阅读说明：本技术 用于控制恒牙胚发育的方法、支架及其用途 (Method for controlling development of permanent tooth germ, bracket and application thereof ) 是由 王松灵 吴晓珊 李国情 李艳 胡磊 于 2019-07-26 设计创作，主要内容包括：本发明公开用于控制恒牙胚发育的方法、支架及其用途。控制恒牙胚发育的方法包括在有此需要的受试者内调节牙板周围的间充质环境的步骤。(The invention discloses a method for controlling development of permanent tooth germ, a bracket and application thereof. A method of controlling permanent tooth germ development includes the step of modulating the mesenchymal environment surrounding a dental plate in a subject in need thereof.)

1. A method of controlling development of a permanent tooth germ comprising the step of modulating the mesenchymal environment surrounding a dental plate in a subject in need thereof;

Preferably wherein the mesenchymal environment is conditioned for a time selected from at least one of (a) - (c) below:

(a) the age at which deciduous teeth erupt until the deciduous teeth should fall off under physiological conditions;

(b) the eruption of deciduous teeth is not normal or delayed, or the mesenchyme around the permanent tooth dental plate is in a biological stress period;

(c) During the period when the permanent dental plate does not begin to develop or has developed but the permanent tooth germ has not been calcified;

Preferably, wherein the adjusting comprises at least one selected from the group consisting of:

(1) Reducing and releasing the tension of the mesenchyme around the dental plate;

(2) Controlling the mesenchymal tension to within a prescribed first range;

(3) inhibiting or reducing the activity or expression level of RUNX2 in mesenchymal cells surrounding a dental plate;

(4) inhibiting or reducing the activity or expression quantity of the Wnt/beta-catenin pathway in mesenchymal cells around the dental plate;

Also preferably, wherein the adjusting comprises at least one selected from the group consisting of:

(1) Controlling the mesenchymal tension to within a specified second range;

(2) increasing or increasing the activity or expression level of RUNX2 in mesenchymal cells surrounding a dental plate;

(3) Improving or increasing the activity or expression quantity of the Wnt/beta-catenin pathway in mesenchymal cells around the dental plate;

Preferably wherein the mesenchymal environment is modulated by mechanical treatment, implantation of a tonicity modifying scaffold and/or administration of a tonicity modifying active factor;

Preferably, the controlling comprises starting, promoting or inhibiting the development of permanent tooth germ, controlling the development speed of permanent tooth germ and guiding the permanent tooth germ to grow to the required direction.

2. A stent for controlling development of permanent tooth germ has a structure adapted to be attached to the surface of a deciduous tooth root and implanted under a gingival sulcus.

3. A scaffold for controlling permanent tooth germ development according to claim 2 comprising a porous material with a pore diameter of 1-10 μ ι η and a pore density of 50-200/mm 2;

Preferably, wherein the porous material comprises at least one selected from the group consisting of a synthetic material, a naturally derived material, and a composite material;

preferably, the scaffold for controlling development of permanent tooth germ further comprises an active factor that alters biological tonicity;

Preferably, wherein said factor that alters tonicity includes a molecule that modulates the Integrin β 1-Erk1-Runx2-Wnt/beta-catenin pathway;

Preferably, wherein the molecule is a cytokine, a recombinant protein, a nucleic acid, and a small molecule drug;

Also preferably, wherein said molecule comprises at least one selected from the group consisting of Dkk1, Sfrp1, Sostdc1, U0126, RUNX2 inhibitor, Wnt inhibitor, shh activator, TGF/Smad pathway modulator, FGF recombinant protein, Wnt ligand molecule, Wnt3a, and Wnt7 a;

preferably, wherein the nucleic acid comprises a construct comprising a RUNX2 gene, an interfering RNA that modulates expression of a RUNX2 gene, a construct comprising a Wnt gene, or an interfering RNA that modulates expression of a Wnt gene.

4. the scaffold for controlling the development of permanent tooth germ as claimed in claim 3, which is arc-shaped with a concave surface for attaching on the surface of the deciduous tooth root, the top width of the scaffold is 3-6mm, the bottom width is 1.5-3.5mm, the average thickness is 300-.

5. Use of a scaffold according to claim 3 or 4 in controlling development of a permanent tooth germ comprising the process of implanting the scaffold in a subject.

6. use of a scaffold according to claim 3 or 4 in the manufacture of a medical device for controlling development of permanent dental embryos.

