隐形矫治器对正畸患者牙周健康牙龈卟啉单胞菌及TSP-1 TIMP-1 MMP-9水平的影响

Effect of the invisible appliance on periodontal health,porphyromonas gingivalis,TSP-1,TIMP-1,and MMP-9 levels

目的 探讨隐形矫治器对正畸患者牙周健康、牙龈卟啉单胞菌(P.g)和龈沟液血小板反应蛋白-1(TSP-1)、基质金属蛋白酶抑制因子-1(TIMP-1)及MMP-9的影响。方法 采用随机数字表法(序列编码放置在不透光密封信封中)将2020年1~8月于合肥市口腔医院就诊的42例正畸患者分为对照组与观察组,每组21例。对照组采用自锁托槽矫治器治疗,观察组采用隐形矫治器治疗。比较两组患者治疗前及治疗6个月后牙周健康指数,龈下菌斑中P.g检出率和百分含量,龈沟液TSP-1、TIMP-1和MMP-9水平以及并发症发生情况。结果 治疗第6个月,两组患者菌斑指数(PLI)、牙周袋探诊深度(PD)、龈沟出血指数(SBI)、附着丧失(CAL)和牙龈指数(GI)均较治疗前升高,且观察组PLI、PD、SBI、CAL、GI治疗前后差值均低于对照组,差异有统计学意义(t=4.828、2.871、6.624、5.724、5.499;P均<0.05);治疗第6个月,观察组患者P.g百分含量低于对照组,差异有统计学意义(t=3.619,P<0.05);治疗第6个月,观察组患者龈沟液TSP-1、MMP-9水平低于对照组,TIMP-1水平高于对照组,差异均有统计学意义(t=6.994、4.922、7.901;P均<0.05);两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论 隐形矫治器有利于口腔卫生维护,减少牙龈卟啉单胞菌,调节龈沟液TSP-1、TIMP-1、MMP-9水平。

Objective To investigate the effect of invisible orthodontic appliance on periodontal health,porphyromonas gingivalis(P.g) percentage content and the levels of thrombospondin-1(TSP-1),tissue inhibitor of metalloproteinase-1(TIMP-1),matrix metallo proteinase-9(MMP-9)in patients with malocclusion.Methods Atotal of 42 orthodontic patients treated between January and August 2020 in Hefei Stomatological Hospital were divided into control group and observation group with 21 cases in each group by random number table method(the sequence code was placed in an opaque sealed envelope).The control group was treated with self-ligating bracket appliance,while the observation group was treated with invisible orthodontic appliance.The periodontal health index,the detection rate and percentage of P.g in subgingival plaque,the levels of TSP-1,TIMP-1 and MMP-9 in gingival crevicular fluid and the occurrence of complications were compared between the two groups before and after treatment for six months.Results At the 6th month,plaque index( PLI),periodontal pocket probing depth( PD),gingival sulcus bleeding index( SBI),clinical attachment loss( CAL) and gingival index( GI) all increased in the two groups.The aforesaid indexes of the observation group were lower than those in the control group;moreover,the levels of PLI,PD,SBI,CAL and GI before and after treatment in the observation group were lower than those in the control group,and the differences were statistically significant( t = 4.828,2.871,6.624,5.724,5.499;all P < 0.05).At the 6th month,the difference value of the percentage of P.g in the observation group was lower than that in the controlgroup,and the difference was statistically significant( t = 3.619,P < 0.05).At the6th month,the levels of TSP-1 and MMP-9 in gingival crevicular fluid of the observation group were significantly lower than those of thecontrolgroup,and the levels of TIMP-1 were significantly higher than those of the control group.The levelsof TSP-1,MMP-9 and TIMP-1were compared before and after treatmentamong the two groups,and the differences were statistically significant( t = 6.994,4.922,7.901;all P < 0.05).Conclusions The invisible orthodontic appliance is beneficial to oral hygiene maintenance,which can reduce porphyromonas gingivalis and regulate the levels of TSP-1,TIMP-1 and MMP-9 in gingival crevicular fluid.