牙周炎致错位前牙正畸牙周联合治疗的CT研究

Computer tomograghy study on periodontal patients with anterior displaced teeth before and after combined orthodontic-periodontal treatment

目的 :对牙周炎致唇向散开的前牙经牙龈环切离断牙槽嵴顶纤维后进行正畸治疗 ,使用CT观察治疗前后牙槽骨高度的变化。方法 :1 6名牙周炎患者唇向散开的上前牙被随机分到牙龈环切组和非环切组。使用前牙区CT扫描和根尖片来比较分析治疗前后牙槽骨高度的变化。结果 :经牙龈环切后正畸压入治疗可以增加错位患牙的牙槽骨高度。牙龈环切后正畸压入的患牙牙槽骨高度平均增加 1 .2mm。牙周病损对称的患牙中牙龈环切组牙槽骨高度平均增加 0 .8mm ,牙周病损不对称的患牙中病损轻、中、重牙龈环切组牙槽骨高度分别增加 0 .9、1 .4、2 .2mm。非牙龈环切组治疗后牙槽骨高度的平均增加量仅为 0 .1mm。牙龈环切组与非环切组间的差异有高度统计学意义。结论 :经牙龈环切后正畸治疗在矫正患牙咬合关系的同时增加了牙槽骨高度 。

Objective:To evaluate evaluation of the changes of alveolar bone height in the periodontal patients with anterior teeth displacement before and after combined orthodontic periodontal treatment with circumferential fibrotomy. Methods: Totally 16 periodontal patients with anterior displaced teeth were analyzed after random clinical trialed as groups with and without circumferential fibrotomy of involving teeth followed by orthodontic intrusion. Evaluations of the changes of alveolar bone were given before and after treatment by means of periapical X ray film and CT scan of the involving teeth. Results: Orthodontic treatment with circumferential fibrotomy can increase the height of crest bone. Alveolar bone height was increased in the patients with circumferential fibrotomy followed by orthodontic intrusion of displaced anterior teeth. Alveolar bone height was increase by 1.2 mm on average in circumferential fibrotomy patient. In the patients with symmetric alveolar bone loss, 0.8 mm increase of alveolar bone height was observed following treatment. For the patients with asymmetric alveolar bone loss, 0.9 mm increase of alveolar bone height was detected in mild bone loss patients, but 1.4 mm and 2.2 mm increase of alveolar bone height were found in moderate and severe bone loss patients, respectively. For patients having the orthodontic treatment without circumferential fibrotomy, the alveolar bone height was increased by 0.1 mm only. Statistic significance was found between the circumferential fibrotomy group and non fibrotomy group. Conclusion: Combined orthodontic periodontal treatment with circumferential fibrotomy could correct the malpositioned teeth, and improve the periodontium conditions and gain the crest bone.