Piezocision联合微孔技术在成年人下颌磨牙前移过程中牙周组织改建的临床研究  

Clinical effect of Piezocision combined with a microporous technique on periodontal tissue reconstruction during anterior displacement of mandibular molars in adults

作　　者：柯云艳 张立港[1] 陆晓俊 朱秀明[1] 陈学鹏[2] Ke Yunyan;Zhang Ligang;Lu Xiaojun;Zhu Xiuming;Chen Xuepeng(Department of Stomatology,Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312000,Zhejiang Province,China;Department of Orthodontics,Affiliated Stomatology Hospital,School of Medicine,Zhejiang University,Hangzhou 310006,Zhejiang Province,China)

机构地区：[1]绍兴市中医院口腔科,绍兴312000 [2]浙江大学医学院附属口腔医院正畸科,杭州310006

出　　处：《中国基层医药》2024年第4期481-486,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省绍兴市科技计划(2020A13041)。

摘　　要：目的探讨Piezocision联合微孔技术加速成年人下颌磨牙前移过程中牙周组织改建的临床效果。方法采用前瞻性随机对照研究,选取2020年1月至2022年9月绍兴市中医院收治的因第一磨牙严重龋坏无法保留或缺失多年无法实行种植的正畸患者30例为研究对象,采用随机数字表法分为单纯正畸对照组(A组)15例、Piezocision联合微孔技术实验组(B组)15例。观察比较治疗后两组下颌第二磨牙近中移动距离、菌斑指数(PI)、牙龈指数(GI)、牙周袋深度(PPD)、角化牙龈宽度(WKG)、牙龈萎缩(GR)、临床附着丧失(CAL)、下第二磨牙近中牙根吸收、牙槽骨高度(测量从下切牙的中心点到颏部前缘距离,即LM-AC距离)、下颌骨高度(测量牙根远中面或近中面至牙槽骨缘距离,即CEJ-AC距离)、矫正满意度。结果治疗后第4、6、8、12周,B组下颌第二磨牙近中移动的距离分别为(0.86±0.13)mm、(2.75±0.24)mm、(3.54±0.24)mm、(4.67±0.13)mm,均大于A组的(0.43±0.06)mm、(1.27±0.14)mm、(1.85±0.53)mm、(2.65±0.06)mm(t=6.83、14.13、18.24、23.78,均P<0.001)。治疗前,两组PI、GI、PPD、WKG、GR、CAL差异均无统计学意义(均P>0.05);治疗后,A组PI、GI、WKG、GR与治疗前差异均无统计学意义(均P>0.05),PPD、CAL水平均较治疗前提高,差异均有统计学意义(t=-2.57、-7.50,均P<0.05);B组PPD、WKG、GR、CAL较治疗前明显提高,差异均有统计学意义(t=-8.66、-5.57、-45.33、-9.72,均P<0.001);且B组PPD、WKG、GR、CAL均显著高于A组,差异均有统计学意义(t=-4.28、-3.18、10.00、10.69,均P<0.001)。两组下颌第二磨牙近中牙根吸收差异有统计学意义(t=4.14,P<0.001)。治疗后两组LM-AC距离差异无统计学意义(P>0.05)。结论Piezocision联合微孔技术能够加速成年人下颌磨牙前移过程,能维护牙周组织健康,值得推广。Objective To investigate the clinical effectiveness of Piezocision combined with a microporous technique in accelerating periodontal tissue reconstruction during the anterior migration of mandibular molars in adults.Methods A prospective,randomized,controlled study was conducted on 30 adult orthodontic patients recruited from Shaoxing Hospital of Traditional Chinese Medicine between January 2020 and September 2022.The inclusion criteria were patients who were unable to retain their first molars due to severe caries or long-term absence and were not suitable for implantation.Using the random number table method,the patients were randomly assigned to two groups:a simple orthodontic control group(Group A,n=15)and a group that received Piezocision combined with a microporous technique(Group B,n=15).After treatment,a comparison was made between the two groups in terms of mesial movement distance of the mandibular second molar,plaque index,gingival index,periodontal pocket depth,width of keratinized gingiva,gingival recession,clinical attachment loss,mesial root resorption of the mandibular second molar,alveolar bone height(measured as the distance from the center of the lower incisor to the anterior margin of the chin,referred to as the LM-AC distance),mandibular bone height(measured by the distance from the distal or mesial surface of the root to the alveolar bone margin,denoted as the CEJ-AC distance),and orthodontic satisfaction.Results The mesial movement distances of the mandibular second molar in Group B patients were(0.86±0.13)mm,(2.75±0.24)mm,(3.54±0.24)mm,and(4.67±0.13)mm at 4,6,8,and 12 weeks,respectively.These values were significantly greater than those observed in Group A,which were(0.43±0.06)mm,(1.27±0.14)mm,(1.85±0.53)mm,and(2.65±0.06)mm(t=6.83,14.13,18.24,23.78,all P<0.001).Prior to treatment,there were no statistically significant differences in plaque index,gingival index,periodontal pocket depth,width of keratinized gingiva,gingival recession,or clinical attachment loss between the two group

关 键 词：牙缺失 磨牙 牙周组织 正畸学 矫正 牙菌斑指数 成年人 

分 类 号：R782.2[医药卫生—口腔医学]