咬合调整对牙周炎正畸治疗患者牙周状况的影响

Effect of occlusal adjustments on the periodontal status of patients with periodontitis after orthodontic treatment

目的 观察咬合调整对牙周病患者正畸治疗前后牙周状况改变的影响。方法 选择成人牙周病正畸患者47例,按照正畸治疗中是否进行咬合调整分为观察组和对照组,对所有患者正畸治疗前、后及治疗后6个月随访时进行牙周状况的检查评估,并作统计学分析。结果 观察组患者在治疗后及随访时的牙周探诊深度(PD)、临床附着丧失(CAL)、出血指数(BI)均较治疗前有明显降低,牙齿松动度(TM)也较治疗前有明显减小,而在随访时与治疗后相比较,PD和CAL的变化也有统计学意义(P<0.05),松动度也有明显减小。对照组患者治疗后的PD、BI及随访时的BI均较治疗前有明显降低,随访时的牙齿松动度较治疗前明显减低,与治疗后比较也有明显变化。组间同期比较,观察组在随访时的PD和CAL与对照组有明显差异,在治疗后及随访时的TM也与对照组间存在明显差异。结论 在牙周炎错患者的正畸治疗中,及时进行咬合调整,能去除病理性因素,消除咬合创伤,恢复咬合平衡,有利于牙周组织的改建及修复。

Objective To observe the changes in occlusal adjustments on periodontal status of patients with periodontal disease before and after orthodontic treatment. Methods Forty-seven cases of adult orthodontic patients periodontal were selected and divided into two groups according to whether occlusal adjustment, named observation group and control group. The periodontal status of all the patients was evaluated during the first visit. After 6 and 12 months, the periodontal status of the patients was evaluated again. The changes in the periodontal status were recorded, and statistical analysis was performed. Results Periodontal probing depth（PD）, clinical attachment loss（CAL）, and bleeding index（BI） observed after six months of the treatment, were significantly lower than those before treatment（P〈0.05）. Tooth loose degrees（TM） also significantly reduced compared to that before treatment. PD and CAL changes of the group six months after treatment compared with treatment was completed, were also lower. The degree of looseness was significantly reduced. PD, BI of the group 6 months after treatment decreased than those before treatment and the control group. The tooth mobility of 6 months after treatment was significantly lower than that before treatment and just after treatment. The PD, CAL and TM of the observed group are statistically different from those in the control group. Conclusion Occlusal adjustment for the malocclusion patients with periodontitis in the cause of orthodontic therapy, which heloed to remove pathological factors,eliminate occlusal trauma, and build the occlusal balance, showed effectiveness in treatment of reconstruction and repair of periodontal tissues.