口腔正畸联合牙周夹板治疗对牙周病致前牙移位患者龈沟液RANKL、OPG和弹性蛋白酶及其抑制因子的影响  

Effect of orthodontic treatment combined with periodontal splint on gingival sulcus fluid RANKL,OPG and elastase and its inhibitors in patients with anterior tooth displacement caused by periodontal disease

作　　者：王蓓[1] 季彤[2] 方明 郑孝娟 徐万田 WANG Bei;JI Tong;FANG Ming;ZHENG Xiaojuan;XU Wantian(Senior Expert Diagnosis and Treatment Center,the Stomatological Hospital Affiliated to Nanjing University School of Medicine/Nanjing Municipal Stomatological Hospital/Institute of Stomatological Medicine of Nanjing University,Nanjing,Jiangsu 210008,China;the Second Outpatient Department,the Stomatological Hospital Affiliated to Nanjing University School of Medicine/Nanjing Municipal Stomatological Hospital/Institute of Stomatological Medicine of Nanjing University,Nanjing,Jiangsu 210008,China;Nanjing Tianshi Stomatological Clinic,Nanjing,Jiangsu 210000,China;the Third Outpatient Department,the Stomatological Hospital Affiliated to Nanjing University School of Medicine/Nanjing Municipal Stomatological Hospital/Institute of Stomatological Medicine of Nanjing University,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属口腔医院/南京市口腔医院/南京大学口腔医学研究所高级专家诊疗中心,江苏南京210008 [2]南京大学医学院附属口腔医院/南京市口腔医院/南京大学口腔医学研究所第二门诊部,江苏南京210008 [3]南京天时口腔诊所,江苏南京210000 [4]南京大学医学院附属口腔医院/南京市口腔医院/南京大学口腔医学研究所第三门诊部,江苏南京210008

出　　处：《检验医学与临床》2024年第23期3494-3498,共5页Laboratory Medicine and Clinic

基　　金：江苏省自然科学基金项目(BK20171122)。

摘　　要：目的观察口腔正畸联合牙周夹板治疗对牙周病致前牙移位患者龈沟液核因子-κB活化因子受体配体(RANKL)、骨保护素(OPG)和弹性蛋白酶(EA)及其抑制因子α_(1)-抗胰蛋白酶(α_(1)-AT)的影响。方法纳入2022年1月至2023年3月南京大学医学院附属口腔医院收治的105例牙周病致前牙移位患者作为研究对象,采用简单随机分组法将其为联合组(53例,口腔正畸联合牙周夹板治疗)和对照组(52例,牙周夹板治疗)。比较治疗前后两组牙周指标[附着丧失(AL)、龈沟出血指数(SBI)、菌斑指数(PLI)、探诊深度(PD)]、RANKL、OPG、RANKL/OPG、EA、α_(1)-AT水平及牙齿舒适度调查量表评分、咀嚼功能量表评分。结果治疗后,两组AL、SBI、PLI、PD低于治疗前,且联合组AL、SBI、PLI、PD低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组RANKL水平、RANKL/OPG低于治疗前,OPG水平高于治疗前,差异均有统计学意义(P<0.05);且治疗后联合组RANKL水平、RANKL/OPG低于对照组,OPG水平高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组牙齿舒适度、咀嚼功能量表评分高于治疗前,且联合组牙齿舒适度、咀嚼功能量表评分高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组EA、α_(1)-AT水平低于治疗前,且联合组EA、α_(1)-AT水平低于对照组,差异均有统计学意义(P<0.05)。结论牙周夹板联合口腔正畸治疗牙周病致前牙移位患者可有效改善牙周症状,提高咀嚼功能,有效调节龈沟液RANKL、OPG、EA、α_(1)-AT水平。Objective To observe the effect of orthodontic treatment combined with periodontal splints on gingival crevicular fluid receptor activator of nuclear factor-κB ligand(RANKL),osteoprotegerin(OPG),elastase(EA)and its inhibitorα_(1)antitrypsin(α_(1)-AT)in patients with anterior tooth displacement caused by periodontal disease.Methods A total of 105 patients with anterior tooth displacement caused by periodontal disease,who enrolled in the Stomatological Hospital Affiliated to Nanjing University School of Medicine from January 2022 to March 2023,were included as research objects,who were divided into combination group(53 cases,treated with orthodontic treatment combined with periodontal splint)and control group(52 cases,treated with periodontal splint)by a simple randomization method.The periodontal indicators[attachment loss(AL),gingival bleeding index(SBI),plaque index(PLI),probing depth(PD)],RANKL,OPG,RANKL/OPG,EA,α_(1)-AT levels and Dental Comfort Survey Scale score and Chewing Function Scale score between the two groups before and after treatment were compared.Results After treatment,AL,SBI,PLI and PD in both groups were lower than those before treatment,and which in the combination group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,RANKL level and RANKL/OPG in both groups were lower than those before treatment,OPG level was higher than that before treatment,and the differences were statistically significant(P<0.05);after treatment,RANKL level and RANKL/OPG in combination group were lower than those in the control group,OPG level was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the Dental Comfort Survey Scale score and Chewing Function Scale score in both group were higher than those before treatment,and which in the combination group were higher than those in the control group,with statistically significant differences(P<0.05).After treatment,EA andα_(1)-AT levels in both gro

关 键 词：口腔正畸 牙周夹板 牙周病致前牙移位 骨保护素 弹性蛋白酶 抑制因子 

分 类 号：R783.5[医药卫生—口腔医学] R446.1[医药卫生—临床医学]