7. The application of a molecule for regulating and controlling an Integrin beta 1-Erk1-Runx2-Wnt/beta-catenin pathway in preparing a composition for controlling development of permanent tooth embryos;

Preferably wherein said molecule is selected from the group consisting of a Runx2 activating or inhibiting agent, a Wnt activating or inhibiting agent.

8. A method for detecting development of permanent tooth germ comprises the steps of detecting molecular expression level or activity in Integrin beta 1-Erk1-Runx2-Wnt/beta-catenin pathway around tooth plate;

Preferably, wherein said molecule comprises Runx2 and/or Wnt;

Preferably, the method for detecting development of a permanent tooth germ comprises the steps of detecting expression levels of Runx2 and/or Wnt genes at different times of the peridental-plaque mesenchyme of the same subject, and comparing the expression levels at different times;

Preferably, the method of detecting development of permanent tooth germ comprises:

(1) Detecting an expression level A1 of Runx2 gene and/or an expression level B1 of Wnt gene in mesenchyme around the dental plate at a first time T1,

(2) Thereafter, at a second time T2, the expression level a2 of Runx2 gene and/or the expression level B2 of Wnt gene in the mesenchyme around the dental plate was detected again;

(3) When A1 is greater than A2 and/or B1 is greater than B2, then the permanent tooth germ is judged to tend to develop, and when A1 is less than A2 and/or B1 is less than B2, then the permanent tooth germ is judged to tend to be inhibited;

Preferably, the method of detecting development of permanent tooth germ comprises: detecting an expression level of Runx2 in the mesenchyme around the dental plate, namely, an expression level A1 and/or an expression level of Wnt, and comparing the detected value with a reference;

Preferably, in the method for detecting development of a permanent tooth germ, the reference comprises the expression level a0 of Runx2 and/or the expression level B0 of Wnt in the mesenchyme around the dental plaque in a normal or healthy homogeneous individual; and when a1 is greater than a0 and/or B1 is greater than B0, it is determined that the permanent tooth germ tends to be inhibited, and when a1 is less than a0 and/or B1 is less than B0, it is determined that the permanent tooth germ tends to develop.

9. The method for detecting development of a permanent tooth germ as claimed in claim 8, wherein the reference comprises a first reference value interval obtained by counting the expression values of Runx2 in the mesenchyme around the same dental plate detected by a plurality of similar individuals and/or a second reference value interval obtained by counting the expression values of Wnt in the mesenchyme around the same dental plate detected by a plurality of similar individuals; and is

when a1 is greater than the maximum value of the first reference interval and/or B1 is greater than the maximum value of the second reference interval, it is determined that the permanent tooth germ tends to be suppressed, when a1 is within the first reference interval and/or B1 is within the second reference interval, it is determined that the permanent tooth germ tends to be stationary, and when a1 is less than the minimum value of the first reference interval and/or B1 is less than the minimum value of the second reference interval, it is determined that the permanent tooth germ tends to develop.

10. A method for detecting development of permanent tooth germ, comprising a step of detecting expression level of Wnt gene in mesenchyme and in tooth plate epithelial cell around tooth plate of the same subject, judging that development of tooth germ is initiated when expression level of Wnt signal in mesenchyme is decreased and at the same time expression level in tooth plate epithelial cell is increased.

Technical Field

The present invention relates generally to the field of dental development and regeneration, and more particularly to the modulation of the biomechanical environment early in dental development, thereby restarting permanent tooth embryos that have prematurely terminated development or inhibiting permanent tooth embryos that have prematurely initiated development.

Background

Congenital permanent tooth loss has a high incidence in the population, with an average of 1.5 teeth per patient, except for the third molar. The congenital lack of teeth can cause partial loss of the chewing function and affect the beauty, thereby reducing the life quality of the sufferers. The onset of congenital permanent tooth loss is generally considered to be genetically related, but the cause cannot be clarified in most patients. In clinical practice, the shape, number and position of permanent tooth germ are generally observed by X-ray film as the main diagnostic method, and congenital permanent tooth loss is diagnosed if permanent tooth germ without calcification in jaw is identified.

It is known in the art that teeth develop from dental plates, which are specific epithelial cords, that begin to develop under appropriate environmental and activating conditions, that begin to calcify after undergoing bud, cap and bell phases, and that gradually develop an image of tooth calcification in the jaw. Current studies indicate that congenital permanent tooth loss is generally associated with early failure of the dental plate to initiate development, and the reason why the dental plate is not further developmentally differentiated at the beginning of development is still unclear. This is also the key to the treatment of such diseases.

disclosure of Invention

In order to solve at least part of the above technical problems, the present inventors have found, after intensive research, that the development of permanent tooth germ can be controlled by regulating the mesenchymal environment around the dental plate. The present invention has been accomplished based at least in part on this finding. Specifically, the present invention includes the following.

