正畸治疗中牙龈退缩的影响因素分析

Influencing factors of gum recession in orthodontic treatment

目的分析正畸治疗对牙龈退缩的影响。方法选择2013年3月至2015年9月在我院口腔科进行正畸治疗的牙周炎伴牙龈退缩患者34例。所有患者在进行牙周基础治疗后继续矫治治疗,观察患者治疗前后的牙龈退缩情况、牙龈相关指标。然后依据正畸治疗后牙龈退缩改善情况分为牙龈退缩改善组23例和牙龈退缩未改善组11例,应用多因素Logistic回归分析正畸治疗影响牙龈退缩的因素。结果正畸治疗后牙龈退缩比例由原来的100.00%(34/34)下降至32.35%(11/34),并且牙龈退缩量由(2.72±0.69)%下降至(1.47±0.51)%,差异均有统计学意义(P<0.05);正畸治疗前临床附着水平(CAL)和牙周袋探针深度(PD)分别为(2.01±0.31)L/mm、(4.97±0.62)L/mm,治疗后分别下降为(1.81±0.24)L/mm、(3.22±0.47)L/mm,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,正畸治疗中牙龈退缩的影响因素有牙周袋深度、邻面龈组织厚度、牙根尖角度及治疗前上下前颌重度拥挤。结论采用正畸治疗能较好缓解牙龈退缩症状,同时对患者其他牙龈指标都有较好的改善作用。其中牙周袋深度、邻面龈组织厚度、牙根尖角度、治疗前上下前颌重度拥挤是正畸治疗中牙龈退缩的主要影响因素,在治疗过程中需要慎重处理。

Objective To explore the effect of orthodontic treatment on gum recession. Methods From March 2013 to September 2015, 34 patients of periodontitis with gum recession in Department of Stomatology of our hospital were enrolled in the study. All the patients underwent orthodontic treatment after periodontal basic treatment.The gum recession situation, gum-related indexes were observed before and after treatment. On the basis of gum recession improvement after orthodontic treatment, the patients were divided into improved group（23 cases） and unimproved group（11 cases）. Logistic regression analysis was applied to analyze the influencing factors of gum recession in orthodontic treatment. Results After treatment, the rate of gum recession decreased to 32.35%（11/34） from 100.00%（34/34） before treatment, and gum recession extent decreased to（1.47±0.51）% from（2.72±0.69）%. CAL, PD were（2.01±0.31） L/mm,（4.97±0.62） L/mm after orthodontic treatment, as compared with（1.81±0.24） L/mm,（3.22±0.47） L/mm before treatment（P〈0.05）. Logistic regression analysis showed that the depth of periodontal pocket, adjacent gum tissue thickness, the angle of the root tip, and premaxillary severe congestion before treatment before treatment were the factors influencing gum retraction in orthodontic treatment. Conclusion Orthodontic treatment can significantly alleviate gum recession symptoms and improve other gum indexes. The depth of periodontal pocket, adjacent gum tissue thickness, angle of the root tip, and premaxillary severe congestion before treatment are the main factors that influence gum recession in orthodontic treatment, which should be paid attention to.