嵴上纤维环切联合正畸治疗牙周炎致切牙扇形移位的初步研究  

A preliminary study of combined periodontal-orthodontic approach for treating labial displacement of incisors in patients with periodontal diseases

作　　者：刘晓峰[1] 潘晓岗[2] 束蓉[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院牙周科,上海200011 [2]上海交通大学医学院附属第九人民医院·口腔医学院口腔正畸科,上海市口腔医学研究所,上海200011

出　　处：《上海口腔医学》2008年第3期264-266,共3页Shanghai Journal of Stomatology

摘　　要：目的:通过嵴上纤维环切联合正畸治疗,观察对切牙病理性移位治疗前、后牙周支持组织临床测量指标的变化,对成人牙周病正畸的疗效进行评估。方法:牙周-正畸联合治疗21例患者唇向散开且两侧病损对称的52颗切牙,随机分为嵴上纤维环切组和非环切组,环切组进行嵴上纤维环切术后正畸治疗,测量牙周病临床指标,前牙区定位摄片观察牙槽骨高度,比较治疗前、后的变化。采用SPSS12.0软件包对治疗前、后嵴上纤维环环切组与非环切组患牙的PD、CAL、CEJAC和RL值进行配对t检验,对治疗前、后的SBI、TM计数进行Wilcoxon符号秩和检验。结果:牙周-正畸联合治疗后,2组松动度、出血指数、探诊深度和临床附着丧失及CEJ至牙槽嵴顶距离均降低,表明正畸治疗有助于牙周病临床参数的改善;牙根长度变化不明显,说明正畸压入未造成牙根吸收。与非环切组相比,环切组的CAL、TM的下降有显著差异(P<0.05),CEJAC的下降也有显著差异(P<0.01)。结论:正畸治疗能令嵴上纤维环切术更有效地增加牙槽骨高度及牙周附着。PURPOSE： The purpose of this study was to evaluate the effect of combined periodontal-orthodontic treatment for patients who had chronic periodontitis with labial displacement of incisors and radiological evidence on migrated incisors. METHODS： Twenty-one adult patients were included in the study. Fifty-two migrated incisors were randomly assigned to treatment with circumferential supracrestal fibrotomy or non-surgery. The mean orthodontic treatment time was 12 months. Before surgery （circumferential supracrestal fibrotomy） and at the end of orthodontic treatment, the following parameters were registered clinically： CAL（clinical attachment loss）, TM（tooth mobility）, SBI （suleus bleeding index）, PD （probing depth）,CEJAC （distance from the CEJ to the alveolar crest） and RL （root length）. Standardized intraoral radiographs were taken. SPSS12.0 software package was used for data analysis. Student＇s t test was performed for coupled data including PD, CAL, CEJAC and RL. Results of SBI and TM were analyzed statistically with Wileoxon signed rank test. RESULTS： Comparison of pre- and post-treatment values showed a statistically significant improvement for all parameters without remarkable root apex resorption. TM and CAL reduction were greater in the surgical group compared to the non-surgical group （P〈0.05）. The reduction of CEJAC between the two groups were significantly different （P〈0.01）. CONCLUSION： The results show the efficacy of combined periodontal-orthodontic approach with circumferential fibrotomy on patients with incisors migration. After proper periodontal surgical therapy, orthodontic movement can positively improve both the alveolar bone and the soft periodontal tissues.

关 键 词：牙周-正畸联合治疗 病理性切牙移位 嵴上纤维环切术 

分 类 号：R781.4[医药卫生—口腔医学]