In a first aspect of the invention, there is provided a method of controlling development of a permanent tooth germ comprising the step of modulating the mesenchymal environment surrounding a dental plate in a subject in need thereof.

in certain embodiments, the mesenchymal environment is modulated for a time selected from at least one of (a) - (c) below:

(a) The age at which deciduous teeth erupt until the deciduous teeth should fall off under physiological conditions;

(b) The eruption of deciduous teeth is not normal or delayed, or the mesenchyme around the permanent tooth dental plate is in a biological stress period;

(c) the permanent dental plate has not yet begun to develop or has developed but the permanent tooth germ has not yet calcified.

In certain embodiments, the modulation comprises at least one selected from the group consisting of:

(1) reducing and releasing the tension of the mesenchyme around the dental plate;

(2) Controlling the tension of the mesenchyme to be within a prescribed first range, wherein the first range is a tension range suitable for permanent tooth embryo development;

(3) Inhibiting or reducing the activity or expression level of RUNX2 in mesenchymal cells surrounding a dental plate;

(4) Inhibiting or reducing the activity or expression quantity of the Wnt/beta-catenin pathway in mesenchymal cells around the dental plate.

in certain embodiments, the modulation comprises at least one selected from the group consisting of:

(1) Controlling the tension of the mesenchyme to be within a prescribed second range, wherein the second range is a tension range suitable for inhibiting the development of permanent tooth embryos;

(2) increasing or increasing the activity or expression level of RUNX2 in mesenchymal cells surrounding a dental plate;

(3) Improving or increasing the activity or expression quantity of the Wnt/beta-catenin pathway in the mesenchymal cells around the dental plate.

In certain embodiments, the mesenchymal environment is modulated by mechanical treatment, implantation of a scaffold that alters biological tonicity and/or administration of an active factor that alters biological tonicity.

In certain embodiments, the controlling comprises initiating, promoting or inhibiting development of permanent tooth germ, controlling the rate of development of permanent tooth germ, and directing the permanent tooth germ to grow in a desired direction.

In a second aspect of the invention, a stent for controlling development of permanent tooth embryos is provided having a structure adapted to be affixed to the surface of a deciduous tooth root and implanted under the gingival sulcus.

In certain embodiments, the scaffold for controlling permanent tooth germ development comprises a porous material having a pore diameter of 1-10 μm and a pore density of 50-200/mm 2.

In certain embodiments, the porous material comprises at least one selected from the group consisting of synthetic materials, naturally derived materials, and composite materials.

In certain embodiments, the scaffold for controlling permanent tooth germ development further comprises an active factor that alters biological tonicity.

In certain embodiments, the active factor that alters tonicity includes a molecule that modulates the Integrin β 1-Erk1-Runx2-Wnt/beta-catenin pathway. Preferably, the molecules are cytokines, recombinant proteins, nucleic acids, and small molecule drugs. More preferably, the molecule comprises at least one selected from the group consisting of Dkk1, Sfrp1, Sostdc1, U0126, RUNX2 inhibitor, Wnt inhibitor, shh activator, TGF/Smad pathway modulator, FGF recombinant protein, Wnt ligand molecule, Wnt3a, and Wnt7 a.

In certain embodiments, the nucleic acid in the scaffold for controlling development of permanent dental embryos comprises a construct comprising a RUNX2 gene, an interfering RNA that modulates expression of a RUNX2 gene, a construct comprising a Wnt gene, or an interfering RNA that modulates expression of a Wnt gene.

In some embodiments, the scaffold for controlling the development of permanent tooth germ is arc-shaped with a concave surface, wherein the concave surface is used for attaching to the surface of the tooth root of the milk, the top width of the scaffold is 3-6mm, the bottom width is 1.5-3.5mm, the average thickness is 300-.

In a third aspect of the invention, there is provided the use of a scaffold of the invention in the control of permanent tooth germ development, comprising the process of implanting the scaffold into a subject.

In a fourth aspect of the invention, there is provided the use of a scaffold according to the invention in the manufacture of a medical device for controlling development of permanent dental embryos.

