螺丝固位修复和粘接固位修复在牙列缺损患者中的应用效果及对龈下菌群分布的影响

Effect of screw retention repair and adhesive retainer repair on subgingival flora distribution in patients with dentition defect

目的探讨螺丝固位修复、粘接固位修复在牙列缺损患者中的应用效果及对龈下菌群分布的影响。方法选择2016年12月至2018年12月在我院进行牙种植并完成修复体的牙列缺损患者98例,参照随机数表法将入组患者分为螺丝固位修复组和粘接固位修复组,各49例。对比两组患者修复后3个月、修复后12个月牙周健康指标[种植义齿边缘骨吸收量(MBL)、探诊深度(PD)、改良菌斑指数(mPLI)、改良出血指数(mSBI)]、咀嚼功能(咬合力、咀嚼效率)以及龈下菌群分布的差异。结果修复后3个月和修复后12个月,两组患者MBL、PD、mPLI、mSBI水平及咬合力、咀嚼效率差异无统计学意义(均P>0.05);两组患者龈下产黑色素菌、伴放线放线杆菌数量差异无统计学意义(均P>0.05)。螺丝固位修复组患者龈下厌氧菌、具核梭杆菌数量大于粘接固位修复组患者(均P<0.05)。结论螺丝固位修复、粘接固位修复均是牙列缺损修复的有效方法,螺丝固位修复可能导致术后龈下厌氧菌繁殖增加,需进行长期监测。

Objective To observe the effect of screw retention repair and adhesive retainer repair on subgingival flora distribution in patients with dentition defect.Methods A total of 98 patients with dentition defect who underwent denture repair in our hospital during December 2016 to December 2018 were randomly divided into the screw retainer group or adhesive retainer group with 49 cases in each group.The differences in periodontal health indexes(MBL,PD,mPLI,mSBI),chewing function(bite force,chewing efficiency)and subgingival flora distribution between two groups were compared 3 months and 12 months after operation respectively.Results Three months and twelve months after repairation,there were no significant difference in MBL,PD,mPLI,mSBI,bite force and chewing efficiency between two groups(all P>0.05).There were no significant differences in the counts of melanin producing bacteria and Actinobacteria spp between two groups(all P>0.05).The counts of anaerobic bacteria and Clostridium nucleophilus in screw retainer group were higher than those in adhesive retainer group(all P<0.05).Conclusion Screw retentive repair and adhesive retentive repair are both effective methods to repair dentition defect.Screw retentive repair may lead to the increase of subgingival anaerobe reproduction after operation,which requires long-term monitoring.