牙周正畸联合治疗牙周病的疗效分析
发布时间：2019-05-23 17:09
【摘要】：[目的]本研究通过对比牙周炎患者在单纯性牙周治疗前(T0)、单纯性牙周治疗后即牙周正畸联合疗前(T1)及牙周正畸联合治疗后(T2)的临床牙周健康指数(松动度TM、牙周袋探诊深度PD、临床附着丧失CAL和探诊出血BOP)、临床牙冠长度、及采用CBCT测量牙周正畸联合治疗前后的牙根长度、牙槽嵴顶到釉牙骨质界的距离及牙槽骨密度的变化,进一步评价牙周病单纯性牙周治疗和牙周正.畸联合治疗的疗效及相关影响因素,为临床牙周病的治疗提供指导。 [方淘选取轻、中度牙周病患者共20例,牙周治疗前测量临床牙周健康指数(松动度TM、牙周袋探诊深度PD、临床附着丧失CAL和探诊出血BOP)、临床牙冠长度及拍摄CBCT。经过3个月牙周治疗完成后测量以上指标及拍摄CBCT。经过评定牙周病进入稳定期,开始牙周正畸联合治疗。排齐整平消除咬牙合创伤约10个月后,再次测量以上指标及拍摄CBCT。实验中采用CBCT测量单纯性牙周治疗前和牙周正畸联合治疗前后牙槽嵴顶到釉牙骨质界的距离、牙根长度及牙槽骨密度的变化,所得数值采用SPSS19.0软件包进行统计学分析。 [结果l 1、探诊出血位点百分比：单纯性牙周治疗后,探诊出血由55.9%±9.7%减小到45.0±10.7%。牙周正畸联合治疗后(T2)探诊出血位点百分比减小到43.4%±11.4%。 2、松动度：单纯性牙周治疗后,松动度由治疗前0.87±0.65减小到治疗后0.31±0.47。牙周正畸联合治疗后(T2)增加到0.63±0.61。 3、牙周袋探诊深度：单纯性牙周治疗后,牙周探诊由治疗前3.71±0.78mm减小到2.5±0.55mm,牙周正畸联合治疗后减小到2.23±0.55mm。 4、临床附着丧失：单纯性牙周治疗后,由2.6±0.68mm减小到1.89±0.8lmm。牙周正畸联合治疗后,临床附着丧失变化无统计学差异(p0.05)。 5、临床牙冠长度：单纯性牙周治疗后,临床牙冠长度由7.43±1.98mmm增加到牙周治疗后(T1)7.8±1.95mm,牙周正畸联合治疗后继续增加到8.48±1.81mm。 6、牙根长度：单纯性牙周治疗后及牙周正畸联合治疗后,牙根长度变化均无统计学差异(p0.05)。结果表明,牙周正畸联合治疗牙周病,未引起牙根吸收。 7、釉牙骨质界到牙槽嵴顶距离：单纯性牙周治疗和牙周正畸联合治疗后釉牙骨质界到牙槽嵴顶距离无统计学差异(p0.05),结果表明牙周正畸联合治疗牙周病未引起牙槽骨吸收。 8、牙槽骨密度：单纯性牙周治疗后,牙槽骨密度增加,牙槽嵴顶区由治疗前333.10±47.77增加到345.52±53.23；根尖区由治疗前310.26±45.56增加到327.25±76.37。牙周正畸联合治疗后,牙槽骨密度减小,牙槽嵴顶区由治疗前345.52±53.23减小到318.64±62.26；根尖区由治疗前327.25±76.37减小到276.35±39.29,下颌较上颌减小得多,中度牙周炎正畸治疗后比轻度牙周炎正畸治疗后牙槽骨密度减小得多。 9、薄扇型牙龈组和厚平型牙龈组牙周正畸联合治疗前后参数的变化：厚平型牙龈组牙周正畸联合治疗后探诊深度减小0.28±0.47mmm,薄扇型牙龈组减小0.27±0.69mm,两者减小差别不大。厚平型牙龈组治疗前后临床附着丧失变化无统计学意义,而薄扇型增加0.23±0.34mm。厚平型牙龈组牙周正畸联合治疗后探诊出血位点数减少3.72±8.0%,薄扇型牙龈组减少1.68±6.2%。厚平型组松动度增加0.31±0.49,薄扇型组增加0.45±0.53。临床牙冠长度厚平型组增加0.48±0.47mm,薄扇型组增加1.10±0.78mm。牙槽骨高度厚平型牙龈组变化无统计学意义,薄扇型增加3.1±0.71mm。牙槽骨密度厚平型组减小49.37±50.25,薄扇型组减小50.97+61.12。 [结论]1、牙周病经牙周治疗后,可以控制牙周病的进一步发展,进入静止期。这时结合正畸治疗,可以进一步改善患者的牙周健康、提高咀嚼功能和改善美观,且未引起牙根和牙槽骨的吸收。2、牙周正畸联合治疗后临床牙冠长度增加,提示牙周正畸联合治疗牙周病,有可能引起牙龈萎缩的风险,而且薄扇型牙龈比厚平型牙龈出现牙龈萎缩的风险更高。3、单纯性牙周治疗后,牙槽骨密度增加,但是牙周正畸联合治疗后,牙槽骨密度减小,减小的程度与牙周病的严重程度有关,下颌牙比上颌牙的牙槽骨密度减小得多,中度牙周病牙槽骨密度比轻度牙周病减小得多。
[Abstract]:[Objective] To study the clinical periodontal health index (the degree of loosening (TM) and the depth of probing of the periodontal pocket (PD) of the patients with periodontitis before (T0), the simple periodontal treatment, the anterior (T1) and the periodontal orthodontic treatment (T2) after the simple periodontal treatment (T0). The length of the clinical crown, the length of the root of the root of the root of the root of the root of the root of the tooth and the density of the alveolar bone before and after the combined treatment of the periodontal orthodontic treatment were measured by the CBCT, and the periodontal treatment and the periodontal positive were further evaluated. The curative effect and related influencing factors of the combined treatment of the teratogenesis provide a guide for the treatment of the clinical periodontal disease. [2] A total of 20 patients with mild and moderate periodontal disease were selected, and the clinical periodontal health index (the loosening degree (TM), the deep PD of the periodontal pocket, the clinical attachment loss CAL and the visiting bleeding BOP), the length of the clinical crown and the shooting of the CBC were measured before the periodontal treatment. T. After 3 months of periodontal treatment, the above indexes were measured and the CBC was taken. T. After the evaluation of periodontal disease into the stabilization period, the combination of periodontal and orthodontic treatment is started. The above index and the shot CBC were measured once more than 10 months after the bite-and-tooth wound was eliminated. T. The distance, the root length and the density of the alveolar bone were measured by CBCT before and after the combined treatment of simple periodontal treatment and before and after the combination of the periodontal and orthodontic treatment. The obtained values were statistically divided by the SPSS19.0 software package. Analysis. [Results:1. The percentage of the detection and bleeding sites: after simple periodontal treatment, the bleeding was reduced from 55.9% and 9.7% to 45.0%. 