In a fifth aspect of the invention, there is provided the use of a molecule that modulates the Integrin β 1-Erk1-Runx2-Wnt/beta-catenin pathway in the preparation of a composition for controlling development of permanent tooth embryos. Preferably, the molecule is selected from the group consisting of a Runx2 activating or inhibiting agent, a Wnt activating or inhibiting agent.

In a sixth aspect of the invention, a first method for detecting development of permanent tooth germ is provided, which comprises the step of detecting expression level or activity of molecules in the Integrin beta 1-Erk1-Runx2-Wnt/beta-catenin pathway around the dental plate. Preferably, the molecule comprises Runx2 and/or Wnt.

In certain embodiments, the first method of detecting development of a permanent tooth germ comprises the steps of detecting expression levels of Runx2 and/or Wnt genes at different times in the peridental-plaque mesenchyme of the same subject, and comparing the expression levels at different times.

In certain embodiments, a method of detecting development of a permanent tooth germ comprises:

(1) Detecting an expression level a1 of Runx2 gene and/or an expression level B1 of Wnt gene within mesenchyme surrounding the dental plate at a first time T1;

(2) Thereafter, at a second time T2, the expression level a2 of Runx2 gene and/or the expression level B2 of Wnt gene in the mesenchyme around the dental plate was detected again;

(3) when a1 is greater than a2 and/or B1 is greater than B2, it is determined that permanent tooth germ tends to develop, and when a1 is less than a2 and/or B1 is less than B2, it is determined that permanent tooth germ tends to be inhibited.

in a seventh aspect of the present invention, there is provided a second method for detecting development of permanent tooth germ, comprising the step of detecting expression levels of Wnt genes in mesenchyme and in tooth plate epithelial cells around a tooth plate of the same subject, judging that development of tooth germ is initiated when expression level of Wnt signal in mesenchyme is decreased and at the same time expression level in tooth plate epithelial cells is increased.

Drawings

figure 1 shows that permanent cuspid embryos initiate the development process.

figure 2 shows the dissection position of a 90-day embryo minipig permanent cuspid tooth embryo.

Fig. 3 shows the initiation of a biological stress-regulated permanent tooth germ.

FIG. 4 shows the high expression of the mechano-regulatory pathway Integrin β 1-ERK1-RUNX2 in mesenchyme between deciduous permanent teeth.

FIG. 5 shows that overexpression of RUNX2 inhibited the priming of permanent tooth embryos and that knockdown RUNX2 activated the priming.

figure 6 shows that the Wnt/β -catenin pathway is expressed in the mesenchyme between deciduous teeth.

Fig. 7 illustrates a process of implanting a biological stent material.

Detailed Description

Reference will now be made in detail to various exemplary embodiments of the invention, the detailed description should not be construed as limiting the invention but as a more detailed description of certain aspects, features and embodiments of the invention.

It is to be understood that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. Further, for numerical ranges in this disclosure, it is understood that the upper and lower limits of the range, and each intervening value therebetween, is specifically disclosed. Every smaller range between any stated value or intervening value in a stated range and any other stated or intervening value in a stated range is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included or excluded in the range.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although only preferred methods and materials are described herein, any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention. All documents mentioned in this specification are incorporated by reference herein for the purpose of disclosing and describing the methods and/or materials associated with the documents. In case of conflict with any incorporated document, the present specification will control.

After the invention is studied by taking a miniature pig (miniature pig) as a model, the permanent tooth dental plate is firstly separated from a bellied period enameling device of deciduous teeth and is kept still for a long time before the deciduous teeth germinate. When deciduous teeth erupt, the biological stress in the jaw bone is released, the molecular expression and function of the biomechanical related pathway in the mesenchyme around the permanent tooth dental plate are reduced, and the permanent teeth start to develop. After further research, the position of the permanent tooth dental plate, the surrounding mesenchymal microenvironment and the interaction between the dental plate and the surrounding mesenchymal environment in the starting process are important for solving the problem of congenital permanent tooth loss. The present invention has been accomplished based at least in part on the above findings. Specifically, the present invention includes at least the following aspects. As described in detail below.

