骨皮质切开手术联合正畸牵引治疗牙周炎致错位前牙的临床疗效及对牙根吸收的影响研究

Effect of cortical incision combined with orthodontic traction on the effect and root resorption of anterior teeth with periodontitis

目的探讨骨皮质切开手术联合正畸牵引治疗牙周炎致错位前牙的临床疗效及对牙根吸收的影响。方法前瞻性选取2020年3月至2022年12月在衡水市人民医院口腔正畸修复科门诊收治的牙周炎致前牙错位成年患者120例,按照随机数字表法分为对照组和观察组,每组各60例。观察组采用骨皮质切开手术联合正畸牵引手术,对照组采用正畸牵引。观察比较两组患者治疗前后的牙周袋深度、牙槽骨高度、前牙覆盖、牙根与牙冠比、咀嚼能力改善状况,比较两组患者的牙根吸收情况,记录不良反应发生情况、牙列排齐整平时间、关闭间隙时间。结果治疗后,两组患者的牙周菌斑指数、牙龈指数、出血指数、探诊深度、牙周袋深度、临床附着丧失、牙根与牙冠比、边缘骨吸收量均明显低于治疗前,牙槽骨高度、咀嚼能力评分均明显高于治疗前,差异均有统计学意义(P<0.05);观察组患者的牙周菌斑指数、牙龈指数、出血指数、探诊深度、牙周袋深度、临床附着丧失、牙根与牙冠比、边缘骨吸收量均明显低于对照组,牙槽骨高度、咀嚼能力评分均明显高于对照组,差异均有统计学意义(P<0.05)。观察组患者的牙列排齐整平时间、关闭间隙时间均明显短于对照组,差异均有统计学意义(P<0.05)。两组患者的不良反应发生率比较(16.67%vs.8.33%),差异无统计学意义(P>0.05)。结论采用骨皮质切开手术联合正畸牵引治疗牙周炎致错位前牙疗效显著,可以有效改善患者的牙周袋深度、牙槽骨高度、前牙覆盖、牙根与牙冠比,改善咀嚼能力,减少牙根吸收,缩短治疗时间,且不良反应少。

Objective To investigate the effect of cortical incision combined with orthodontic traction on the curative effect and root resorption of periodontitis-induced malpositioned anterior teeth.Methods A total of 120 adult patients with anterior tooth dislocation caused by periodontitis admitted to the outpatient of the Department of Orthodontic Prosthodontics of Hengshui People's Hospital from March 2020 to December 2022 were forward-looking selected and randomly divided into control group and observation group accroding to the random number table method,with 60 cases in each group.The observation group received corticotomy combined with orthodontic traction,while the control group received orthodontic traction.The periodontal pocket depth,alveolar bone height,anterior tooth coverage,root to crown ratio and chewing ability improvement of the two groups were observed and compared before and after treatment.The root resorption of the two groups was compared,and the occurrence of adverse reactions,the time of dental alignment and closing space were recorded.Results After treatment,the periodontal plaque index,gingival index,bleeding index,probing depth,periodontal pocket depth,clinical attachment loss,root to crown ratio and marginal bone absorption in two groups were lower than before treatment,and the alveolar bone height and masticatory ability scores were higher than before treatment,the differences were statistically significant(P<0.05).The periodontal plaque index,gingival index,bleeding index,probing depth,periodontal pocket depth,clinical attachment loss,root to crown ratio and marginal bone absorption in observation group were lower than those in control group,and the alveolar bone height and masticatory ability scores were higher than those in control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidence of adverse reactions between the two groups(16.67%vs.8.33%)(P>0.05).The time of dental alignment and the time of closing space were shorter than those of control group,the differences were statistically significant(P<0.05).Conclusion The curative effect of treatment of dislocated anterior teeth caused by periodontitis with osteotomy combined with orthodontic traction can effectively improve the depth of periodontal pocket,the height of alveolar bone,the coverage of anterior teeth,the ratio of root to crown,improve chewing ability,reduce root resorption,shorten treatment time,and reduce adverse reactions.