摘要
目的:评价伴错畸形的侵袭性牙周炎(aggressive periodontitis,Ag P)患者行牙周-正畸联合治疗的临床疗效及安全性。方法:纳入25名就诊于北京大学口腔医院牙周科并完成牙周-正畸治疗的Ag P患者,回顾性评价初诊(T0)、正畸治疗前(T1)、正畸治疗完成后(T2)的探诊深度(probing depth,PD)、出血指数(bleeding index,BI)、探诊后出血比率(percentage of sites with bleeding on probing,BOP%),通过根尖片评价正畸前后剩余牙槽骨高度(residual alveolar bone height,RBH)的变化及牙根吸收发生状况。结果:(1)在牙周治疗后、正畸治疗前(T1)及正畸治疗完成后(T2),PD、BI、BOP%以及PD>3 mm位点的百分比均有显著降低(P<0.001)。(2)T0时全口RBH均值为68.37%±15.60%,牙周-正畸治疗后RBH为70.27%±14.23%,差异有统计学意义,其中上切牙[T0为58.79%±16.71%,T2为65.54%(55.74%,78.13%)]、上尖牙[T0为77.62%(66.06%,87.17%),T2为79.57%(69.75%,86.52%)]及上磨牙[T0为74.30%(61.69%,84.45%),T2为76.76%(68.12%,85.09%)]在正畸治疗后RBH增高明显(P<0.05)。(3)正畸治疗后人均有23.94%±13.45%的牙发生牙根吸收,其中以下切牙及上切牙的发生率最高,总发生率分别为68.48%和65.31%。结论:伴错畸形的Ag P患者,在规范的牙周治疗后,正畸治疗不会引起牙周炎症加重或牙槽骨吸收;约2/3的上、下切牙可发生轻度的牙根吸收。
Objective: To evaluate the clinical effect and safety of periodontal-orthodontic treatment in patients with aggressive periodontitis( Ag P) and malocclusion. Methods: A retrospective analysis was conducted in 25 Ag P patients,who had received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology. Clinical indexes,including probing depth( PD),bleeding index( BI) and percentage of sites with bleeding on probing( BOP%) were evaluated at three time points:Baseline( T0); active periodontal treatment finished and before orthodontic treatment( T1); and after orthodontic treatment( T2). Also changes of ratio of the residual alveolar bone height( RBH) and the occurrence of root resorption were evaluated by periapical radiographs. Results:( 1) Compared with T0,all the clinical parameters including PD,BI,BOP% and percentage of sites with PD 3 mm were significantly improved( P 〈0. 001).( 2) Significant difference was observed in the average RBH between T0( 68. 37% ± 15. 60% and T2( 70. 27% ± 14. 23%). RBH in upper incisors [( 58. 79% ± 16. 71% at T0,65. 54%( 55. 74%,78. 13%) at T2 ],upper canines [77. 62%( 66. 06%,87. 17%) at T0,79. 57%( 69. 75%,86. 52%) at T2] and upper molars [74. 30%( 61. 69%,84. 45%) at T0,76. 76%( 68. 12%,85. 09%) at T2] showed significant increase( P 〈0. 05).( 3) After orthodontic treatment,varying degrees of root resorption occurred in( 23. 94% ± 13. 45%) of teeth per capita,among which the lower and upper incisors showed the highest incidence( 68. 48% and 65. 31% in homogeneous teeth,respectively). Conclusion: After active periodontal treatment,orthodontic treatment in Ag P patients had not aggravated inflammation and alveolar bone resorption; root resorption occurred in two-thirds of incisors approximately.
出处
《北京大学学报(医学版)》
CAS
CSCD
北大核心
2017年第1期60-66,共7页
Journal of Peking University:Health Sciences
关键词
侵袭性牙周炎
正畸学
矫正
牙槽骨质丢失
牙根吸收
Aggressive periodontitis
Orthodontics
corrective
Alveolar bone lose
Root resorption