口腔卫生预防措施对固定正畸患者牙周菌群和牙周临床指数的影响  

Effects of oral hygiene prophylaxis on the periodontal microflora and clinical(indexes) of fixed orthodontic patients

作　　者：吴亚菲[1] 吴爱华[2] 肖丽英[3] 肖晓蓉[3] 朱(石米) 龚其美[3] 

机构地区：[1]四川大学华西口腔医院口腔内科,四川成都610041 [2]四川大学华西口腔医学杂志编辑部,四川成都610041 [3]四川大学口腔生物医学工程教育部重点实验室,四川成都610041

出　　处：《中国微生态学杂志》2005年第5期341-343,共3页Chinese Journal of Microecology

基　　金："十五"国家科技攻关计划项目(2004BA720A26)

摘　　要：目的采用牙周洁治和强化的口腔健康教育方法,通过检测牙周菌群和牙周临床指数的动态变化,探讨口腔卫生预防措施对固定正畸患者牙周菌群的影响。方法选择正畸初诊患者20例,平均分为试验组(T组)和对照组(C组)。于正畸治疗开始前检查右上颌第一磨牙16和右下颌中切牙41牙周状况,并采集其近中颊轴嵴处龈缘菌斑做细菌分离培养。T组于治疗前进行全口洁治,每月复诊加力时均给予口腔卫生检查,强调口腔卫生的重要性;C组仅在初诊时进行口腔卫生指导,其余不作处理。2组患者分别于矫治器安装后1、3和6个月进行临床及细菌学检查。结果随观察时间的延长,T组颊侧菌斑指数和牙龈指数在第1、3、6个月时较基线降低;C组颊侧菌斑指数第6个月时较基线降低,舌侧探诊深度则升高(P<0.05)。细菌检出率和检出量的变化在T组可见韦荣球菌属降低而弯曲杆菌属和Gn产黑色素厌氧杆菌(BPAR)升高,C组消化链球菌属和BPAR升高(P<0.05);BPAR在第3个月、消化链球菌属在第6个月时T组检出率低于C组(P<0.05),而细菌检出量和牙周临床指数在2组间没有观测到处理因素的作用(P>0.05)。结论正畸前即存在牙龈炎的患者,建议进行预防性牙周洁治;牙周洁治必须和口腔卫生教育、正确的日常菌斑控制措施结合进行。Objective The oral hygiene of malocclusion patients was kept by periodontal scaling and reinforced oral hygiene prophylaxis. The dynamic variation of periodontal microflora and clinical indexes was observed to study the effects of professional prophylaxis to periodontal microflora. Methods 20 malocclusion patients were divided into two groups. Group T was experimental, and group C was control. Right maxillary first molar 16 and right mandibular central incisor 41 were the observed teeth. Before orthodontic treatment, the periodontal status of the observed teeth were examined, and gingival sulcular plaques were collected and cultured. Group T accepted supragingival scaling before orthodontic treatment and oral hygiene instruction when return visited monthly. Group C accepted no special treatment except the initial oral hygiene instruction. The clinical indexes and microflora were examined at the 1st, 3rd and 6th months after treatment. Results With the observational time prolonged, the plaque index and gingival index of buccal side decreased at the 1st, 3rd, 6th months compared with baseline in group T. The plaque index of buccal side increased while the probing depth of lingual side decreased at the 6th months compared with baseline in group C. The detective rate and counts of Veillonella in group T decreased, while that of Campylobacter and black-pigmented gram negative anaerobic rod （BPAR） in group T and Peptostreptococcus and BPAR in group C increased. The detective rate of BPAR at the 3rd month and that of Peptostreptococcus at the 6th month in group T lower than that in group C （P〈0.05）. The detective counts of flora and the clinical indexes were no significant between two groups （P〉0. 05）. Conclusions Preventive periodontal scaling was proposed for gingivitis patients before orthodontic treatment. Periodontal scaling should combine with oral hygiene instructions and methods of plaque controlling daily.

关 键 词：固定矫治器 口腔卫生预防措施 菌斑控制 牙周洁治 

分 类 号：R378[医药卫生—病原生物学]