牙周基础治疗对慢性牙周炎伴继发性咬合创伤患牙临床及咬合影响的随机对照研究  

Effect of periodontal initial therapy on teeth with chronic periodontitis and secondary occlusai trauma

作　　者：王鹏程[1] 唐杭瑞[1] 许杰[1] 张戎[1] 刘玲侠[1] 王勤涛[1] 

机构地区：[1]第四军医大学口腔医学院牙周科,西安710032

出　　处：《中华口腔医学杂志》2013年第5期266-271,共6页Chinese Journal of Stomatology

摘　　要：目的 评价龈下刮治、根面平整与调（牙合）对合并继发性咬合创伤的牙周炎患牙力学状况及牙周临床指标改善的影响，以期为临床提供参考。方法将18例慢性牙周炎合并咬合创伤患者按咬合时间测定值大小分层区组随机分为A、B两组，每组9例；0d时（基线），A组先实施全口龈下刮治＋根面平整治疗，B组实施咬合创伤牙位调（牙合）治疗；第28天，A组接受咬合创伤牙位调（牙合）治疗，B组接受全口龈下刮治＋根面平整治疗。调（牙合）在T—ScanIII型咬合分析系统指导下完成。在0、28、56d检查A、B两组全口牙周探诊深度、附着丧失、出血指数、咬合创伤牙位咬合时间及咬合受力百分比。采用SPSS18．0统计软件对基线时A、B两组间牙周临床指标及咬合指标差异、各组内治疗前后牙周临床指标与咬合指标变化、两组在28、56d牙周临床指标与咬合指标变化值的差异进行配对t检验，检验水准为双侧α=0．05。结果基线时A组与B组全口平均探诊深度、附着丧失、出血指数差异均无统计学意义（P〉0．05）；A组与B组咬合创伤牙位平均探诊深度、附着丧失、出血指数差异均无统计学意义（P〉0．05）；同时，A、B组间咬合创伤牙位咬合时间[分别为（1．29±0．39）、（1．34±0．35）S1、咬合受力百分比[分别为（6．8±2．1）％及（7．4±1．7）％]差异均无统计学意义（P〉0．05）。龈下刮治＋根面平整前后咬合创伤牙位牙周临床指标及咬合时间均显著降低（P〈0．05）；A、B两组单纯调哈前后纳入牙位牙周临床指标差异均无统计学意义（P〉0．05）。终点时，A、B两组牙周临床指标较基线的改变值差异均无统计学意义（P〉0．05）；咬合时间、咬合受力百分比相比基线的改变值A组[分别为（0．85±0．41）s、（2．2±2．2）％]均显著大于B组[（0．70±0．38）s、（1．5±1．Objective To evaluate the effect of subgingivaI sealing/root planning （SRP） and occlusal adjustment on clinical and oeclusal parameters in teeth with chronic periodontitis and secondary ocelusal trauma. Methods Eighteen patients with chronic periodontitis and occlusal trauma were included and randomly divided into group A and group B. On day 0, group A was treated by full-mouth subgingival scaling and root planning, and group B was treated by oeclusal adjustment in occlusal trauma site. On day 28, group A was treated by occlusal adjustment in occlusal trauma site, and group B was treated by full-mouth subgingival scaling and root planning. Probing depth（ PD）, attachment loss （AL）, bleeding index （BI） were evaluated on 0,28 and 56 d, and the occlusal time （OT） and the percentage of occlusal force were evaluated on 0,28 and 56 d in occlusal trauma site. The data was statistically analyzed. Results In baseline, the PD[（4.42 ± 1.41） mm vs （4.36 ± 1.38） mm],AL[（2.75 ± 1.32） mm vs （2.63 ±1.37 ） mm and BI [ （ 2. 20± 0. 81 ） vs （ 2.24 ±0. 89 ） ] of the full-mouth showed no significant difference between the two groups （ P 〉 0. 05 ）. There was no significant difference in PD [ （ 5.21 ±1.21 ） mm vs （5.08±1. 12） mm] ,AL[ （4. 94 ± 1.47） mm vs （4.89± 1.32） mm],BI[（2.61 ±0.92） vs 2.50± 0. 79） ] ,OT[ （1.29±0. 39） s vs （1.34 ＋0. 35） s] and the percentage ofoeclusal force[ （6. 8 ±2. 1）% vs （7.4 ± 1.7 ） % ] in oeclusal trauma site between the two groups （ P 〉 0. 05 ）. After SRP therapy, the PD, AL, BI and OT were significantly decreased （ P 〈 0. 05 ）. The clinical parameters exhibited no significant difference after only occlusal adjustment（P 〉 0. 05 ）. On 56 d, the reduction in clinical parameters was not significantly different between the two groups （ P 〉 0. 05 ） , however the reduction of OT and the change of the percentage of oeelusal force in group A [ （0. 85 ± 0. 41 ） s, （2. 2 ±2. 2）% ]

关 键 词：牙周炎 牙龈下刮治术 咬合创伤 调[牙合] 

分 类 号：R781.4[医药卫生—口腔医学]