[ method of controlling development of permanent tooth embryo ]

In a first aspect of the invention, there is provided a method of controlling permanent tooth germ development (sometimes referred to herein simply as "the method of the invention") comprising the step of modulating the mesenchymal environment surrounding a dental plate in a subject in need thereof.

a "subject" of the invention is a subject in need of control of development of permanent tooth germ, typically a subject with congenital permanent tooth loss. Unlike a typical congenital tooth loss, a patient with a congenital permanent tooth loss usually has deciduous teeth, and the deciduous teeth usually develop normally. Congenital permanent tooth loss is mainly diagnosed by observing the form, the quantity and the position of permanent tooth embryos by an X-ray film, and if the permanent tooth embryos without calcification in the jaw are clear, the congenital permanent tooth loss is diagnosed. Although primary permanent teeth are usually missing, the presence or absence of corresponding primary teeth does not affect the method of the present invention, and the presence or absence of corresponding primary teeth may be sufficient if the mesenchymal position of the dental plate and the surrounding area of the subject can be confirmed. The subject of the invention is preferably free from the following conditions, except that it is diagnosed as having congenital permanent tooth loss: (a) congenital permanent tooth loss without obvious hereditary diseases; (b) the presence of calcified permanent tooth germ in jaw bone is confirmed by using X-ray examination before the method of the invention is carried out; (c) there is permanent tooth loss whose genetic factors are clear.

In the method of the present invention, timing of adjusting the mesenchymal environment around the dental plate is important. Preferably, the mesenchymal environment is conditioned for a time selected from at least one of (a) - (c) below:

(a) the age at which deciduous teeth erupt until the deciduous teeth should fall off under physiological conditions;

(b) The eruption of deciduous teeth is not normal or delayed, or the mesenchyme around the permanent tooth dental plate is in a biological stress period;

(c) the permanent dental plate has not yet begun to develop or has developed but the permanent tooth germ has not yet calcified.

The control of the invention comprises the steps of starting, promoting or inhibiting the development of permanent tooth embryos, controlling the development speed of the permanent tooth embryos, guiding the permanent tooth embryos to grow in a required direction and the like. Wherein, the initiation means that the permanent tooth germ is originally in a static state and is converted into a development starting state from the static state through induction and the like. The promotion means that the development of the permanent tooth germ is started, but the development speed is too slow, and the development speed of the permanent tooth germ is accelerated by regulation and control. Inhibition means that the development speed of the permanent tooth germ is too fast, and the speed is reduced by regulating the mesenchymal environment around the dental plate. In certain embodiments, the methods of the present invention for controlling development of permanent tooth embryos comprise reducing, releasing the tension of the mesenchyme surrounding the dental plate, thereby promoting or initiating development of permanent tooth embryos.

In certain embodiments, the mesenchymal environment is modulated by mechanical treatment in the method of controlling permanent tooth germ development of the invention. By mechanical treatment is meant any treatment which separates the root surface of the deciduous tooth from the periodontal ligament. It may be cut, peeled, etc. The purpose of the mechanical treatment is to relieve stress and the like at the site to be treated. Preferably, the mechanical treatment is performed within a distance below the gingival sulcus on the lingual side of the erupting deciduous teeth. More preferably, micromanipulation is performed. The location of the mechanical treatment includes the lingual side of the deciduous teeth near the gingival sulcus. Mechanical treatment to separate the root surface of the deciduous teeth from the periodontal ligament, down to under the permanent tooth germ, thus exposing the gap between the deciduous permanent teeth.

In certain embodiments, the mesenchymal environment is modulated by implanting a scaffold that can alter biological tension in the method of controlling permanent tooth germ development of the invention. The location of implantation may be the same as the location of mechanical treatment. Preferably, the implantation site is a site of separation between the tooth root surface of the deciduous tooth and the periodontal ligament, or a site of exposure therebetween. The term "scaffold for altering biological tension" herein may be the same as "scaffold for controlling development of permanent tooth germ" which will be described below. And will not be described in detail herein.

