正畸治疗中、重度慢性牙周炎的临床初步研究

发布时间：2018-05-29 20:13

本文选题：中 + 重度牙周炎　；参考：《浙江大学》2014年硕士论文

【摘要】：引言：牙周炎是一种累及牙周支持组织的疾病,随着牙槽骨进行性吸收,常导致牙齿扭转、倾斜、伸长并继发咬合创伤、错(?)畸形,最终导致牙齿松动脱落。因此,牙周病是导致牙列缺损的重要原因之一。中、重度牙周炎严重影响患者的口腔功能及面部美观,导致患者生活质量下降,常对患者造成较重的心理压力。因此,如何有效治疗和保存牙周病患牙,对每位牙科医生来说,都是挑战。口腔正(?)能使牙齿在颌骨中三维移动,包括对牙周病患者扇形散开、伸长前牙的压低、内收等；牙齿移动的同时,牙槽骨、牙龈有相应的改建再生。因此,正畸治疗是保存牙周病患牙的有效手段。近年来,牙周-正畸联合治疗的模式已成为牙周病综合治疗的措施之一目的：本研究通过检测经牙周治疗后的中、重度慢性牙周炎患者,正畸治疗前后牙周检查各项指数的变化,同时与牙周正常的正畸患者做2年的对比研究,探讨中、重度慢性牙周炎患者正畸治疗的特点、可行性和有效性,为正畸治疗中、重度慢性牙周炎的预后及患牙的保存提供指导。方法：本研究选取到浙江大学医学院附属第二医院口腔正畸科就诊的牙周病患者10例,其中男性1例,女性9例,平均年龄37.3±9.8周岁,称为牙周病伴错(?)畸形正畸治疗组(实验组),所有患者正畸治疗前已完成牙周基础治疗。另选牙周正常错(?)畸形患者10例,其中男性5例,女性5例,平均年龄23.4±3.0周岁,称为牙周正常错(?)畸形组(对照组)。两组患者在正畸治疗前后接受牙周检查并拍摄全景片。牙周检查包括检测菌斑指数(plaque index, PLI),探诊出血(bleeding on probing, BOP),出血指数(bleeding index, BI),牙龈外形指数(papilla presence index,PPI),牙周袋探诊深度(probing depth, PD)和临床附着丧失(clinical attachment loss,CAL)。全景片测量釉牙骨质界到牙槽嵴顶的距离(AH)。结果：①在牙周病进入静止期后继续观察发现,实验组PLI、BI的变化均无显著性差异(p0.5),PPI、PD、CAL和AH均显著性减小(p0.5),但与对照组比较仍有显著性差异(p0.5)；②对照组患者在正畸治疗前后各项指数变化均没有显著性差异(p0.5)。③在正畸治疗观察期内,所有牙周病患者牙齿均没有脱落缺失。结论：正畸治疗能恢复牙龈形态、重建覆(?)覆盖关系,从而有效改善牙周病患者的前牙美观；正畸治疗有利于菌斑控制及牙槽骨改建,使牙周治疗的疗效得以长期维护；中、重度慢性牙周炎患者在炎症控制、病情稳定后可以接受正畸治疗,规范的正畸治疗能有效的保存牙周病患牙。
[Abstract]:Introduction: periodontitis is a disease involving periodontal supporting tissue, which often causes tooth torsion, tilt, elongation and secondary occlusal trauma as alveolar bone resorbs. Deformity, eventually leading to tooth loosening and falling off. Therefore, periodontal disease is one of the important causes of dentition defect. Moderate and severe periodontitis seriously affects the oral function and facial beauty of the patients, leading to a decline in the quality of life of patients, often causing severe psychological pressure on patients. Therefore, how to effectively treat and preserve periodontal teeth is a challenge for every dentist. Oral cavity It can make the teeth move in the jaws, including the fan-shaped spread of periodontal disease patients, elongation of the anterior teeth, internal adduction, etc. At the same time of tooth movement, the alveolar bone and gingiva have corresponding remodeling and regeneration. Therefore, orthodontic treatment is an effective means to preserve periodontal disease teeth. In recent years, the combined periodontal and orthodontic treatment model has become one of the comprehensive treatment measures for periodontal diseases. Objective: to investigate the changes of periodontal indexes in patients with moderate and severe chronic periodontitis after periodontal treatment, and to investigate the changes of periodontal indexes before and after orthodontic treatment. The characteristics, feasibility and effectiveness of orthodontic treatment in patients with severe chronic periodontitis provide guidance for the prognosis of severe chronic periodontitis and the preservation of affected teeth. Methods: ten patients with periodontitis were selected from the Department of Orthodontics, second affiliated Hospital of Zhejiang University Medical College, including 1 male and 9 female, with an average age of 37.3 卤9.8 years. Orthodontic treatment group (experimental group), all patients completed periodontal basic treatment before orthodontic treatment. Other normal periodontal malformation) There were 10 patients with malformation, including 5 males and 5 females, with an average age of 23.4 卤3.0 years, which was called normal periodontal malformation. Deformity group (control group). The two groups received periodontal examination and panoramic film before and after orthodontic treatment. Periodontal examination included plaque index (pli), probing bleeding on probing, BOPN, bleeding index (BII), gingival shape index (PAPilla presence), periodontal pouch probing depth (PDD) and clinical attachment loss (CALL). The distance from the enamel cementum to the alveolar crest was measured by panoramic film. Results after the periodontal disease entered into a static period, There was no significant difference in the changes of PLII BI between the experimental group and the control group, but there was no significant difference between the two groups before and after orthodontic treatment, and there was no significant difference between the two groups before and after orthodontic treatment, p0.5.3 was not significantly different between the two groups before and after orthodontic treatment. During the observation period of teratological treatment, No tooth loss was found in all patients with periodontal disease. Conclusion: orthodontic treatment can restore gingival shape and reconstruct the overburden. The coverage relationship can effectively improve the aesthetic appearance of anterior teeth of patients with periodontal disease; orthodontic treatment is beneficial to plaque control and alveolar bone remodeling, so that the curative effect of periodontal treatment can be maintained for a long time; patients with moderate and severe chronic periodontitis are under the control of inflammation. Orthodontic treatment can be accepted after stable condition, standard orthodontic treatment can effectively preserve periodontal disease teeth.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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