔牙窝的 60%~70%,C、D组新生骨量有所增加,但骨粉未完全降解,E 组骨粉基本降解,新生骨与周围骨组织融合良好。骨参数方面,所有组别的BMD和BV/TV均随时间推移而升高。其中,E 组术后4周的BMD为0.51 g/cm3、BV/TV为36.14%,术后8周的BMD为0.57 g/cm3、BV/TV为43.23%,且在各时间点均显著高于其他组（P<0.05）。术后 8 周,E组 β-catenin核转位率达 58.7%,成骨相关因子呈高表达状态;同时,DKK-1水平（45.32 pg/mL）及p-GSK-3β/GSK-3β比值（0.21）均为各组最低（P<0.05）。组织学检查结果显示,E 组新生骨组织致密且炎症反应轻微;组间成骨效果呈现 E 组>C/D 组>B 组>A 组的差异趋势。结论: Er,Cr:YSGG 激光联合GBR可通过下调DKK-1、抑制GSK-3β活性,解除 Wnt/β-catenin 通路的抑制状态,进而促进成骨,为临床牙周骨缺损的治疗提供了实验依据。

关键词: Er,Cr:YSGG 激光, Wnt/β-catenin信号通路, 重度牙周炎, 拔牙位点保存

Abstract: PURPOSE: To investigate the synergistic effect of Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet (Er,Cr:YSGG) laser combined with guided bone regeneration (GBR) on osteogenesis at the extraction site in rats with severe periodontitis, as well as its regulatory mechanism on the Wnt/β-catenin signaling pathway. METHODS: A total of 60 SD rats were used to establish a severe periodontitis model, and 50 rats were successfully modeled. They were randomly divided into 5 groups (n=10 in each group), group A (blank control, simple teeth extraction), group B (teeth extraction+Er,Cr:YSGG laser irradiation), group C (teeth extraction+bone powder+barrier membrane), group D (teeth extraction+Er,Cr:YSGG laser irradiation +bone powder), and group E (teeth extraction+Er,Cr:YSGG laser irradiation+GBR). At 4 and 8 weeks postoperatively, 5 animals from each group were sacrificed for subsequent experiments. CBCT was performed to detect bone mineral density (BMD) and bone volume/total volume (BV/TV). Histological observation was conducted. Enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qPCR) were used to detect β-catenin, Runx2 and other related factors. Meso scale discovery (MSD) technology was employed to determine the nuclear translocation of β-catenin and the phosphorylation level of GSK-3β. RESULTS: CBCT results showed that at 4 weeks postoperatively, the extraction sockets in groups A and B presented with a large area of low-density shadow, a small amount of fibrous callus was observed in group C and D, while group E had higher density of fibrous callus and local high-density shadow. At 8 weeks postoperatively, the bone defect still accounted for 60%-70% of the extraction socket in group A and B; new bone increased but bone powder was not fully degraded in group C and D; in group E, bone powder was basically degraded and new bone fused well with the surrounding bone. In terms of bone parameters, BMD and BV/TV in all groups increased with time. The BMD and BV/TV in group E were 0.51 g/cm3 and 36.14% at 4 weeks postoperatively and 0.57 g/cm3 and 43.23% at 8 weeks postoperatively, which were significantly higher than those in other groups at all time points(P<0.05). The nuclear translocation rate of β-catenin in group E reached 58.7% at 8 weeks postoperatively, with high expression of osteogenic factors, while the levels of Dickkopf-related protein 1(DKK-1, 45.32 pg/mL) and phosphorylated GSK-3β/GSK-3β (0.21) were the lowest (P<0.05). Histological results showed that group E had dense new bone and less inflammation, and the intergroup difference in osteogenic effect was group E > groups C/D > group B > group A. CONCLUSIONS: Er,Cr:YSGG laser combined with GBR can down-regulate DKK-1 expression, inhibit GSK-3β activity, relieve the inhibition of the Wnt/β-catenin pathway and promote osteogenesis. This study can provide experimental evidences for the clinical treatment of periodontal bone defects.

Key words: Er,Cr:YSGG laser, Wnt/β-catenin signaling pathway, Severe periodontitis, Extraction socket preservation

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