上前牙改良固定树脂平面导板对深覆患者牙周组织的影响

Effect of resin modified fixed flat bite plate in anterior teeth on periodontal tissue in patients with deep overbite

目的在深覆患者上前牙制作改良式固定树脂平面导板并对反映牙周健康的菌斑指数、出血指数、探诊深度、附着丧失及龈沟液量进行测定,来评价改良式树脂平面导板对牙周组织的影响。方法选择2014年8月至2015年8月就诊于内蒙古包钢医院,牙周健康的深覆患者40例作为研究对象,随机选择上前牙11、12或21、22作为实验组,对侧同名牙设为对照组,在实验组的舌侧制作改良式固定树脂平面导板。对照组不做任何处理。制作平面导板前、制作平面导板后6周及拆除平面导板后2周这3个时相点,由同一位医师测定两组菌斑指数、出血指数、探诊深度、附着丧失,同时用滤纸条法提取龈沟液,并测定其重量。两组数据比较采用单因素方差分析及t检验。结果实验组这3个时相点出血指数、探诊深度及龈沟液量比较,差异均无统计学意义(F=0.42、0.84、0.34,P=0.66、0.44、0.71);实验组这3个时相点菌斑指数比较,差异有统计学意义(F=5.82,P=0.05);制作平面导板后6周,实验组菌斑指数1.38±0.64,分别与制作平面导板前1.10±0.70、拆除平面导板后2周1.17±0.61比较,差异均有统计学意义(t=3.18、2.58,P=0.02、0.01)。对照组这3个时相点菌斑指数、出血指数、探诊深度及龈沟液量比较,差异均无统计学意义(F=0.13、1.44、0.11、0.22,P=0.88、0.24、0.90、0.81)。在制作平面导板前、拆除平面导板后2周,实验组与对照组的临床指标菌斑指数、出血指数、探诊深度及龈沟液比较,差异均无统计学意义(P值均大于0.05)。制作平面导板后6周,实验组与对照组比较,菌斑指数明显升高,差异有统计学意义(P<0.05);其余指标出血指数、探诊深度及龈沟液量,差异均无统计学意义(P值均大于0.05)。制作平面导板前、制作平面导板后6周、拆除平面导板后2周,实验组与对照组的附着丧失均为0。结论改良后固定式树脂平面导板不会引起牙周组织的炎症。对于菌斑的影响,可以通过加强刷牙方式的指导来抑制菌斑的附着。

Objective To study the outcome of the application of clinical orthodontics. Patients with deep overbite in this study intend to create front teeth resin modified fixed flat bite plates,which were modified to reflect their periodontal health,including plaque index,bleeding index,probe pocket depth,attachment loss and gingival crevicular fluid. These measurements were used to create the resin bite plates,which will help clinical orthodontists to provide guidance for the treatment of patients with deep overbites.Methods Forty patients with deep overbite receiving periodontal care were chosen in Inner Mongolia Baogang Hospital from August 2014 to August 2015. Teeth 11,12 or 21,22 were randomly selected as the experimental group. The contralateral tecth were set as the control group. A modified fixed resin flat guide plate was prepared for the experimental group. No intervention was given to the control group. Before wearing,6 weeks after and 2 weeks after the removal of the guides,plaque index,bleeding index,probe pocket depth and attachment loss were determined and recorded by a physician and gingival crevicular fluid was measured using the filter paper method and weighed of both groups. The resulting data was processed with one-way ANOVA and t test. Results In the experimental group,the bleeding index,the depth of the probe and the amount of gingival liquid were not statistically significant( F = 0. 42,0. 84,0. 34,P = 0. 66,0. 44,0. 71). However,the difference of plaque index was statistically significant( F = 5. 82,P = 0. 05).The plaque index of experimental group in 6 weeks after making plane plate was 1. 38 ± 0. 64,compared with the before making plane guide 1. 10 ± 0. 70 and 2 weeks after the removal of the plane plate 1. 17 ± 0. 61,the differences were statistically significant( t = 3. 18,2. 58,P = 0. 02,0. 01). For the control group,there were no significant differences in the plaque index,bleeding index,probing index,loss of attachment and gingival crevicular fluid among the 3 phases( F = 0. 13,0. 22,0. 11,1. 44,P = 0. 88,0. 24,0. 90,0. 24). Before making plane plate,2 weeks after removal of plane plate,a comparison of was made between the experimental group and control group,there were no statistically significant difference( with P values above 0. 05). In the 6 weeks after making the plane guide,the experimental group and the control group showed a significant increase in plaque index,and the difference was statistically significant( P < 0. 05).The other indicators of hemorrhage index,depth of diagnosis and gingival fluid volume were not statistically significant( with P values above 0. 05). The attachment loss of the experimental group and the control group was 0 for 6 weeks after making the plane guide plate,before making the plane guide plate and after removing the plane guide plate for 2 weeks. Conclusions Resin modified fixed flat bite plate does not cause periodontal tissue inflammation. As for the impact of plaque, plaque adhesion can be suppressed by improving brushing guidance.