Ⅳ期牙周炎患者的正畸考量和时机选择  

Orthodontic considerations and timing selection for patients with stageⅣperiodontitis

作　　者：彭焱 张驰 高雳 李希庭[1] 赵川江[1] PENG Yan;ZHANG Chi;GAO Li;LI Xiting;ZHAO Chuanjiang(Department of Periodontology,Hospital of Stomatology,Guanghua School of Stomatology,Sun Yat-sen University&Guangdong Provincial Clinical Research Center of Oral Diseases,Guangzhou 510055,China)

机构地区：[1]中山大学附属口腔医院、光华口腔医学院牙周病科,广东省口腔疾病临床医学研究中心,广东广州510055

出　　处：《口腔医学》2025年第1期25-36,共12页Stomatology

基　　金：国家自然科学基金(81870770,82370958)。

摘　　要：Ⅳ期牙周炎患者的牙槽骨破坏严重,失牙较多,通常伴有咀嚼功能障碍和咬合紊乱、牙齿移位或扭转等问题,仅通过牙周治疗不足以稳定病情、解决咀嚼功能障碍并改善患者的生活质量,因此常需进行复杂的咬合重建和跨学科治疗,其中就包括正畸治疗。正畸治疗有利于改善患者的咀嚼功能和美观,促进牙周健康,但Ⅳ期牙周炎患者的牙周支持组织不足,正畸治疗风险较大,是临床上的难点。本文就Ⅳ期牙周炎患者的正畸考量和时机选择作一综述,并附典型病例——牙周炎(Ⅳ期,C级)的牙周正畸正颌联合治疗1例,以期为广大牙周与正畸医生提供参考。Patients suffering from stageⅣperiodontitis manifest substantial alveolar bone destruction and pronounced tooth loss,frequently accompanied by masticatory dysfunction,occlusal disorder and tooth displacement or torsion.Standard periodontal interventions alone are insufficient to stabilize the condition,address masticatory dysfunction,and enhance patients-quality of life.Hence,intricate reconstructive and interdisciplinary regimens,encompassing orthodontic treatment,are often indispensable.Orthodontic therapy can optimize the masticatory function and esthetic appearance of patients,and promote periodontal well-being.However,individuals with stageⅣperiodontitis present with inadequate periodontal support tissue and a heightened risk profile,rendering their orthodontic management a considerable clinical challenge.This article reviews the orthodontic considerations and optimal timing for intervention in patients with stageⅣperiodontitis and presents a representative case of combined periodontal-orthodontic-orthognathic treatment for periodontitis(stageⅣ,grade C),in order to provide reference for periodontists and orthodontists.

关 键 词：Ⅳ期牙周炎 牙周正畸联合治疗 正畸考量及时机选择 

分 类 号：R781.4[医药卫生—口腔医学]