错[牙合]畸形正畸治疗前后口腔菌群变化及其与并发慢性牙龈炎的关系分析

Analysis of changes in oral flora before and after orthodontic treatment for malocclusion and its relationship with concurrent chronic gingivitis

目的 探讨错[牙合]畸形正畸治疗前后口腔菌群变化及其与并发慢性牙龈炎的关系。方法 选择2020年10月—2022年3月本院收治的109例进行错[牙合]畸形正畸治疗的患者作为正畸组,并在治疗3个月后根据有无并发慢性牙龈炎将其分为并发组(45例)和未并发组(64例);另选取同期109例牙周健康者作为对照组。比较正畸组治疗前后和对照组的口腔细菌分布变化及细菌检出情况,采用Logistic多因素回归性分析法分析错[牙合]畸形患者正畸治疗后并发慢性牙龈炎的影响因素。结果 正畸组患者治疗前口腔细菌分布情况与对照组相比差异无统计学意义(P>0.05),与对照组和正畸组治疗前相比,正畸组治疗3个月后球菌、杆菌所占比例均下降(P<0.05),丝状菌、梭状菌、螺旋体比例均上升(P<0.05);正畸组患者治疗前变异链球菌、乳酸杆菌、具核梭杆菌、牙龈卟啉单胞菌检出率与对照组相比差异无统计学意义(P>0.05),与对照组和正畸组治疗前相比,正畸组治疗3个月后,以上细菌检出率均升高(P<0.05);并发组与未并发组在性别构成占比方面差异无统计学意义(P>0.05),但并发组年龄<18岁、每次刷牙时间≤2 min、变异链球菌、乳酸杆菌、具核梭杆菌、牙龈卟啉单胞菌检出率均高于未并发组(P<0.05);经多因素Logistic回归性分析,年龄<18岁、每次刷牙时间≤2 min、变异链球菌、乳酸杆菌、具核梭杆菌、牙龈卟啉单胞菌均是正畸患者并发慢性牙龈炎的危险因素(P<0.05)。结论 正畸治疗可导致患者口腔菌群失调,且口腔菌群的改变与患者并发慢性牙龈炎有关。

Objective To investigate the changes of oral flora before and after orthodontic treatment for concurrent malocclusion and its relationship with chronic gingivitis.Methods 109 patients with malocclusion treated in our hospital from October 2020 to March 2022 were selected as the orthodontic group,and they were divided into the complication group(45 cases)and the non-complication group(64 cases)based on the presence or absence of chronic gingivitis after 3 months of treatment.At the same time,109 people with healthy periodontal were selected as the control group.The distribution and detection of oral bacteria in orthodontic group before and after treatment and control group were compared.Logistic multivariate regression analysis was used to analyze the influencing factors of chronic gingivitis in patients with malocclusion after orthodontic treatment.Results There was no significant difference in the distribution of oral bacteria between the orthodontic group before treatment and the control group(P>0.05).Compared with the control group and the orthodontic group before treatment,the proportion of cocci and bacilli decreased after 3 months of orthodontic treatment(P<0.05),while the proportion of filamentous bacteria,clostridium and spirochete increased(P<0.05).The detection rates of Streptococcus mutans,Lactobacillus,Fusobacterium nucleatum and Porphyromonas gingivalis in the orthodontic group before treatment were not significantly different from those in the control group(P>0.05).Compared with control group and orthodontic group before treatment,the detection rates of above bacteria in orthodontic group increased after 3 months of treatment(P<0.05).There was no statistically significant difference in the proportion of sex composition between the concurrent group and the non-complicated group(P>0.05).However,the proportion of age younger than 18 years old,and brushing time less or equal to 2 minutes each time,and the detection rates of Streptococcus mutans,Lactobacillus,Clostridium nucleatum and Porphyromonas gingivalis in the concurrent group were higher than those in the non-concurrent group(P<0.05).Multivariate Logistic regression analysis showed that age younger than 18 years,brushing time less or equal to 2 minutes,Streptococcus mutans,Lactobacillus,Fusobacterium nucleatum,Porphyromonas gingivalis were all risk factors for orthodontic patients with chronic gingivitis(P<0.05).Conclusions Orthodontic treatment can lead to imbalance of oral microflora,and the change of oral microflora is related to chronic gingivitis.