10.7%. The percentage of bleeding sites was reduced to 43.4% after combined treatment with periodontal orthodontics (T2). 11.4%.2, Loosening: After simple periodontal treatment, the degree of loosening was reduced from 0.87 to 0.65 prior to treatment to 0. 31-0.47. The combined treatment of periodontal orthodontic treatment (T2) increased to 0. 63-0.61.3, the depth of probing into the periodontal pocket: after the simple periodontal treatment, the periodontal examination was reduced from 3.71 to 0.78mm before the treatment to 2.5 to 0.55mm, and the periodontal orthodontic treatment was reduced to 2 after the combined treatment. 23-0.55 mm.4, clinical attachment loss: after simple periodontal treatment, decreased from 2.6 to 0.68 mm to 1.89.8 lmm. After the combined treatment of periodontal orthodontic treatment, the loss of clinical attachment was lost. The length of the clinical crown was increased from 7.43 to 1.98mmm to the post-periodontal treatment (T1) 7.8 to 1.95 mm after the periodontal treatment. The length of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root There was no statistical difference between the two groups (p0.05). The results showed that the periodontal orthodontics In combination with the treatment of periodontal disease, the tooth root absorption was not caused.7. The distance between the enamel and the bone of the glaze was not statistically significant (p0.05) after the combination of the simple periodontal treatment and the periodontal orthodontic treatment. The results showed that the periodontal disease was not significant (p0.05). Alveolar bone resorption was not induced by orthodontics in the treatment of periodontal disease.8. Density of alveolar bone: After simple periodontal treatment, the density of alveolar bone increased, and the apical area of the alveolar bone increased from 333.10 to 345.52-53.23 before treatment, and the apical area was 310.26% before treatment. 5.56 To 327.25-76.37. After the combined treatment of the periodontal orthodontic treatment, the density of the alveolar bone was reduced, and the apical area of the alveolar bone was reduced to 318.64-62.26 by the treatment of 345.52-53.23, and the apical area was decreased from 327.25 to 76.37 before treatment to 276. .35-39.29, the lower jaw of the lower jaw is much lower than that of the upper jaw, and the post-treatment ratio of the orthodontic treatment of the moderate periodontitis The changes of the alveolar bone density after orthodontic treatment with mild periodontitis were much lower than those before and after the combined treatment of the gingival and the thick and flat gingival group: the depth of the probing after the combined treatment of the thick and flat gingival group was reduced by 0.28 to 0.47mmm, and the tissue of the thin fan type was decreased. The difference in clinical attachment loss before and after treatment with thick and flat gum group was not statistically significant. The results showed that the number of bleeding sites decreased by 3.72-8 after the combined treatment of the thick-flat gingival group and the periodontal-orthodontics. .0%, thin fan type gingival group decreased by 1.68%.2%. The loosening degree of the thick flat group was increased by 0.31. The thickness of the thin fan group increased by 0.45 to 0.53. The thickness of the clinical crown increased by 0.48 to 0.4. 7 mm, the thickness of the thin-fan group increased by 1.10 to 0.78mm. There was no change in the height of the alveolar bone and the gingival group. For statistical significance, the thickness of the thin fan was increased by 3.1 to 0.71 mm. The thickness of the alveolar bone was reduced by 49.37% to 50. .25. The thin fan-type group was reduced by 50.97 + 61.12.