牙周组织再生术联合无托槽隐形矫治器治疗牙周炎效果及对炎症因子水平的影响

Effect of guided tissue regeneration combined with bracketless invisible appliance in treating periodontitis and its influence on levels of inflammatory factors

目的观察采用牙周组织再生术(GTR)与无托槽隐形矫治器联合治疗牙周炎的效果,并探讨其影响炎症因子水平的规律。方法选取2017年4月至2019年1月该院收治的牙周炎患者64例,将其分为研究组和对照组,每组32例。对照组采用GTR治疗方式,研究组在GTR治疗基础上加用无托槽隐形矫治器治疗。比较2组患者总有效率、治疗前后龈沟液和血清炎症因子[包括白细胞介素-1β(IL-1β)、IL-5和肿瘤坏死因子α(TNF-α)]水平、牙周情况[牙周探诊深度(PD)、龈沟出血指数(SBI)、牙菌斑指数(PLI)、临床附着丧失(AL)和牙龈指数(GI)]、咬合指标、相对骨密度(RBD)等。结果研究组患者总有效率明显高于对照组,差异有统计学意义(P<0.05)。2组患者治疗后3个月龈沟液和血清IL-1β、IL-5、TNF-α水平,以及PD、SBI、PLI、AL、GI均较治疗前明显降低,且研究组患者治疗后3个月龈沟液和血清IL-1β、IL-5、TNF-α水平,以及PD、SBI、PLI、AL、GI降低程度均明显优于对照组,差异均有统计学意义(P<0.05)。研究组患者治疗后咬合指标明显优于对照组和治疗前,RBD明显高于对照组,差异均有统计学意义(P<0.05)。结论对牙周炎患者采用GTR与无托槽隐形矫治器联合治疗能显著减弱炎性反应,缓解患者牙周炎症状,具有临床应用价值。

Objective To observe the effect of guided tissue regenneration(GTR)combined with bracketless invisible appliance in the treatment of periodontitis,and to explore the law affecting the levels of inflammatory factors.Methods A total of 64 patients with periodontitis admitted to this hospital from April 2017 to January 2019 were selected and divided into the study group and control group,32 cases in each group.The control group adopted the GTR treatment mode,and the study group added the bracketless invisible appliance on the basis of GTR treatment.The total effective rate,levels of inflammatory factors in the posterior gingival crevicular fluid and serum before and after treatment[including interleukin-1β(IL-1β),IL-5 and tumor necrosis factorα(TNF-α)],periodontal conditions[periodontal probe depth(PD),sulcus bleeding index(SBI),plaque index(PLI),clinical attachment loss(AL),gingival index(GI),bite indicators and relative bone mineral density(RBD)before and after treatment were compared between the two groups.Results The total effective rate after treatment in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The levels of gingival crevicular fluid and serum IL-1β,IL-5 and TNF-α,PD,SBI,PLI AL and GI after 3-month treatment in the two groups were significantly decreased compared with those before treatment,moreover their decrease amplitude in the study group was significantly better than that in the control group,and the differences were statistically significant(P<0.05).The occlusion indexes after treatment in the study group were significantly better than those in the control group and before treatment,RBD was significantly higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Adopting GTR combined with bracketless invisible appliance in the patients with periodontitis can significantly reduce the inflammatory reactions and relieve the periodontitis symptoms,and has the clinical application value.