无托槽隐形矫治器在牙周病患者中的临床效果及对组织应力的影响研究

The clinical effect of invisible appliance without brackets in patients with periodontal disease and its influence on tissue stress

目的:探讨无托槽隐形矫治器在牙周病患者中的临床效果及对组织应力的影响。方法:选择2015年1月~2019年6月就诊的牙周病患者60例作为研究对象,随机数字表法分为对照组(n=30)和观察组(n=30)进行正畸治疗。对照组采用传统固定矫治,观察组采用无托槽隐形矫治器治疗;治疗后均完成10个月随访,比较两组牙周健康状况、炎性因子水平及组织应力。结果:观察组与对照组治疗后10个月牙龈指数、牙周探诊深度及龈沟出血指数差异均无统计学意义(P>0.05)。观察组治疗后10个月菌斑指数低于对照组(P<0.05);炎性因子CRP、IL-6及TNF-α水平均低于对照组(P<0.05);IL-2水平高于对照组(P<0.05)。观察组无托槽隐形矫治后10个月组织部位等效应力为32.59 MPa高于对照组等效应力(22.15 MPa)(P<0.05)。结论:无托槽隐形矫治器用于牙周病患者中能改善牙周健康状况,降低炎性因子水平并提高组织应力。

Objective:To explore the clinical effect of invisible appliances without brackets in patients with periodontal disease and its effect on tissue stress.Methods:Sixty patients with periodontal disease from January 2015 to June 2019 were selected as subjects.The random number table method was divided into a control group(n=30)and observation group(n=30).The control group was treated with traditional fixed orthodontic treatment,and the observation group was treated with invisible braces without brackets.After treatment,all patients were followed up for 10 months.Periodontal health status,inflammatory factor levels,and tissue stress were compared between the two groups.Results:The gingival index,periodontal depth of exploration and gingival sulcus bleeding index of the observation group and the control group were not statistically significant at 10 months after treatment(P>0.05).The plaque index of the observation group after 10 months of treatment was lower than that of the control group(P<0.05),the levels of inflammatory factors CRP,IL-6 and TNF-αwere lower than the control group 10 months after treatment(P<0.05),and IL-2 levels were higher than the control group(P<0.05).The equivalent stress at the tissue site in the observation group after 10 months without the bracket invisible appliance was 32.59 MPa higher than the equivalent stress at the control group(22.15 MPa)(P<0.05).Conclusion:The bracketless invisible appliance can improve the periodontal health of patients with periodontal disease,reduce the level of inflammatory factors and increase tissue stress.