自锁托槽和无托槽隐形矫治器对正畸患者牙周组织炎症状态的影响

Effect of self-ligating bracket and bracketless invisible appliance on inflammation status of periodontal tissue in orthodontic patients

目的探讨自锁托槽和无托槽隐形矫治器对正畸患者牙周组织炎症状态的影响。方法选取104例错[牙合]畸形患者,根据患者自愿原则采用无托槽隐形矫治器和自锁托槽矫治器,各52例,评估两组粘戴托槽前及粘戴托槽24 h后的口腔咬合功能[去皮花生仁的咀嚼次数(MT),并计算咀嚼效能(ME)、最大咬合力(MF)、最大合力时间(MFT)、咬合速率(SO)],对比两组矫治前及矫治6个月后的牙周指数[牙龈指数(GI)、龈沟探诊深度(SPD)、龈沟出血指数(SBI)、菌斑指数(PLI)]、龈沟液中白细胞介素1β(IL-1β)、肿瘤坏死因子(TNF-α)水平和天门冬氨酸转氨酶(AST)及碱性磷酸酶(ALP)含量。结果两组粘戴托槽24 h后的ME、MT、MF及SO值较粘戴托槽前有显著性降低(P<0.05),MFT值较粘戴托槽前有显著性升高(P<0.05),无托槽组矫治6个月后的GI、SPD、SBI及PLI值较矫治前无明显差异(P>0.05),而自锁托槽组较矫治前有显著提高(P<0.05),无托槽组上述指标变化幅度显著小于自锁托槽组(P<0.05);两组矫治6个月后的龈沟液中IL-1β、TNF-α、AST及ALP含量水平较矫治前有显著提升(P<0.05),但无托槽组显著低于自锁托槽组(P<0.05)。结论无托槽隐形矫治器用于正畸治疗中,能明显改善患者粘戴托槽后的咬合功能,改善牙周组织健康状态,并有效减少龈沟液中IL-1β、TNF-α、AST及ALP过量分泌,以缓解牙周组织炎症状态。

Objective The aim of this study was to investigate the effect of self-ligating bracket and bracketless invisible appliance on periodontal tissue inflammation in orthodontic patients.Methods A total of 104 patients with malocclusion were selected and divided into self-ligating bracket group and bracketless group according to the principle of voluntariness,with 52 cases in each group.The bracketless group was given bracketless invisible appliance for orthodontics,and the self-ligating bracket group applied self-ligating bracket appliance.The oral occlusion function[mastication times(MT)of blanched groundnut kernel,masticatory efficiency(ME),maximum masticatory force(MF),maximum force time(MFT),speed of occlusion(SO)]in the two groups were evaluated before wearing brackets and after 24 h of wearing brackets.Periodontal indexes[gingival index(GI),sulcus probing depth(SPD),sulcus bleeding index(SBI),plaque index(PLI)],levels of gingival crevicular fluid interleukin 1β(IL-1β)and tumor necrosis factor(TNF-α)and contents of aspartate aminotransferase(AST)and alkaline phosphatase(ALP)were compared between the two groups before orthodontics and after 6 months of orthodontics.Results The ME,MT,MF and SO of the two groups after 24h of wearing brackets were significantly lower than those before wearing brackets(P<0.05)while MFT value was significantly higher than that before wearing brackets(P<0.05).There were no significant differences in the GI,SPD,SBI and PLI in bracketless group after 6 months of orthodontics compared with those before orthodontics(P>0.05),and the above indicators in self-ligating bracket group were significantly increased compared to those before orthodontics(P<0.05),and the changes of the above indicators in the bracketless group were significantly lower than those in self-ligating bracket group(P<0.05).The levels of IL-1β,TNF-α,AST and ALP in gingival crevicular fluid of the two groups after 6 months of orthodontics were significantly higher than those before orthodontics(P<0.05),but the levels of bracketless group were significantly lower than those of self-ligating bracket group(P<0.05).Conclusion The application of bracketless invisible appliance in orthodontic treatment can significantly improve the occlusion function after wearing brackets,improve the health of periodontal tissues,and effectively reduce the excessive secretions of IL-1β,TNF-α,AST and ALP in the gingival crevicular fluid to relieve the inflammation status of periodontal tissue.