咬合调整对慢性牙周炎伴咬合创伤患者患牙转归的影响

Effect of Occlusal Adjustment on Tooth Prognosis for Patients with Chronic Periodontitis Combined with Occlusal Trauma

目的对比分析咬合调整与暂时性牙周夹板固定对慢性牙周炎伴咬合创伤患者患牙转归的影响。方法回顾性分析2017年6月至2018年6月南京市浦口医院口腔科收治的80例慢性牙周炎伴咬合创伤患者的病历资料,并将咬合调整治疗者设为试验组(40例),暂时性牙周夹板固定治疗者设为对照组(40例),对比分析两组患者治疗前及治疗第4、8、12周时患牙的牙周袋深度、附着丧失、Mazza出血指数、咬合时间、咬合受力百分比及治疗第12周时的患牙松动度。结果治疗后,两组患者患牙牙周袋深度、附着丧失及Mazza出血指数均呈逐渐降低的趋势(试验组:F=63.230、31.620、62.900,P均=0.000;对照组:F=33.480、16.110、48.740,P均=0.000),且各时间点试验组患者患牙牙周袋深度、附着丧失及Mazza出血指数均明显低于对照组(第4周:t=2.044、2.159、2.027,P=0.044、0.034、0.046;第8周:t=2.491、2.368、2.741,P=0.015、0.020、0.008;第12周:t=5.452、2.691、4.133,P=0.000、0.009、0.000);治疗后,两组患者患牙咬合时间及咬合受力百分比均呈先降低后升高的趋势(试验组:F=49.620、24.870,P均=0.000;对照组:F=46.620、41.420,P均=0.000),且各时间点试验组患者患牙咬合时间及咬合受力百分比均明显高于对照组(第4周:t=2.463、4.569,P=0.016、0.000;第8周:t=2.024、2.653,P=0.046、0.010;第12周:t=2.054、2.711,P=0.043、0.008);治疗第12周,试验组患者患牙松动度为Ⅰ度者27例、Ⅱ度者13例,明显优于对照组患者的患牙松动度为Ⅰ度者15例、Ⅱ度者20例、Ⅲ度者5例(Mann-Whitney U=527.500,Z=-2.960,P=0.003)。结论与暂时性牙周夹板固定相比,咬合调整对慢性牙周炎伴咬合创伤患者的患牙转归具有更良好地促进作用。

Objective To compare and analyze the effect of occlusal adjustment and temporary periodontal splint fixation on tooth prognosis for patients with chronic periodontitis combined with occlusal trauma.Methods The medical records of 80 patients with chronic periodontitis and occlusal trauma,admitted to The Fourth Affiliated Hospital of Nanjing Medical University from June 2017 to June 2018 were retrospectively analyzed.The patients treated with occlusal adjustment were set as experiment group(40 cases)and the patients treated with temporary periodontal splint fixation were set as control group(40 cases).The periodontal pocket depth,attachment loss,Mazza bleeding index,occlusion time,occlusion force percentage and tooth mobility of the two groups were compared and analyzed before treatment and after 4,8,and 12 weeks of treatment.Results After treatment,the periodontal pocket depth,attachment loss,Mazza bleeding index in the two groups showed a trend of gradual decrease(experiment group:F=63.230,31.620,62.900,all P=0.000;control group:F=33.480,16.110,48.740,all P=0.000)and they were significantly lower in the experiment group than in the control group at each time point(week 4:t=2.044,2.159,2.027,P=0.044,0.034,0.046;week 8:t=2.491,2.368,2.741,P=0.015,0.020,0.008;week 12:t=5.452,2.691,4.133,P=0.000,0.009,0.000);after treatment,the occlusion time and occlusion force percentage in the two groups showed a trend of decrease first followed by increase(experiment group:F=49.620,24.870,all P=0.000;control group:F=46.620,41.420,all P=0.000)and they were significantly higher in the experiment group than in the control group at each time point(week 4:t=2.463,4.569,P=0.016,0.000;week 8:t=2.024,2.653,P=0.046,0.010;week 12:t=2.054,2.711,P=0.043,0.008);12 weeks after treatment,27 cases in the experiment group gotⅠdegree tooth mobility and 13 cases gotⅡdegree tooth mobility,which were significantly better than those in the control group,in which there were 15 cases ofⅠdegree,20 cases ofⅡdegree and 5 cases ofⅢdegree(Mann-Whitney U=527.500,Z=-2.960,P=0.003).Conclusion Compared with temporary periodontal splint fixation,occlusal adjustment has a better effect on tooth prognosis for patient with chronic periodontitis combined with occlusal trauma.