巨噬细胞介导免疫–骨耦联参与正畸牙移动的研究进展

Research Progress on Macrophage-Mediated Immuno-Bone Coupling in Orthodontic Tooth Movement

摘要: 正畸通过施加适当的机械力来刺激牙周组织的重塑，从而实现错位牙齿的有序移动，改善咬合关系及口腔功能，其过程涉及复杂的生物学调控机制。正畸牙移动(orthodontic tooth movement, OTM)过程中，牙及牙周微环境发生无菌性炎症，产生各类信号转导因子和炎症介质，诱导各种细胞反应，最终导致压迫侧骨吸收和张力侧骨形成的协同发生。巨噬细胞作为一种重要的免疫细胞，是连接机械刺激、免疫反应与骨代谢的关键枢纽，在正畸牙移动的不同阶段，巨噬细胞呈现明显的时空分布特征和功能异质性，通过介导多种细胞间信号交流，参与调控牙齿移动、牙根吸收、牙周组织修复、骨组织改建及局部炎症反应等重要生物学过程。基于巨噬细胞在正畸过程中的重要作用，其在提高正畸治疗效果、预防正畸复发、降低并发症发生风险中具有潜在的应用价值。本文围绕巨噬细胞介导的免疫–骨耦联机制，系统综述其在正畸牙移动过程中的作用及调控机制，并探讨其潜在的临床应用前景，以期为正畸治疗中靶向调控巨噬细胞提供理论依据和新的研究思路。

Abstract: Orthodontic treatment applies appropriate mechanical forces to stimulate periodontal tissue remodeling, thereby achieving the orderly movement of malpositioned teeth and improving occlusal relationships and oral function. This process involves complex biological regulatory mechanisms. During orthodontic tooth movement (orthodontic tooth movement, OTM), a sterile inflammatory response occurs within the dental and periodontal microenvironment, leading to the release of various signaling molecules and inflammatory mediators. These factors induce coordinated cellular responses and ultimately result in coupled bone resorption on the compression side and bone formation on the tension side. Macrophages, as important immune cells, serve as a key regulatory hub linking mechanical stimulation, immune responses, and bone metabolism. At different stages of orthodontic tooth movement, macrophages exhibit distinct spatiotemporal distribution patterns and functional heterogeneity. Through mediating multiple forms of intercellular communication, they participate in the regulation of critical biological processes, including tooth movement, root resorption, periodontal tissue repair, bone remodeling, and local inflammatory responses. Given the essential role of macrophages in orthodontic processes, they hold potential application value in improving orthodontic treatment outcomes, preventing orthodontic relapse, and reducing the risk of treatment-related complications. This review focuses on macrophage-mediated immune-bone coupling mechanisms, systematically summarizing the roles and regulatory pathways of macrophages during orthodontic tooth movement and discussing their potential clinical applications. The aim is to provide a theoretical basis and new perspectives for macrophage-targeted regulation in orthodontic treatment.