[Conclusion] 1. Periodontal disease is periodontal disease. after the treatment, the further development of the periodontal disease can be controlled, the rest period can be controlled, the periodontal health of the patient can be further improved, the chewing function is improved, the appearance is improved, and the absorption of the root and the alveolar bone is not caused by the combination of the orthodontic treatment, and the periodontal orthodontic treatment The length of the post-clinical crown was increased, and it was suggested that the periodontal treatment combined with the treatment of the periodontal disease may cause the risk of gingival atrophy, and the risk of gingival atrophy in the thin-fan-type gum is higher than that of the thick flat-type gums.3. After simple periodontal treatment, the alveolar bone density The degree of alveolar bone density is decreased and the degree of reduction is related to the severity of the periodontal disease, and the density of the alveolar bone in the lower jaw is lower than that of the upper jaw.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5
[Abstract]:[Objective] To study the clinical periodontal health index (the degree of loosening (TM) and the depth of probing of the periodontal pocket (PD) of the patients with periodontitis before (T0), the simple periodontal treatment, the anterior (T1) and the periodontal orthodontic treatment (T2) after the simple periodontal treatment (T0). The length of the clinical crown, the length of the root of the root of the root of the root of the root of the root of the tooth and the density of the alveolar bone before and after the combined treatment of the periodontal orthodontic treatment were measured by the CBCT, and the periodontal treatment and the periodontal positive were further evaluated. The curative effect and related influencing factors of the combined treatment of the teratogenesis provide a guide for the treatment of the clinical periodontal disease. [2] A total of 20 patients with mild and moderate periodontal disease were selected, and the clinical periodontal health index (the loosening degree (TM), the deep PD of the periodontal pocket, the clinical attachment loss CAL and the visiting bleeding BOP), the length of the clinical crown and the shooting of the CBC were measured before the periodontal treatment. T. After 3 months of periodontal treatment, the above indexes were measured and the CBC was taken. T. After the evaluation of periodontal disease into the stabilization period, the combination of periodontal and orthodontic treatment is started. The above index and the shot CBC were measured once more than 10 months after the bite-and-tooth wound was eliminated. T. The distance, the root length and the density of the alveolar bone were measured by CBCT before and after the combined treatment of simple periodontal treatment and before and after the combination of the periodontal and orthodontic treatment. The obtained values were statistically divided by the SPSS19.0 software package. Analysis. [Results:1. The percentage of the detection and bleeding sites: after simple periodontal treatment, the bleeding was reduced from 55.9% and 9.7% to 45.0%. 10.7%. The percentage of bleeding sites was reduced to 43.4% after combined treatment with periodontal orthodontics (T2). 11.4%.2, Loosening: After simple periodontal treatment, the degree of loosening was reduced from 0.87 to 0.65 prior to treatment to 0. 31-0.47. The combined treatment of periodontal orthodontic treatment (T2) increased to 0. 63-0.61.3, the depth of probing into the periodontal pocket: after the simple periodontal treatment, the periodontal examination was reduced from 3.71 to 0.78mm before the treatment to 2.5 to 0.55mm, and the periodontal orthodontic treatment was reduced to 2 after the combined treatment. 