| 冯小东,赵 晶,吴建有,张 玺,林 江.牙周基础治疗和牙周再生术联合正畸治疗对广泛型侵袭性牙周炎合并牙槽骨缺损患者的临床研究[J].,2022,(5):842-846 |
| 牙周基础治疗和牙周再生术联合正畸治疗对广泛型侵袭性牙周炎合并牙槽骨缺损患者的临床研究 |
| Clinical Study of Periodontal Basic Treatment and Periodontal Regeneration Combined with Orthodontic Treatment in Patients with Extensive Invasive Periodontitis Complicated with Alveolar Bone Defect |
| 投稿时间：2021-09-07 修订日期：2021-09-30 |
| DOI：10.13241/j.cnki.pmb.2022.05.009 |
| 中文关键词: 牙周基础治疗 牙周再生术 正畸治疗 广泛型侵袭性牙周炎 牙槽骨缺损 炎症因子 细菌微生态 |
| 英文关键词: Periodontal basic treatment Periodontal regeneration Orthodontic treatment Generalized aggressive periodontitis Alveolar bone defect Inflammatory factors Bacterial microecology |
| 基金项目:北京市医院管理局重点医学专业发展计划项目（ZYLX201407） |
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| 中文摘要: |
| 摘要 目的：观察牙周基础治疗和牙周再生术联合正畸治疗对广泛型侵袭性牙周炎合并牙槽骨缺损患者的临床疗效及对血清炎症因子和牙龈沟细菌微生态的影响。方法：分析我院2017年8月~2018年8月期间接收的83例广泛型侵袭性牙周炎合并牙槽骨缺损患者的临床资料。根据治疗方式的不同将患者分为A组（40例，牙周基础治疗和牙周再生术治疗）和B组（43例，牙周基础治疗和牙周再生术联合正畸治疗）。观察两组疗效、血清炎症因子、牙龈沟细菌微生态、牙周指标及牙槽骨密度、牙槽骨缺损高度。结果：B组的临床总有效率高于A组（P<0.05）。B组治疗结束后龈沟出血指数（SBI）、牙周探诊深度（PD）、临床附着丧失（AL）、牙菌斑指数（PLI）、牙龈指数（GI）低于A组（P<0.05）。B组治疗结束后牙槽骨缺损高度低于A组，牙槽骨密度高于A组（P<0.05）。B组治疗结束后血清白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白介素-8（IL-8）水平低于A组（P<0.05）。B组治疗结束后杆菌、球菌、丝状菌、弯曲菌检出率低于A组，梭状菌、螺旋体检出率高于A组（P<0.05）。结论：广泛型侵袭性牙周炎合并牙槽骨缺损患者采用牙周再生术、牙周基础治疗联合正畸治疗，疗效显著，可有效改善牙周状况及牙槽骨缺损情况，降低血清炎症因子水平，但该联合治疗方案会对口腔的细菌微生态产生破坏作用。因此，在接受该方案治疗时，应注意口腔清洁，尽量减轻对牙龈沟细菌微生态的影响。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the clinical efficacy of periodontal basic treatment and periodontal regeneration combined with orthodontic treatment in patients with extensive invasive periodontitis complicated with alveolar bone defect and the effects on serum inflammatory factors and gingival sulcus bacterial microecology. Methods: The clinical data of 83 patients with generalized aggressive periodontitis with alveolar bone defect who were received in our hospital from August 2017 to August 2018 were analyzed. According to the different treatment methods, the patients were divided into group A(40 cases, periodontal basic treatment and periodontal regeneration)and group B(43 cases, periodontal basic treatment and periodontal regeneration combined with orthodontic treatment). The therapeutic effect, serum inflammatory factors, microbial ecology of gingival groove bacteria, periodontal index, alveolar bone mineral density and alveolar defect height were observed in the two groups. Results: The total clinical effective rate of group B was higher than that of group A (P<0.05). The gingival sulcus bleeding index (SBI), periodontal depth (PD), clinical attachment loss (AL), plaque index (PLI) and gingival index (GI) of group B after treatment were lower than those of group A(P<0.05). The height of alveolar defect of group B was lower than that of group A, and the alveolar bone mineral density was higher than that of group A(P<0.05). After treatment, the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) of group B were lower than those of group A(P<0.05). The detection rate of bacillus, cocci, filamentous bacteria and campylobacter of group B after treatment were lower than those of group A, and detection rate of spindle bacteria and spirochete were higher than those of group A (P<0.05). Conclusion: Periodontal basic treatment and periodontal regeneration combined with orthodontic treatment for extensive invasive periodontitis combined with alveolar bone defect have significant effect, which can effectively improve the periodontal condition and reduce the level of inflammatory factors, but the combined treatment can destroy the oral bacterial microecology. Therefore, when receiving orthodontic treatment, attention should be paid to oral cleanliness to minimize the impact on the bacterial microecology of gingival crevise. |
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