In certain embodiments, the method of the invention for controlling development of permanent tooth germ controls development of permanent tooth plaque by administering an active factor that alters biological tonicity. The effect of "administration" in the present invention includes increasing or decreasing the amount, both absolute and relative, of the active factor that alters the biological tension in the mesenchyme surrounding the dental plate; also included is promoting or delaying the release of active factors that alter biological tonicity from the mesenchymal cells surrounding the dental plate to the extracellular space, thereby increasing or decreasing the amount of extracellular active factors. The inventor researches and discovers that when deciduous teeth sprout, the biological stress in the jaw bone is released, the biomechanical related pathway in mesenchyme around the permanent tooth dental plate, particularly the molecular expression and the function of the Integrin beta 1-Erk1-Runx2-Wnt/beta-catenin pathway are reduced, and the permanent teeth start to develop. Substances that participate in or regulate biomechanically relevant pathways are collectively referred to herein as "active factors that alter biological tonicity. The methods of the invention preferably comprise administering an agent capable of modulating or participating in the Integrin β 1-Erk1-Runx2-Wnt/β -catenin pathway. Such substances preferably include cytokines, recombinant proteins, nucleic acids, and small molecule drugs. Examples of recombinant proteins include, but are not limited to, Dkk1, Sostdc1, and Sfrp 1. Examples of small molecule drugs include, but are not limited to, U0126. Examples of nucleic acids include, but are not limited to, the RUNX2 gene, a construct (e.g., a vector) comprising RUNX2, an interfering RNA that modulates expression of the RUNX2 gene, a Wnt gene, a construct (e.g., a vector) comprising Wnt, an interfering RNA that modulates expression of the Wnt gene, and the like. Preferably, the nucleic acid is an expression vector comprising a RUNX2 gene (e.g., a lentiviral vector), or a knock-down vector comprising a RUNX2 interfering RNA (e.g., a lentiviral vector). Methods for nucleic acid preparation or construction are known in the art and reference may be made to, for example, publications in the fourth edition of the molecular cloning instructions of Cold spring harbor.

The administration method of the present invention is not particularly limited, but is preferably an administration method in which the above-mentioned substance is targeted to the mesenchyme around the permanent tooth plaque, and the targeting here means specifically acting in the mesenchyme rather than the epithelium. The inventors found that inhibiting or reducing expression of Runx2 in the mesenchyme surrounding the dental plate promotes permanent tooth development. The development of permanent tooth embryos is inhibited by Runx2 superficially passing through mesenchyme around the permanent tooth dental plate.

in certain embodiments, the method of controlling permanent tooth germ development of the present invention modulates biomechanics in the mesenchymal environment by at least two selected from the group consisting of mechanical treatment, implantation of a scaffold that alters tonicity, and administration of an active factor that alters tonicity, thereby further enhancing the controlling effect. Particularly preferred is a method in which mechanical treatment, implantation of a scaffold that changes the biological tonicity, and administration of an active factor that changes the biological tonicity are carried out simultaneously.

[ Stent for controlling development of permanent tooth embryo ]

in a second aspect of the present invention, there is provided a stent for controlling development of permanent tooth germ (sometimes referred to simply as "the inventive stent" in the present invention) having a structure adapted to be attached to the root surface of a deciduous tooth and implanted under the gingival sulcus.

The bracket is used for controlling the development of the permanent tooth germ, and can be in an arc shape with a concave surface in order to be attached to the tooth root surface of a primary tooth and implanted below a gingival sulcus, wherein the concave surface is used for being attached to the tooth root surface of the primary tooth, the top width of the bracket is 3-6mm, the bottom width of the bracket is 1.5-3.5mm, the average thickness of the bracket is 300-.

The scaffolds of the present invention generally have a Poisson's ratio of 0.25-0.40, preferably 0.28-0.38. The Young's modulus of the scaffold of the present invention is generally 0.10 to 0.25MPa, preferably 0.15 to 0.20 MPa. The poisson's ratio and young's modulus of the present invention may be determined in known manner.

The scaffold material of the invention comprises synthetic materials, naturally derived materials and composite materials. Wherein the synthetic material comprises inorganic material, organic material and organic material. Examples of inorganic materials include, but are not limited to, bioceramics (e.g., alumina ceramics, hydroxyapatite, tricalcium phosphate), porous metals (stainless steel, cobalt-based alloys, memory alloys), titanium and titanium alloys, calcium phosphate cements (e.g., hydroxyapatite, tricalcium phosphate). Examples of organic materials include, but are not limited to, polybutanoic acid, polyphosphazenes, polyanhydrides, polyethylene glycols, polyurethanes, polylactic acid, polyglycolic acid, and copolymers thereof. Preferably polylactic acid, polyglycolic acid and polylactic acid-polyglycolic acid copolymer. The nanometer material is a scaffold material prepared from an atomic level, and has the biggest characteristics of high specific surface area and porosity, and is beneficial to cell inoculation, migration and proliferation. The bionic microenvironment of the nanofiber material can influence the interaction between cells and the interaction between the cells and the matrix, and regulate the biological behavior of the cells.

the natural derivative material includes natural bone, natural organic high molecular material and natural inorganic material. Wherein the natural bone is derived from allogeneic or xenogeneic animal bone. Examples of natural organic polymeric materials include, but are not limited to, collagen, fibrin, chitin, alginate, chitosan. Examples of natural inorganic materials include, but are not limited to, coral materials, which have the advantages of porosity and high porosity, good biodegradability, certain mechanical strength and plasticity, and abundant sources.

