牙周序列治疗在成人牙周炎患者正畸过程中疗效观察

The effects of sequential periodontal treatment in adult orthodontic patients with chronic periodontitis

目的:通过观察牙周菌斑中组成成分的变化,评价牙周序列治疗在成人牙周炎患者正畸过程中的作用。方法:选择47例伴有轻、中度牙周炎的成人正畸治疗患者,在正畸治疗前1个月开始牙周序列治疗并持续至正畸治疗结束,记录正畸治疗前(基线对照)和治疗后1、3、6、12月以及正畸治疗结束时的各项牙周临床指标--菌斑指数(PLI)、牙龈指数(GI)、牙龈出血指数(SBI)、牙周袋深度(PD)、临床牙周附着丧失(CAL);同时,每次刮取患者16、21、24、36、41、44共6颗指数牙牙周袋中牙菌斑,提取细菌DNA,利用q RT-PCR技术比较患者牙菌斑中主要细菌(牙龈卟啉单胞菌Pg、具核梭杆菌Fn、福赛坦氏菌Tf、伴放线放线杆菌Aa)检出率有无差异。结果:配合牙周序列治疗,成人牙周炎患者正畸治疗过程中与治疗结束时各项牙周检查指标(PLI、GI、SBI、PD、CAL)较治疗前有明显改善(P<0.05),牙菌斑中Pg、Fn、Tf、Aa检出率较治疗前明显降低(P<0.05);与正畸治疗前比较,正畸治疗结束时患者牙菌斑中Pg检出率约降低8.5%,Fn检出率约降低21.3%,Tf检出率约降低23.4%,Aa检出率约降低36.2%。结论:成人牙周炎患者在正畸治疗前及治疗过程中同时进行牙周序列治疗可促进牙周疾病的愈合,改善患者口腔中细菌微生物的生态系统。

Objective：To evaluate the effectiveness of sequential periodontal treatment in adult orthodontic patients with chronic periodontitis,and to investigate whether there is a change in the dental plaque content and composition. Method：47 adult periodontal patients who had the demand for orthodontic treatment were selected. The sequential periodon-tal treatment was initiated in a month before orthodontic treatment, and continued to the whole course. The clinical parame-ters of PLI,GI,SBI,PD and CAL were recorded before periodontal treatment,and at 1 months,3 months,6 months,12 months after periodontal treatment. Moreover,the plaque was obtained from the periodontal pockets of 16、21、24、36、41、44, and the bacterial DNA in the plaque （Pg,Fn,Tf,Aa） was extracted to analyze the change of the dental plaque content and composition,to compare the change of bacteria detection rate. Result：All clinical periodontal indexes were improved signifi-cantly after combining sequential periodontal treatment into the process of orthodontic treatment comparing with the initial status（P〈0.05）. The detection rates of the main bacteria in dental plaque（Pg,Fn,Tf,Aa） were obviously lower than those before therapy （P〈0.05）. Compared with before orthodontic,the detection rates of the main bacteria Pg in orthodontic pa-tients reduced by about 8.5 %,Fn detection rate reduced by about 21.3 %,Tf detection rate reduced by about 23.4 %,Aa detection rate reduced by about 36.2%. Conclusion：The sequential periodontal treatment could promote the healing of pe-riodontal disease and improved the oral ecological system in the orthodontic patients with chronic adult periodontitis.