上颌切牙扇形移位的牙周-正畸联合治疗效果研究

Clinical effects of periodontal-orthodontic treatment for maxillary incisors with fan-shaped drift

目的 探讨伴上颌切牙病理性扇形移位错畸形的牙周-正畸联合治疗效果。方法 选择2016年1月至2021年12月于南京大学医学院附属口腔医院正畸科就诊的经牙周-正畸联合治疗的伴有上颌切牙扇形移位的Ⅳ期/C级牙周炎患者18例,其中扇形移位的切牙31颗。回顾性分析患者正畸治疗前及正畸治疗后的出血指数(bleeding index,BI)、探诊深度(probing depth,PD)、探诊出血(bleeding on probing,BOP)位点百分比;采用锥形束CT评价扇形移位切牙的剩余牙槽骨高度(residual alveolar bone height,RBH)、切牙倾斜度及牙根吸收比的变化情况。结果 与正畸治疗前相比,正畸治疗后PD显著降低(P <0.05);正畸治疗后,扇形移位的切牙腭侧及近中RBH显著增加(均P <0.05),切牙倾斜度显著减少(P <0.001);正畸治疗后唇侧、腭侧及远中上颌中切牙RBH的变化程度大于上颌侧切牙(均P <0.05),上颌切牙总体牙根吸收比为0.08±0.01。结论 在完善的牙周治疗基础上,正畸治疗有助于扇形移位切牙的牙周组织健康。

Objective To evaluate the effects of periodontal-orthodontic treatment for malocclusion with pathological fan-shaped drift of maxillary incisors. Methods Eighteen orthodontic patients with stage Ⅳ/Grade C periodontitis visiting the Department of Periodontology of Nanjing Stomatological Hospital were selected,who had received periodontalorthodontic treatment,and 31 incisors had fan-shaped drift. Bleeding index(BI),probing depth(PD),and percentage of sites with bleeding on probing(BOP)were analyzed before and after orthodontic treatment. The residual alveolar bone height(RBH),tooth inclination to lip and palate,and ratio of root resorption were also evaluated by cone-beam CT(CBCT)for the retrospective study. Results Compared with before orthodontic treatment,PD was significantly reduced after orthodontic treatment(P < 0.05);there was a significant increase in palatal-and mesial-RBH of incisors with fanshaped drift(P < 0.05),and the incisor inclination was significantly reduced(P < 0.001);the changes of RBH in labial,palatal and distal maxillary central incisors were greater than those in maxillary lateral incisors(P < 0.05),and the general ratio of root resorption of maxillary incisors was 0.08 ± 0.01. Conclusion After complete periodontal treatment,orthodontic treatment contributes to the health of periodontal tissues of the teeth with fan-shaped drift.