球面和方形自锁托槽对牙周指数及龈沟液炎性因子的影响

Effects of spherical self-ligating bracket and square self-ligating bracket on periodontal indices and inflammatory cytokine levels

目的本研究比较球面及方形自锁托槽在矫治初期对牙周指数及炎症因子的影响,判断球面托槽是否更有利于牙周健康。方法选择中山大学附属第一医院2020年10月—2021年9月收治的符合纳入标准的患者20例,采用分口设计原则,每个患者口内对角象限的侧切牙为一组,随机分配为A、B组,A组粘接方形自锁托槽,B组粘接球面自锁托槽。临床评估两组矫治前(T0)、托槽粘接30天(T1)侧切牙的菌斑指数(Plaque index,PLI)、牙龈指数(Gingiva index,GI)及龈沟出血指数(Sulcus bleeding index,SBI),并测量每组龈沟液中肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)及白介素-6(IL-6)的浓度水平。结果在T1时期,A组的PLI、GI和SBI值均比B组高且有统计学意义(P<0.05);A组TNF-α、IL-1β及IL-6浓度的变化程度比B组高,其中两组的TNF-α浓度的变化有统计学差异(P<0.05),IL-1β及IL-6浓度的变化无统计学差异(P>0.05)。两组矫治器的牙周指数及炎症因子的浓度均从治疗前到粘接30天后有统计学意义的增加(P<0.05)。结论在矫治初期球面自锁托槽会妨碍口腔卫生的维护,但优于方形自锁托槽,似乎更有利于正畸患者牙周组织炎症的预防。

Objective This study compared the influence of spherical self-ligating brackets and square self-ligatingbrackets on periodontal indices and inflammatory cytokine levels to determine whether spherical self-ligating bracket are more conducive in periodontal health.Methods Totally 20 fixed orthodontic patients met the inclusion criteria were selected in the First Affiliated Hospital of Sun Yat-sen University from Oct.2020 to Sept.2021.Using split-mouth design,lateral incisors in diagonal quadrants was randomly assigned to receive the same bracket,either the square self-ligating bracket regarding as group A or the spherical self-ligating bracket regarding as group B.Examined the periodontal indices of PLI,GI and SBI,and collected gingival crevicular fluid(GCF)samples at baseline(T0),30 days after bonding(T1)for the detection of the concentrations of TNF-α,IL-1βand IL-6.Results Compared to group B,group A showed much higher increases in PLI,GI and SBI values at T1(P<0.05).The levels of the TNF-α,IL-1βand IL-6 in group A increased higher than those of group B,the differences in the increase of TNF-αwere statistically significant(P<0.05),and the increases in IL-1βand IL-6 were similar in both groups(P>0.05).After the 30 days of bonding,periodontal indices and inflammatory cytokine levels showed statistically significant increases in both groups.Conclusion Compared with square self-ligating bracket,spherical self-ligating bracket could have greater oral hygiene and would be beneficial to prevent periodontitis among orthodontic patients.