23-0.55 mm.4, clinical attachment loss: after simple periodontal treatment, decreased from 2.6 to 0.68 mm to 1.89.8 lmm. After the combined treatment of periodontal orthodontic treatment, the loss of clinical attachment was lost. The length of the clinical crown was increased from 7.43 to 1.98mmm to the post-periodontal treatment (T1) 7.8 to 1.95 mm after the periodontal treatment. The length of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root of the root There was no statistical difference between the two groups (p0.05). The results showed that the periodontal orthodontics In combination with the treatment of periodontal disease, the tooth root absorption was not caused.7. The distance between the enamel and the bone of the glaze was not statistically significant (p0.05) after the combination of the simple periodontal treatment and the periodontal orthodontic treatment. The results showed that the periodontal disease was not significant (p0.05). Alveolar bone resorption was not induced by orthodontics in the treatment of periodontal disease.8. Density of alveolar bone: After simple periodontal treatment, the density of alveolar bone increased, and the apical area of the alveolar bone increased from 333.10 to 345.52-53.23 before treatment, and the apical area was 310.26% before treatment. 5.56 To 327.25-76.37. After the combined treatment of the periodontal orthodontic treatment, the density of the alveolar bone was reduced, and the apical area of the alveolar bone was reduced to 318.64-62.26 by the treatment of 345.52-53.23, and the apical area was decreased from 327.25 to 76.37 before treatment to 276. .35-39.29, the lower jaw of the lower jaw is much lower than that of the upper jaw, and the post-treatment ratio of the orthodontic treatment of the moderate periodontitis The changes of the alveolar bone density after orthodontic treatment with mild periodontitis were much lower than those before and after the combined treatment of the gingival and the thick and flat gingival group: the depth of the probing after the combined treatment of the thick and flat gingival group was reduced by 0.28 to 0.47mmm, and the tissue of the thin fan type was decreased. The difference in clinical attachment loss before and after treatment with thick and flat gum group was not statistically significant. The results showed that the number of bleeding sites decreased by 3.72-8 after the combined treatment of the thick-flat gingival group and the periodontal-orthodontics. .0%, thin fan type gingival group decreased by 1.68%.2%. The loosening degree of the thick flat group was increased by 0.31. The thickness of the thin fan group increased by 0.45 to 0.53. The thickness of the clinical crown increased by 0.48 to 0.4. 7 mm, the thickness of the thin-fan group increased by 1.10 to 0.78mm. There was no change in the height of the alveolar bone and the gingival group. For statistical significance, the thickness of the thin fan was increased by 3.1 to 0.71 mm. The thickness of the alveolar bone was reduced by 49.37% to 50. .25. The thin fan-type group was reduced by 50.97 + 61.12.[Conclusion] 1. Periodontal disease is periodontal disease. after the treatment, the further development of the periodontal disease can be controlled, the rest period can be controlled, the periodontal health of the patient can be further improved, the chewing function is improved, the appearance is improved, and the absorption of the root and the alveolar bone is not caused by the combination of the orthodontic treatment, and the periodontal orthodontic treatment The length of the post-clinical crown was increased, and it was suggested that the periodontal treatment combined with the treatment of the periodontal disease may cause the risk of gingival atrophy, and the risk of gingival atrophy in the thin-fan-type gum is higher than that of the thick flat-type gums.3. After simple periodontal treatment, the alveolar bone density The degree of alveolar bone density is decreased and the degree of reduction is related to the severity of the periodontal disease, and the density of the alveolar bone in the lower jaw is lower than that of the upper jaw.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5
【参考文献】
相关期刊论文 前7条
1 管增娥;段银忠;;两种方法治疗牙周病疗效分析[J];实用诊断与治疗杂志;2007年04期
2 袁建桥;张月兰;刘林]，
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