Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2025; 13(24): 107535
Published online Aug 26, 2025. doi: 10.12998/wjcc.v13.i24.107535
Mechanism analysis of periostin in osteoclasts differentiation of dental follicle: Two case reports
Jun Cai, Han Qin
Jun Cai, Department of Anesthesia, The Maternal and Child Health Hospital of Lianyungang City, Lianyungang 222006, Jiangsu Province, China
Han Qin, Department of Stomatology, The Lianyungang Affiliated Hospital of Xuzhou Medical University, Lianyungang First People's Hospital, Lianyungang 222002, Jiangsu Province, China
Author contributions: Cai J and Qin H contributed to designed the research study; Cai J contributed to performed the research; Cai J and Qin H contributed to analyzed the data; Qin H contributed to wrote the manuscript; Both authors read and approved the final manuscript.
Supported by The Xuzhou Medical University Affiliated Hospital Development Fund Support Project, No. XYFM202457; the 521 Scientific Research Project of Lianyungang City, No. LYG 06521202362.
Informed consent statement: Informed consent forms were assigned by the patient's parents before she/he were enrolled in the research.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Han Qin, Professor, Department of Stomatology, The Lianyungang Affiliated Hospital of Xuzhou Medical University, Lianyungang First People's Hospital, No. 182 Tongguan Road, Lianyungang 222002, Jiangsu Province, China. qinhan2005@163.com
Received: March 26, 2025
Revised: April 10, 2025
Accepted: May 10, 2025
Published online: August 26, 2025
Processing time: 82 Days and 17 Hours
Abstract
BACKGROUND

This study analyzed the dental follicle and alveolar bone of two patients with tooth eruption disorders, aiming to provide some reference for exploring the etiology and selecting treatment plans of this disease from the perspective of the influence of extracellular matrix on osteoclasts differentiation in dental follicle.

CASE SUMMARY

Collect dental follicle and alveolar bone tissue from one patient with single tooth eruption disorder and one patient with full permanent tooth eruption disorder, respectively. Simultaneously collect the dental follicle and alveolar bone tissue of obstructed teeth that need to be extracted due to orthodontic treatment as the control group. Hematoxylin and eosin (HE) staining was used to observe the morphology of dental follicle cells. Immunohistochemical staining was used to observe the expression of periostin, receptor activator of nuclear factor kappa B ligand (RANKL), and osteoprotegerin (OPG) protein in dental follicle and alveolar bone tissue. And observe the eruption of teeth after removing resistance from the crown of the permanent tooth germ.

CONCLUSION

HE staining of two cases of dental follicle tissues showed that the volume of dental follicle cells decreased, the nuclei were condensed, and there seemed to be cellular fibrosis. The immunohistochemical staining showed that both the dental follicle and alveolar bone tissue exhibited increased expression of periostin, decreased expression of RANKL and OPG proteins, and decreased RANKL/OPG ratio. After removing resistance, the permanent tooth germ often appears to have normal eruption. Tooth eruption disorders may be accompanied by abnormal remodeling of periostin, which affects the differentiation function of osteoclasts in the dental follicle and leads to metabolic imbalance of alveolar bone, resulting in tooth eruption disorders. Whether it is a single or full permanent tooth eruption disorder, once the coronal resistance is removed, the teeth can often erupt normally.

Keywords: Tooth eruption disorder; Dental follicle; Osteoclast differentiation; Periostin; Case report

Core Tip: This study analyzed the periostin and bone metabolic factors in the dental follicle and alveolar bone of two patients with tooth eruption disorders. And the results suggest that tooth eruption diseases may be accompanied by abnormal remodeling of periostin, which can affect the differentiation function of osteoclasts in the dental follicle, leading to an imbalance in alveolar bone metabolism and resulting in tooth eruption disorders. This provides some reference for the etiology and treatment of tooth eruption disorders from a new research perspective of the effect of extracellular matrix on the differentiation of osteoclasts in dental follicle.