无托槽隐形矫治对错牙合畸形伴牙周病患者的牙周健康影响研究

The Effect of Bracketless Invisible Treatment on the Periodontal Health of Patients with Malocclusion and Periodontal Disease

目的:评估牙周病患者在接受无托槽隐形矫治过程中的牙周健康状况。方法:选取60例接受正畸治疗的慢性牙周炎患者(均已接受过系统性牙周基础治疗),根据接受正畸治疗的方法将其分为治疗组(n=30,接受无托槽隐形矫治)和对照组(n=30,接受固定矫治),两组患者均接受频率一致的牙周健康状况评估。评估指标包括牙龈指数(GI)、菌斑指数(PI)、龈乳头出血指数(PBI)和龈沟探诊深度(SPD)。评估从中切牙至第一磨牙的唇(颊)舌(腭)侧的GI、PI和PBI三个指标,其中上颌右侧和下颌左侧象限选取颊(唇)侧评估,上颌左侧和下颌右侧象限选取腭(舌)侧评估;评估四个象限中所有第一前磨牙和第一磨牙近中、远中、颊侧和腭(舌)侧的SPD。每次评估结束后给予患者详细和个性化的口腔卫生宣教。结果:PI指标在无托槽隐形矫治组中较低,差异具有统计学意义(P<0.05)。此外,对照组与治疗组的整体牙周健康状况比较,差异无统计学意义(P>0.05)。结论:无托槽隐形矫治器对牙周炎患者的牙周健康状况较固定矫治组有更好的维护,这归因于无托槽隐形矫治器可以自行摘戴,更加便于口腔清洁。

Objective To evaluate the periodontal health of patients with periodontal disease during the process of invisible orthodontics without brackets.Methods Select 60 patients with chronic periodontitis who received orthodontic treatment(all have received systemic periodontal basic treatment),and divided them into treatment group(n=30,receive invisible correction without brackets)and control group according to the surgical method(n=30,receive fixed treatment),both groups of patients received periodontal health assessment with the same frequency.Evaluation indicators include gingival index(GI),plaque index(PI),gingival papillary bleeding index(PBI)and sulcus probing depth(SPD).To evaluate the GI,PI and PBI from the central incisor to the lip(buccal)lingual(palatal)side of the first molar,the right side of the upper jaw and the left side of the lower jaw are selected for evaluation on the buccal(labial)side,the left side of the upper jaw and the right side of lower jaw are selected for evaluation on the palatal(lingual)side.The SPD of the mesial,distal,buccal and palatal(lingual)sides of all first premolars and first molars in the four quadrants were evaluated.After each evaluation,the patients will be given detailed and personalized oral hygiene education.Results The PI index was lower in the non-bracket invisible correction group,and the difference was statistically significant(P<0.05).In addition,there was no significant difference in overall periodontal health between the control group and the treatment group,the difference was no significant difference(P>0.05).Conclusion Even if the bracketless invisible appliance covers the entire tooth and keratinized gingiva,the patient’s periodontal health is still relatively better maintained than the control group.This is due to the fact that the bracketless invisible appliance can be self-sustaining.