牙尖形态重塑法在正畸治疗中对牙周的影响研究

Study on the effect of cusp morphological remodeling on dental periphery in orthodontic treatment

目的运用牙尖形态重塑法治疗安氏Ⅱ类,观察作用牙牙周状况,从而判断该方法对牙周的影响。方法选取30名单侧个别牙安氏Ⅱ类错畸形患者,实验侧为安氏Ⅱ类错矫治中单侧个别Ⅱ类作用牙,采用纳米树脂(3M z100)改形局部牙齿形态,形成树脂式人工牙尖,加以颌间Ⅱ类牵引该侧,通过牙尖形态重塑法,对照侧则常规正畸治疗,加以颌间Ⅱ类牵引,用统计学方法比较治疗前后实验侧及对照侧的牙周变化情况。结果治疗前后实验侧及对照侧治疗前后颞下颌关节改变无统计学差异(P>0.05),实验侧与对照侧牙根吸收率、PD、CEJ到牙槽嵴顶距离与治疗前比较差异均有统计学意义(P<0.05),但在治疗允许范围内。实验侧和对照侧治疗前后PD、CEJ到牙槽嵴顶距离差值差异无统计学意义(P>0.05)。结论牙尖重塑法对矫治个别Ⅱ类错有明显的效果且损伤作用牙牙周,作为一种可有效矫治安氏Ⅱ类错畸形的方法,牙尖形态重塑法在治疗过程中对作用牙的牙周状况会产生一定的影响,但该影响在可接受范围内。

Objective To apply cusp morphological remodeling to treat Angle Ⅱ malocclusion and to observe the peri- odontal status of the targeted tooth, so as to determine the effect of this method on periodontium. Methods 30 patients with Angle Ⅱ malocclusion of single side individual tooth were selected. In the experimental side, nano resin （3M z100） was used in single side Angle Ⅱ targeted teeth to modify local tooth morphology to form resin artificial cusp, combined with intermaxillary traction Ⅱ . This side was used with cusp morphological remodeling. The control side is given con- ventional orthodontic treatment plus intermaxillary traction Ⅱ. The changes of periodontal condition in the experimental side and the control side before and after treatment were detected by statistical method. Results The temporomandibu- lar joint changes in the experimental side and the control side before and after treatment were not significantly different （P〉0.05）. The root resorption rate, PD and CEJ to alveolar crest distance in experimental side and the control side were statistically significant compared with before treatment（P〈0.05） within the scope of treatment. There was no significant difference between the experimental side and the control side in the difference of PD and CEJ to alveolar crest distance before and after the treatment（P〉0.05）. Conclusion The cusp morphological remodeling method of individualized treatment in Angle Ⅱ malocclusion tooth has obvious effect and can cause periodontal damage. As a kind of effective treatment of Angle Ⅱ malocclusion, the cusp morphological remodeling method in the course of treatment will have a certain impact on the periodontal status, but the impact is in the acceptable range.