隐形矫治器、自锁托槽与传统托槽对成人正畸患者牙周指数及龈沟液炎性因子的影响

The effects of bracketless invisible appliance,self-ligating bracket and conventional bracket on periodontal indices and inflammatory cytokine levels in gingival crevicular fluid in adult patients

目的:研究隐形矫治器、自锁托槽及传统托槽对成人正畸患者牙周指数及龈沟液内炎性因子水平的影响。方法:90例成人正畸患者随机分为传统组、自锁组及隐形组(n=30),分别佩戴传统MBT托槽、Damon Q自锁托槽及Invisalign隐形矫治器,观察矫治前、矫治后1、3、6个月及矫治结束时患者菌斑指数(PLI)、探诊深度(PD)及龈沟液内白介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)的变化情况。结果:矫治后1~6个月,传统组及自锁组患者牙周指数及龈沟液内炎性因子水平持续升高(P<0.05),6个月达最高峰,矫治后1个月自锁组与传统组比较无显著差异(P>0.05),矫治后3个月至矫治结束自锁组牙周指数及炎性因子水平均明显低于传统组(P<0.05)。隐形组患者PLI、IL-1β及TNF-α在矫治后6个月较矫治前升高(P<0.05),但矫治后各项指标均显著低于传统组及自锁组(P<0.05)。结论:自锁托槽在正畸矫治中后期对牙周组织的影响小于传统托槽,隐形矫治器及自锁托槽与传统托槽相比,在正畸矫治后各个时期均更利于牙周组织的健康。

Objective： To investigate the effects of bracketless invisible appliance（ BI）, self-ligating bracket（SB） and conventional brackets（CB） on periodontal indices（PI） and inflammatory cytokine levels in gingival crevicular fluid（GCF） in adult orthodontic patients. Methods： 90 orthodontic patients were randomly divided into CB, SB and BI groups （n = 30）. The subjects in the 3 groups accepted invisalign, Demon Q self-ligating brackets and conventional MBT brackets respectively. Plaque index（ PLI）, probing depth （PD） and interleukin- 1β （ IL- 1β）, tumor necrosis factor-α （ TNF- α） in GCF were analyzed before treatment, 1,3 and 6 months after treatment, and after appliance removed respectively. Results： 1 to 6 months after treatment, PI, IL-β and TNF-α rose constantly in CB and SB groups and reached to their top 6 months after treatment. There were no statistical differences between CB and SB groups 1 months after treatment, while PI, IL-β and TNF-α of SB group were lower than those of CB group 3 and 6 months after treatment and after therapy completed. PLI,IL-1β and TNF-α of BI group were significantly increased 6 months after treatment. However, each index of BI group was significantly reduced compared with SB and CB groups after treatment. Conclusion： The SB has fewer disadvantages on peridentium than CB, while the BI is more conductive to protect the periodontal health status than SB and CB.