The composite scaffold material comprises hydroxyl octanoic acid copolymer and nano hydroxyapatite compounded with collagen. Wherein, the hydroxyl octanoic acid copolymer is natural high molecular polyester material polyhydroxyalkanoic acid synthesized by microorganisms, which has good cell compatibility and biodegradability. The nano hydroxyapatite compounded with the collagen has good biocompatibility and degradability.

The scaffold material of the present invention preferably comprises a porous material, in particular an absorbable porous material. The average pore diameter of the porous material is generally 1 to 10 μm, preferably 2 to 8 μm, and more preferably 4 to 6 μm. The average pore density of the porous material is generally from 50 to 200 per mm2, preferably from 60 to 180 per mm2, more preferably from 70 to 150 per mm 2. In certain embodiments, the porous material has an average pore diameter of 5 μm and an average pore density of 100/mm 2.

The scaffold of the present invention preferably further comprises an active factor that alters the biological tonicity. The active factors that alter the biological tonicity have been described in detail above. And will not be described in detail herein. In the present invention, the scaffold may comprise an active factor for changing the biological tonicity by means of embedding, binding, or the like. Preferably, the active factor that alters the biological tonicity is contained within the pores of the porous material of the scaffold. Also preferably, the active factor that alters the biological tonicity may be released from the scaffold, preferably in a manner that enables control of the rate of release.

In certain embodiments, the scaffolds of the present invention comprise a vector (e.g., a lentiviral vector) over-expressing RUNX2, and the slow release of the bioscaffold is used to specifically transfect the lentiviral vector into mesenchymal cells between deciduous permanent teeth, thereby inhibiting the onset of permanent tooth development. In certain embodiments, the scaffolds of the present invention comprise RUNX2 knockdown viral vectors, and the slow release effect of the scaffold is used to specifically transfect the lentiviral vectors into mesenchymal cells between deciduous permanent teeth, thereby promoting the premature onset of permanent teeth. Methods for constructing RUNX2 over-expressing lentiviral vectors and RUNX2 knock-down viral vectors are known in the art and reference is made, for example, to the publications in molecular cloning, A laboratory Manual, fourth edition, Cold spring harbor, et al. Since the stent of the present invention is implanted at a specific site in a subject, it is advantageous that a vector (e.g., a lentiviral vector) regulates or controls only cells at the specific site, thereby avoiding side effects.

the scaffold of the present invention may further comprise other active factors in addition to the active factors that alter biological tonicity described above. Examples of other active factors include, but are not limited to, Epithelial Growth Factor (EGF), Epithelial Growth Factor Receptor (EGFR), Fibroblast Growth Factor (FGF), and the like. The other active factors of the present invention may be one or a combination of more of the above substances. The manner of binding or embedding of other active factors to the scaffold may be consistent with the manner of active factors that alter biological tonicity.

[ first use of the stent ]

In a third aspect of the invention, there is provided the use of a scaffold of the invention in the manufacture of a medical device for controlling development of permanent dental embryos, briefly referred to as the first use. The stent of the present invention has been described in detail as described above. And will not be described in detail herein. The invention relates to a medical device for controlling the development of permanent tooth embryos. Wherein the medical device preferably comprises an intracorporeal implant, in particular an implant that can be inserted between deciduous permanent teeth, isolating the latter and thereby changing the biomechanical environment in which the permanent teeth grow. Preferably, the implant has a flexibility, in particular a flexibility which is less than the hardness of the surface of the mammary root. The main purpose of the implant of the invention is to implant under the gingival sulcus, which plays the role of supporting the gum on the lingual side, maintaining the pore between the soft tissue of the gum on the lingual side and the deciduous tooth, and preventing the gum on the lingual side from excessively adhering to the surface of the deciduous tooth to form tension. The scaffold is implanted by operation and the like, and the biomechanical environment of the initial development stage of the dental lamina is adjusted by combining the slow release of the bioactive factor, so that the treatment aim can be effectively achieved, and the scaffold has great social benefit and economic benefit.

[ second use of the stent ]

In a fourth aspect, the invention provides the use of the scaffold of the invention for controlling development of permanent tooth germ, referred to as the second use. Comprising the process of implanting the stent in a subject. The second use of the present invention can be understood as a method of controlling permanent tooth germ development using the inventive scaffold. The scaffold of the present invention has been described in detail above, and a method for controlling development of permanent tooth germ using the scaffold of the present invention is also mentioned in the method for controlling development of permanent tooth germ. For details, reference is made to the above description and no further description is made here.

