正畸加力后牙周疼痛与龈沟液中生物活性物质变化的相关研究

The Correlation between Tooth Pain and Bioactivators Changes in Gingival Crevicular Fluid after Applying Orthodontic Stress

目的观察正畸患者正畸加力后疼痛的时间变化规律,了解正畸加力前后龈沟液中生物活性物质的变化特点,以及两者之间的相关性。方法采用放射免疫测定法,测定正畸患者50例样本上颌侧切牙受唇向倾斜力前和后12h、24h、48h、72h龈沟液中前列腺素E2(PGE2)、P物质(SP)、白细胞介素-6(IL-6)和巨噬细胞集落刺激因子(GM-CSF)的浓度变化,记录并描述正畸加力后疼痛的时间规律。对正畸加力后疼痛与生物活性物质的变化进行相关分析。结果正畸加力后12h左右开始出现疼痛,24h左右疼痛程度最高,72h左右明显减轻。正畸加力后12h左右PGE2、SP、IL-6和GM-CSF的浓度升高,24h后SP、PGE2达到高峰,而IL-6和GM-CSF的浓度无明显变化;72h,IL-6和GM-CSF保持较高水平,而PGE2、SP的浓度明显下降。结论正畸牙加力后疼痛呈规律性变化,而这种变化与牙周某些局部生物活性物质如SP和PGE2的浓度变化相关。

Objective To investigate the changes of tooth pain in patients with orthodontic tooth movement,to study the changes of bioactivators in GCF in patients with orthodontic tooth movement,and explore the correlation between pain and bioactivators in orthodontic patients.Methods50patients were included,each having one treatment tooth and one contralateral control tooth.The levels of PGE 2 ,P substances,IL-6and GM-CSF in GCF of upper lateral incisor were investigated before activation and at12 th hour,24 th hour,48 th hour and72th hour after the applying labial orthodontic force,by using highly sensitive radioimmunassay.To record the changes of pain in orthodontic patients at12 th hour,24 th hour,48 th hour and72 th hour after applying stress.Results At experimental sides,total amount of GCF PGE 2 ,P substances(SP),IL-6and GM-CSF levels was significantly elevated compared with that before activation.The concentration of PGE 2 and SP in GCF increased significantly and reached peak point at24 th hour in patients,while the levels of IL-6and GM-CSF in GCF remained at higher baseline through the experiment.There was an rhythm change of periodontal pain during orthodontic tooth movement.Conclusion There was an rhythm changes of pain after stress in patients with orthodontic tooth movement,and the rhythm pain was correlated to the changes of some activator such as P substances and PGE 2 in periodontal ligament.