微型种植体支抗与口外弓支抗对错颌畸形患者牙周炎性微环境的影响分析

Effects of Micro-implant Anchorage and Facebow Anchorage on Periodontal Inflammatory Microenvironment in Patients with Malocclusion

目的观察分析微型种植体支抗与口外弓支抗对错颌畸形患者牙周炎性微环境的影响。方法选取2015年5月—2017年6月治疗的86例安氏Ⅱ类1分类错颌畸形患者进行观察研究,根据治疗方式的不同分为研究组与对照组,每组43例。对照组给予口外弓支抗治疗,研究组给予微型种植体支抗治疗。观察记录2组治疗后的矫治成功率、矫治疗程及拔牙间隙关闭时间,检测治疗前后X线头影与模型测量指标水平,并检测牙周组织培养上清液炎性因子水平。结果研究组的矫治疗程及拔牙间隙关闭时间均低于对照组,且矫治成功率高于对照组(P<0.05)。治疗后,2组上下齿槽座角(ANB)、下齿槽座角(SNB)、上齿槽座角(SNA)、下中切牙-MP(L1-MP)、鼻根点下齿槽座点与下中切牙长轴连线的距离(L1-NB)、上中切牙长轴与前颅底平面夹角(U1-SN)、上齿槽座点与上中切牙点至鼻根点连线的距离(U1-NA)以及覆盖(OJ)和覆牙颌(OB)水平低于治疗前,下颌角颏顶点连线与SN平面夹角(GoGn-SN)、上下中切牙角(U1-L1)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及基质金属蛋白酶-9(MMP-9)水平高于治疗前(P<0.05);治疗后,研究组ANB、L1-MP、L1-NB、U1-SN、U1-NA、OJ、OB以及TNF-α、IL-6和MMP-9水平低于对照组,U1-L1水平明显高于对照组(P<0.05)。结论微型种植体支抗应用于口腔正畸治疗的疗效显著,其对牙周微环境的刺激相对较小,可明显提高矫治成功率。

Objective To observe and analyze effects of micro-implant anchorage and facebow anchorage on periodontal inflammatory microenvironment in patients with malocclusion.Methods A total of 86 malocclusion patients with Angle ClassⅡDivision 1 admitted during May 2015 and June 2017 were divided into study group and control group(n=43 in each group)according to different therapeutic methods.Control group was treated with facebow anchorage,while study group was treated with micro-implant anchorage.After treatment,success rate of orthodontic treatment,orthodontic course of treatment and closure time of interdental space by tooth extraction were observed and recorded;X-ray cephalometric and model measurement index levels were detected,and levels of inflammatory cytokines in supernatant of periodontal tissue cultures were measured.Results In study group,course of orthodontic treatment and closure time of interdental space by tooth extraction were significantly lower,while success rate of orthodontic treatment was significantly higher than those in control group(P<0.05).After treatment,levels of ANB,SNB,SNA,L1-MP,L1-NB,U1-SN,U1-NA,OJ and OB were significantly lower,while levels of GoGn-SN,U1-L1,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and matrix metalloproteinases-9(MMP-9)were significantly higher than those before treatment in two groups(P<0.05);in study group,levels of ANB,L1-MP,L1-NB,U1-SN,U1-NA,OJ,OB,TNF-α,IL-6 and MMP-9 were significantly lower,while U1-L1 level was significantly higher than those in control group(P<0.05).Conclusion Micro-implant anchorage in application of orthodontic treatment may achieve good effectiveness and little stimulation to periodontal microenvironment,which may significantly improve success rate of orthodontic treatment.