[ use of molecules that modulate Integrin beta 1-Erk1-Runx2-Wnt/beta-catenin pathway in the preparation of compositions for controlling development of permanent tooth embryos ]

In a fifth aspect of the invention, there is provided the use of a molecule that modulates the Integrin β 1-Erk1-Runx2-Wnt/β -catenin pathway in the preparation of a composition for controlling development of permanent tooth embryos. The invention finds that a close relation exists between molecules (sometimes referred to as the molecules of the invention) participating in the Integrin beta 1-Erk1-Runx2-Wnt/beta-catenin pathway and the development of permanent tooth embryos. And proves that molecules using Integrin beta 1-Erk1-Runx2-Wnt/beta-catenin pathway can regulate the mesenchymal environment around dental plates and influence the development of permanent tooth embryos.

In certain embodiments, the molecule of the invention is selected from at least one of the group consisting of a Runx2 activator and/or inhibitor, a Wnt activator and/or inhibitor.

[ first method for detecting development of permanent tooth embryo ]

In a sixth aspect of the present invention, there is provided a first method for detecting development of permanent tooth germ (the present invention is sometimes simply referred to as "first detection method") comprising a step of detecting expression level or activity of a molecule in the Integrin β 1-Erk1-Runx2-Wnt/β -catenin pathway in the mesenchyme around the dental plate. Preferably, the molecule of the invention comprises Runx2 and/or Wnt.

In certain embodiments, the first detection method comprises the steps of detecting the expression levels of Runx2 and/or Wnt genes at different times in the peridental plaque mesenchyme of the same subject, and comparing the expression levels at different times. Preferably, the first detection method of the present invention includes:

(1) Detecting an expression level a1 of Runx2 gene and/or an expression level B1 of Wnt gene within mesenchyme surrounding the dental plate at a first time T1;

(2) Thereafter, at a second time T2, the expression level a2 of Runx2 gene and/or the expression level B2 of Wnt gene in the mesenchyme around the dental plate was detected again;

(3) when a1 is greater than a2 and/or B1 is greater than B2, it is determined that permanent tooth germ tends to develop, and when a1 is less than a2 and/or B1 is less than B2, it is determined that permanent tooth germ tends to be inhibited. Also preferably, the first detection method of the present invention comprises the step of detecting the expression level of Runx2 in the mesenchyme around the dental plate, a1 and/or the expression level of Wnt, and comparing the obtained detection value with a reference.

in certain embodiments, the reference comprises the expression level of Runx2 within the surrounding mesenchyme of the dental plaque a0 and/or the expression level of Wnt B0 in a normal or healthy homogeneous individual; and when a1 is greater than a0 and/or B1 is greater than B0, it is determined that the permanent tooth germ tends to be inhibited, and when a1 is equal to a0 and/or B1 is equal to B0, it is determined that the permanent tooth germ tends to develop.

In certain embodiments, the reference comprises a first reference value interval obtained by counting the expression values of Runx2 in the mesenchyme around the same dental plate obtained by detecting a plurality of similar individuals, and/or a second reference value interval obtained by counting the expression values of Wnt in the mesenchyme around the same dental plate obtained by detecting a plurality of similar individuals; and when a1 is greater than the maximum value of the first reference value interval and/or B1 is greater than the maximum value of the second reference value interval, determining that the permanent tooth germ tends to be inhibited; when A1 is within the first reference data interval and/or B1 is within the second reference data interval, determining that the permanent tooth germ tends to be still; when A1 is less than the minimum value of the first reference value interval and/or B1 is less than the minimum value of the second reference value interval, the permanent tooth germ is judged to tend to develop.

[ second method for detecting development of permanent tooth embryo ]

In the seventh aspect of the present invention, there is provided a second method for detecting development of a permanent tooth germ (the present invention may be simply referred to as "second detection method") which comprises a step of detecting expression levels of Wnt genes in mesenchyme around a dental plate and in epithelial cells around the dental plate of the same subject, and judges initiation of development of a tooth germ when a Wnt signal is transferred from the mesenchyme to the epithelium. "metastasis" as used herein includes the tendency of Wnt signaling to diminish or disappear in the mesenchyme surrounding the dental plate, while at the same time Wnt signaling tends to increase in the dental plate epithelium.