The effect of bracketless invisible appliance on periodontal health in periodontitis with malocclusion deformity
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摘要:
目的 探讨在牙周炎伴有错 畸形患者中应用无托槽隐形矫治器的效果及安全性,并分析对患者牙周健康、炎症的影响,以期为该病临床治疗提供参考。方法 选取2021年1月—2022年12月首都医科大学附属北京口腔医院收治的200例牙周炎伴有错 畸形患者,按正畸方式分为对照组(94例,直丝弓矫治器治疗)与研究组(106例,无托槽隐形矫治器治疗),比较2组矫治效果。结果 研究组总有效率为95.28%(101/106),与对照组[92.55%(87/94)]比较差异无统计学意义(P>0.05)。2组牙齿平整时间和咬合打开时间比较差异均无统计学意义(P>0.05)。研究组治疗后临床附着丧失(CAL)、牙龈沟探测深度(PD)、牙龈沟出血指数(SBI)、菌斑指数(PLI)、牙龈指数(GI)分别为(3.26±1.05)mm、(2.44±0.61)mm、1.21±0.31、1.56±0.41、0.65±0.17,对照组分别为(3.81±1.19)mm、(2.83±0.49)mm、1.75±0.49、2.51±0.50、1.12±0.25,研究组均低于对照组(P<0.05)。研究组治疗后白介素-8(IL-8)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)均低于对照组(P<0.05)。研究组并发症总发生率为5.66%(6/106),对照组为15.96%(15/94),研究组并发症总发生率低于对照组(χ2=5.621,P=0.018)。 结论 无托槽隐形矫治器用于牙周炎伴有错 畸形的矫治效果确切,可改善患者牙周健康。Abstract:Objective To investigate the effect and safety of bracketless invisible appliance on periodontitis with malocclusion deformity, and to analyze the influence on periodontal health and inflammation of patients, in order to provide reference for clinical treatment of this disease. Methods A total of 200 patients with periodontitis with malocclusion deformity admitted to Beijing Stomatological Hospital Capital Medical University from January 2021 to December 2022 were selected and divided into the control group (94 cases, straight wire appliance) and the study group (106 cases, bracketless invisible appliance) according to the orthodontic methods. The treatment effect was compared between the two groups. Results The total effective rate in the study group was 95.28% (101/106), which had no difference compared with 92.55% (87/94) in the control group (P > 0.05). There was no difference in tooth leveling time and occlusal opening time between the two groups (P > 0.05). In the study group, clinical attachment loss (CAL), gingival line probe depth (PD), gingival sulcus bleeding index (SBI), plaque index (PLI), gingival index (GI) [(3.26±1.05) mm, (2.44±0.61) mm, 1.21±0.31, 1.56±0.41, 0.65±0.17] after treatment were lower than those in the control group [(3.81±1.19) mm, (2.83±0.49) mm, 1.75±0.49, 2.51±0.50, 1.12±0.25], all P < 0.05. After treatment, the levels of interleukin-8 (IL-8), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the study group were lower than those in the control group (P < 0.05). The total complication rate in the study group was 5.66% (6/106), which was lower than that in the control group [15.96% (15/94), χ2=5.621, P=0.018]. Conclusion The bracketless invisible appliance has a definite effect on the treatment of periodontitis with malocclusion deformity, which can significantly improve the periodontal health of patients. -
表 1 2组牙周炎伴有错
畸形患者矫治效果比较[例(%)]Table 1. Comparison of curative effect of periodontitis with malformation in 2 groups[cases (%)]
组别 例数 显效 有效 无效 总有效 研究组 106 41(38.68) 60(56.60) 5(4.72) 101(95.28) 对照组 94 33(35.11) 54(57.45) 7(7.45) 87(92.55) 注:2组总有效率比较,χ2=0.658,P=0.417。 表 2 2组牙周炎伴有错
畸形患者正畸时间比较(x±s,月)Table 2. Comparison of orthodontic time of periodontitis patients with malocclusion in 2 groups(x±s, Month)
组别 例数 牙齿整平时间 咬合打开时间 研究组 106 7.71±1.20 4.55±1.04 对照组 94 7.99±1.31 4.26±1.18 t值 1.577 1.847 P值 0.116 0.066 表 3 2组牙周炎伴有错
畸形患者牙周指标比较(x±s)Table 3. Comparison of periodontal indexes in 2 groups of periodontitis patients with malocclusion(x±s)
组别 例数 CAL(mm) PD(mm) SBI PLI GI 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 研究组 106 3.35±1.01 3.26±1.05 2.30±0.25 2.44±0.61b 1.62±0.40 1.21±0.31b 2.17±0.61 1.56±0.41b 0.62±0.15 0.65±0.17 对照组 94 3.33±1.02 3.81±1.19b 2.32±0.27 2.83±0.49b 1.59±0.41 1.75±0.49b 2.15±0.58 2.51±0.50b 0.64±0.13 1.12±0.25b 统计量 0.139a 264.908c 0.544a 377.034c 0.523a 718.448c 0.237a 1 125.306c 1.001a 1 197.082c P值 0.890 0.001 0.587 <0.001 0.601 <0.001 0.813 <0.001 0.318 <0.001 注:a为t值,c为F值;与同组治疗前比较,bP<0.05。 表 4 2组牙周炎伴有错
畸形患者炎症指标比较(x±s,pg/mL)Table 4. Comparison of inflammatory indexes in 2 groups of periodontitis patients with malocclusion(x±s, pg/mL)
组别 例数 IL-8 IL-1β TNF-α 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 研究组 106 10.69±2.05 21.51±3.26b 24.31±2.27 32.39±3.48b 21.61±2.57 26.39±3.69b 对照组 94 10.92±2.17 27.58±3.74b 24.75±2.09 37.71±3.94b 21.45±2.81 32.01±3.48b 统计量 0.770a 935.378c 1.420a 773.443c 0.421a 842.168c P值 0.442 <0.001 0.157 <0.001 0.675 <0.001 注:a为t值,c为F值;与同组治疗前比较,bP<0.05。 表 5 2组牙周炎伴有错
畸形患者并发症发生率比较[例(%)]Table 5. Comparison of complication rate of periodontitis with malocclusion in 2 groups[cases (%)]
组别 例数 牙周粘连 牙釉脱矿 牙根吸收 牙龈萎缩 总发生 研究组 106 0 1(0.94) 2(1.89) 3(2.83) 6(5.66) 对照组 94 2(2.13) 4(4.26) 3(3.19) 6(6.38) 15(15.96) 注:2组并发症总发生率比较,χ2=5.621,P=0.018。 -
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