正畸治疗对牙周病患者牙龈退缩的影响

发布时间：2018-02-23 05:43

本文关键词： 牙龈退缩正畸治疗牙周组织牙移动　出处：《广西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：[目的]牙龈退缩是指牙龈缘向釉牙骨质界的根方退缩而致使的牙根暴露，可造成牙本质敏感、根面磨损和根面龋的发生，并严重影响颜面美观。牙龈退缩的发生并非由单一病因引起，目前认为其致病因素是多因子共同作用的结果，包括病理因素、解剖因素、牙齿位置异常、医源性损伤、牙合创伤和生活中的不良习惯等。牙龈退缩的分类有很多种，其中临床最常使用的分类方法是1985年由Miller提出的分度法，此方法能很好地用来评价术后疗效。临床上针对牙龈退缩的治疗方法有很多，正畸治疗则是其中之一，但是，对于正畸治疗是否会改善牙龈退缩或引起、加重牙龈退缩，至今尚无一致的观点。有一部分学者通过临床研究和动物实验探索发现，正确的正畸治疗方法能够有助于改善牙龈退缩，而更多学者则认为正畸治疗会引起或加重牙龈退缩。严重的牙龈退缩，正畸治疗很难使牙龈完全再生，因此，需要根据情况在正畸治疗前后行牙周手术扩增附着龈，以更好改善牙龈美观。 [方法]报告2例牙周病伴牙龈退缩的正畸临床典型病例，根据病史和临床检查分析患者的病因，判断患者待解决的问题，以及给予患者制定合适的矫治方案，患者的矫治过程在牙周科积极配合下完成，全程使用轻力，采用间断力及延长复诊时间，片切前牙邻面，控制牙根转矩，解决拥挤及反牙合，排齐牙列，去除牙合干扰，平均疗程16个月，透明压模保持器保持。 [结果]患者牙列排列整齐，前牙覆牙合覆盖基本正常，无创伤牙合，牙周病得到很好地控制，牙龈退缩有明显改善，达到预期的矫治目标。 [结论]通过2例典型临床病例报告及文献回顾，，探讨了牙龈退缩的病因和分类，以及正畸治疗对牙龈退缩的影响。正确的诊断，完善的矫治计划，细丝轻力的应用，以及贯穿始终的牙周治疗是矫治成功的关键，正畸治疗在一定程度上可以对牙龈退缩起到积极的作用。
[Abstract]:[objective] gingival retraction refers to the root exposure caused by the gingival margin retreating to the root side of the enamel bone, which can cause dentin sensitivity, root surface wear and root surface caries. The occurrence of gingival retraction is not caused by a single cause. At present, it is considered that the cause of gingival retraction is the result of the combined action of many factors, including pathological factors, anatomical factors, abnormal position of teeth, iatrogenic injury. There are many kinds of classification of gingival retraction, among which the most commonly used classification method in clinic is the graduation method proposed by Miller in 1985. This method can be used to evaluate the effect of gingival retraction. There are many clinical methods for gingival retraction, and orthodontic treatment is one of them. However, if orthodontic treatment can improve or cause gingival withdrawal, it will aggravate gingival withdrawal. So far, there is no consensus. Some scholars have found that correct orthodontic treatment can help to improve gingival retraction through clinical research and animal experiments. However, more scholars believe that orthodontic treatment can cause or aggravate gingival withdrawal. Serious gingival retraction is very difficult for orthodontic treatment, so it is necessary to perform periodontal surgery before and after orthodontic treatment to expand the adherent gingiva according to the situation. To better improve the beauty of the gums. [methods] two typical orthodontic cases of periodontal disease with gingival retraction were reported. According to the history and clinical examination, the etiology of the patients was analyzed, the problems to be solved were judged, and the appropriate treatment plan was made. The correction process of the patients was completed with the active cooperation of periodontal department. The whole process used light force, used discontinuous force and extended the time of re-diagnosis, cut the adjacent surface of the anterior teeth, controlled the root torque, solved the crowding and reverse occlusion, arranged the dentition, and removed the occlusion interference. The average course of treatment was 16 months, and the transparent die holder was maintained. [results] the teeth of the patients were arranged neatly, the overbite of the anterior teeth was basically normal, the periodontal disease was well controlled, the gingival retraction was obviously improved, and the expected correction goal was achieved. [conclusion] the etiology and classification of gingival retraction and the effect of orthodontic treatment on gingival retraction were discussed through the reports of 2 typical clinical cases and literature review. Orthodontic treatment can play a positive role in gingival retraction to some extent.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

【共引文献】