正畸联合牙周治疗对伴错[牙合]畸形牙周炎的临床疗效分析  

Clinical efficacy of orthodontics combined with periodontal treatment on malocclusion with periodontitis

作　　者：余赛男 晏艳[2] 李文慧 YU Sainan;YAN Yan;LI Wenhui(Department of Stomatology,the 2nd Affiliated Hospital,Chengdu Medical College•Nuclear Industry 416 Hospital,Chengdu 610057;Department of Stomatology,the First People′s Hospital of Kunming,Kunming 650034)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院口腔科,成都610057 [2]昆明市第一人民医院口腔科,昆明650034

出　　处：《郑州大学学报（医学版）》2024年第5期704-708,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：深圳市孔雀人才C类科研启动基金项目(827000471)。

摘　　要：目的:探究正畸联合牙周治疗对伴错牙合畸形牙周炎患者的临床疗效。方法:选取98例伴错牙合畸形牙周炎患者为研究对象,采用随机数排秩法分为观察组和对照组各49例,对照组行单纯牙周治疗,观察组行正畸联合牙周治疗,比较治疗前后牙周指标[牙周袋深度(PD)、牙龈指数(GI)、牙菌斑指数(PLI)、牙龈出血指数(SBI)、牙周附着丧失(CAL)]、牙周致病菌[牙周伴放线聚集杆菌(A.a)、牙龈卟啉单胞菌(P.g)、具核梭杆菌(F.n)]、牙周炎症因子(CRP、TNF-α、IL-4、IL-6)水平、龈沟液骨代谢指标[骨钙素(BGP)、Ⅰ型前胶原N端前肽(PⅠNP)、Ⅰ型胶原C端肽(CTX-Ⅰ)及降钙素原(PCT)]及临床疗效、并发症。结果:观察组总有效率高于对照组(93.88%vs 79.59%,P=0.037)。治疗后观察组PD、GI、SBI、PLI、CAL,A.a、P.g、F.n,CRP、TNF-α、IL-4、IL-6水平,龈沟液BGP、PⅠNP、CTX-Ⅰ、PCT水平改善情况均优于对照组(P<0.05)。两组并发症比较,差异无统计学意义(P=0.268)。结论:正畸联合牙周治疗对伴错牙合畸形牙周炎临床疗效突出,并发症较少。Aim:To explore clinical efficacy of orthodontics combined with periodontal treatment on malocclusion with periodontitis.Methods:A total of 98 patients with malocclusion and periodontitis were selected as research subjects,and allocated into observation group and control group with 49 cases in each group according to random number ranking method.Control group received simple periodontal treatment,and the observation group was given combined orthodontics-periodontal treatment.Before and after treatment,comparisons were performed on periodontal clinical indexes[probing depth(PD),gingival index(GI),plaque index(PLI),sulcus bleeding index(SBI),clinical attachment loss(CAL)],periodontal pathogenic bacteria[aggregatibacter actinomycetemcomitans(A.a),porphyromonas gingivalis(P.g),fusobacterium nucleatum(F.n)],levels of periodontal inflammatory factors(CRP,TNF-α,IL-4,IL-6),gingival crevicular fluid bone metabolism indicators[bone gla-protein(BGP),procollagenⅠtype N-terminal peptide(PⅠNP),C-telopeptide of typeⅠprocollagen(CTX-Ⅰ),procalcitonin(PCT)]and clinical efficacy,complications.Results:The total effective rate of the observation group was higher than that of control group(93.88%vs 79.59%,P=0.037).After treatment,the change degree of PD,GI,SBI,PLI,CAL,A.a,P.g and F.n,levels of CRP,TNF-α,IL-4 and IL-6,and the levels of BGP,PⅠNP,CTX-Ⅰand PCT in gingival crevicular fluid in the observation group were larger than those in control group(P<0.05).There were no significant differences in complications between the 2 groups(P=0.268).Conclusion:Orthodontics combined with periodontal treatment has a prominent clinical efficacy on malocclusion with periodontitis with few postoperative complications.

关 键 词：牙周炎 错牙合畸形 正畸治疗 牙周致病菌 牙周组织炎症 

分 类 号：R781.4[医药卫生—口腔医学]