牙周组织再生术联合口腔正畸治疗牙周炎的疗效及对牙周指数、炎症反应的影响

Efficacy of periodontal tissue regeneration combined with orthodontic treatment on periodontitis and its influence on periodontal indexes and inflammatory response

目的:探讨牙周组织再生术联合口腔正畸治疗牙周炎的疗效及对牙周指数、炎症反应的影响。方法:选取2018年6月至2021年6月河北省优抚医院收治的牙周炎患者100例,随机分为对照组与观察组,各50例。对照组给予牙周基础治疗+牙周组织再生术治疗,观察组给予牙周基础治疗+牙周组织再生术+口腔正畸治疗。比较两组临床疗效和治疗前后的牙周指数[牙龈指数(gingival index,GI)、牙菌斑指数(plaqueindex,PLI)、牙周探诊深度(probingdepth,PD)、牙龈出血指数(sulcus bleeding index,SBI)、临床牙周附着丧失(clinical attachment loss,CAL)]、龈下致病菌检出情况(包括牙龈卟啉单胞菌、伴放线菌嗜血菌)及龈沟液中炎症因子[包括C反应蛋白(C-reactive protein,CRP)、白细胞介素-17(interleukin-17,IL-17)、干扰素-γ(interferon-γ,INF-γ)、白细胞介素-33(interleukin-3 3, I L-3 3)]水平。结果:观察组总有效率为9 4.0 0%,与对照组的7 8.0 0%相比明显升高(χ2=5.316,P<0.05)。治疗后3个月,观察组GI、PLI、PD、SBI、CA L及龈下牙龈卟啉单胞菌、伴放线菌嗜血菌占牙周细菌总量的百分比均显著低于对照组(分别t=14.614、9.744、10.728、6.7 0 1、 1 1.8 6 5、 1 3.4 9 2、 2 2.1 3 6,均P <0.0 5)。治疗后3个月,观察组龈沟液中C R P、 I L-1 7、INF-γ、IL-33水平均显著低于对照组(分别t=14.614、9.744、10.728、6.701、11.865,均P<0.05)。结论:牙周组织再生术联合口腔正畸治疗可以提高牙周炎的临床疗效,进一步改善患者牙周指数及炎症反应,是一种高效的治疗方案。

Objective:To investigate the efficacy of periodontal tissue regeneration combined with orthodontic treatment on periodontitis and its influence on periodontal indexes and inflammatory response. Methods: A total of 100 patients with periodontitis admitted to Youfu Hospital of Hebei Province from June 2018 to June 2021 were randomly divided into a control group and an observation group, with 50 cases in each group. The control group was treated with periodontal basic treatment + periodontal tissue regeneration, and the observation group was treated with periodontal basic treatment + periodontal tissue regeneration + orthodontic treatment. The clinical efficacy, periodontal indexes [gingival index (GI), plaque index (PLI), probing depth (PD), sulcus bleeding index (SBI), and clinical attachment loss (CAL)], detection of subgingival pathogenic bacteria (including Porphyromonas gingivalis, actinomycete haemophilus) and levels of inflammatory factors [including C-reactive protein (CRP), interleukin-17 (IL-17), interferon-γ (INF-γ), interleukin-33 (IL-33)] in gingival crevicular fluid before and after the treatment were compared between the 2 groups. Results: The total effective rate of the observation group was 94.00%, which was significantly higher than 78.00% of the control group (χ2=5.316, P<0.05). Three months after treatment, the detection rates of GI, dental PLI, periodontal PD, SBI, CAL, and subgingival Porphyromonas gingivalis and actinomycete haemophilus in the observation group were significantly lower than those in the control group (t=14.614, 9.744, 10.728, 6.701, 11.865, 13.492, 22.136, all P<0.05). Three months after the treatment, the levels of CRP, IL-17, INF-γ, and IL-33 in gingival crevicular fluid of the observation group was significantly lower than those of the control group (t=14.614, 9.744, 10.728, 6.701, 11.865, all P<0.05). Conclusion: Periodontal tissue regeneration combined with orthodontic treatment can improve the clinical efficacy of periodontitis and further improve the periodontal index and inflammatory response of patients, which is an effective treatment scheme.