正畸舌侧固定保持器与压膜保持器在口腔正畸下颌固定保持中的应用价值对比研究

Comparative Study of Orthodontic Lingual Fixator and Lamination Retainer in Oral Orthodon- tic Mandibular Fixation

【目的】对比探讨正畸舌侧固定保持器与压膜保持器在口腔正畸下颌固定保持中的应用价值。[A-法】抽取2014年1月至2015年12月本院84例13腔正畸矫治后患者，按照随机数表法分为两组，每组42例。A组佩戴正畸舌侧固定保持器，B组佩戴压膜保持器。随访1年，对比两组固定矫治器拆除时及佩戴保持器1年后Little前牙不齐指数、尖牙牙弓宽度、磨牙牙弓宽度及佩戴1周后与6个月后牙周组织情况[菌斑指数（PI）、牙龈指数（GI）、牙石指数（CI）]、龈沟液成分[硫化物（PS）、碱性磷酸酶（ALP）、谷草转氨酶（AST）]，并统计两组佩戴舒适度。【结果】①保持效果：固定矫治器拆除时及佩戴保持器1年后两组Little指数、尖牙牙弓宽度、磨牙牙弓宽度组间比较差异均无统计学意义（P〉0．05），佩戴保持器1年后，两组Little指数、尖牙牙弓宽度、磨牙牙弓宽度均有所改变，但与固定矫治器拆除时比较差异无统计学意义（P〉0．05）；②牙周组织：佩戴保持器1用后，两组PI、GI、CI差异无统计学意义（P〉0．05），6个月后。两组PI、GI、CI均有所增加，但B组变化幅度小于A组，差异有统计学意义（P〈0．05）；③龈沟液成分：佩戴保持器1周后，两组PS与ALP、AST水平差异无统计学意义（P〉0．05），6个月后，两组PS及ALP、AST水平均有所提高，但B组变化幅度小于A组，差异有统计学意义（P〈0．05）；④舒适度：A组舒适度92．86％（39／42）高于B组73．81％（31／42），差异有统计学意义（P〈0．05）。【结论】正畸舌侧固定保持器与压膜保持器在13腔正畸下颌固定保持中均能取得良好保持效果，前者舒适度高但对患者牙周组织影响相对较大，后者对口腔健康影响小，但舒适度及佩戴依从性相对较低。

[Objective] To compare the application value of orthodontic lingual fixator and lamination re- tainer in oral orthodontic mandibular fixation. [MethodslFrom January 2014 to December 2015 84 cases of oral orthodontic patients in our hospital were randomly divided into two groups, 42 cases in each group. Group A was wearing orthodontic lingual fixed retainer, while Group B group wearing retainer. After 1 year of follow up, the Little anterior teeth irregularity index, the width of the canine tooth arch and the width of the molar arch were compared between the two groups when the appliance was removed and the retainer was worn 1 years later and periodontal tissue [-plaque index （PI）, gingival index （GI）, calculus index （CI）], gingival erev- icular fluid composition [（PS）, sulfide alkaline phosphatase （ALP）, aspartate aminotransferase （AST）] wearing after 1 week and 6 months after, and wearing comfort degree of the two groups were counted.IRe suits]（1） Maintainence effect： There was no significant difference between the Little index, the width of the dental arch and the width of the dental arch （ P ~〉 0.05） between the two groups at the time of removal and 1 year after the appliance of the retainer; 1 year after wearing the retainer, Little index, canine arch width, mo lar teeth, arch width of the two groups were changed, but the difference was not statistically significant corn paring with fixed appliance removal （ P〈0.05） （2）Periodontal tissue： There was no significant difference in PI, GI and CI between the two groups after one week of wearing the holder （ P 〉0.05） ; after 6 months, PI, GI and CI were increased in both groups, but the change of the group B was smaller than that of the group A, the difference was statistically significant （ P 〈0.05） ; （3） Gingival crevieular fluid composition： After 1 week wearing the holder, the difference of PS and ALP and AST between the two groups was not statistically significant （ P 〉0.05） ; after 6 months, the levels of PS and ALP and AST in the two groups were increased, but the change of the group B was smaller than that of the group A,the difference was statistically significant （ P 〈0.05）; （4） Comfort： Comfort of the A group was 92.86% （39/42）, which was higher than that of the group B 73.81% （31/42）, the difference was statistically significant （ P 〈0.05）. [Conclusion] Both orthodontic tongue side fixation and lamination retainer can achieve good retention effect in the oral orthodontic mandibular fixation, the former has a high comfort but has a relatively large impact on the periodontal tissue of the patient, the latter has little effect on oral health, but the comfort and wear compliance are relatively low.