| 姜文心,夏晨蕾,丁 弦,刘美希,刘桂荣.牙周-正畸联合治疗对侵袭性牙周炎患者牙周功能和龈沟液TSLP、IL-33的影响及其预后的影响因素研究[J].,2022,(20):3972-3976 |
| 牙周-正畸联合治疗对侵袭性牙周炎患者牙周功能和龈沟液TSLP、IL-33的影响及其预后的影响因素研究 |
| Effects of Periodontal-Orthodontic Combined Treatment on Periodontal Function, Gingival Crevicular Fluid TSLP and IL-33 and its Influence Factors Study of Prognosis in Patients with Invasive Periodontitis |
| 投稿时间：2022-04-10 修订日期：2022-04-30 |
| DOI：10.13241/j.cnki.pmb.2022.20.034 |
| 中文关键词: 牙周-正畸联合治疗 侵袭性牙周炎 牙周功能 TSLP IL-33 预后 影响因素 |
| 英文关键词: Periodontal-orthodontic combined treatment Invasive periodontitis Periodontal function TSLP IL-33 Prognosis Influence factors |
| 基金项目:山东省医药卫生科技发展计划项目（2017WS310） |
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| 中文摘要: |
| 摘要 目的：观察牙周-正畸联合治疗对侵袭性牙周炎（AgP）患者牙周功能和龈沟液胸腺基质淋巴细胞生成素（TSLP）、白介素-33（IL-33）的影响，并分析其预后的影响因素。方法：选择2017年1月至2021年6月期间我院收治的AgP患者119例，根据治疗方式的不同分为对照组（牙周基础治疗）和联合组（牙周-正畸联合治疗），例数分别为58例和61例。对比两组患者的牙周功能[牙周袋深度（PD）、牙龈指数（GI）、菌斑指数（PLI）、临床附着丧失（AL）]和龈沟液TSLP、IL-33水平，根据PD判断联合组患者的预后情况，采用单因素、多因素Logistic回归分析预后的影响因素。结果：两组治疗后PD、GI、PLI、AL均较治疗前下降，且联合组低于对照组（P<0.05）。两组治疗后龈沟液TSLP、IL-33水平均较治疗前下降，且联合组低于对照组（P<0.05）。61例采用牙周-正畸联合治疗的AgP患者，6个月后复查发现，PD＜4 mm的患者有38例（预后良好组），PD≥4 mm患者有23例（预后不良组）。单因素分析结果显示，牙周-正畸联合治疗AgP患者的预后与患牙上下/前后分布位置、患牙最深PD值、牙槽骨高度基线值、PLI、根型态异常情况有关（P<0.05）。多因素Logistic回归分析结果显示：患牙分布位置为下颌牙、根型态存在异常情况、患牙分布位置为前牙、患牙最深PD值偏大、PLI偏高、牙槽骨高度基线值偏高均是牙周-正畸联合治疗AgP患者不良预后的危险因素（P<0.05）。结论：与单纯的牙周基础治疗相比，牙周-正畸联合治疗可有效改善AgP患者的临床症状，控制局部炎性反应。同时，患牙上下/前后分布位置、患牙最深PD值、牙槽骨高度基线值、PLI、根型态异常情况均是牙周-正畸联合治疗AgP患者预后的影响因素，需引起临床重视。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of periodontal-orthodontic combined treatment on periodontal function, gingival crevicular fluid thymic stromal lymphopoietin (TSLP) and interleukin-33 (IL-33) in patients with invasive periodontitis (AgP), and to analyze the influencing factors of prognosis. Methods: 119 patients with AgP who were treated in our hospital from January 2017 to June 2021 were selected, and they were divided into control group (periodontal basic treatment) and combined group (periodontal-orthodontic combined treatment), with 58 cases and 61 cases respectively. The periodontal function [periodontal pocket depth (PD), gingival index (GI), plaque index (PLI) and clinical attachment loss (AL)] and the levels of gingival crevicular fluid TSLP and IL-33 were compared between the two groups. The prognosis of the combined group was judged according to PD, and the influencing factors of prognosis were analyzed by univariate and multivariate Logistic regression. Results: After treatment, PD, GI, PLI and AL in the two groups decreased compared with those before treatment, and those in the combined group were lower than those in the control group (P<0.05). The levels of gingival crevicular fluid TSLP and IL-33 in the two groups after treatment decreased compared with those before treatment, and the levels in the combined group were lower than those in the control group (P<0.05). In 61 patients with AgP treated with periodontal-orthodontic combined treatment, it was found that there were 38 patients with PD < 4 mm (good prognosis group) and 23 patients with PD ≥ 4 mm (poor prognosis group). Univariate analysis showed that the prognosis of patients with AgP treated with periodontal-orthodontic combined treatment was related to the upper and lower / anterior and posterior distribution position of affected teeth, the deepest PD value of affected teeth, the baseline value of alveolar bone height, PLI and abnormal root shape (P<0.05). The results of multivariate Logistic regression analysis showed that the distribution position of affected teeth was mandibular teeth, the root type was abnormal, the distribution position of affected teeth was anterior teeth, the deepest PD value of affected teeth was too large, the PLI was too high and the baseline value of alveolar bone height was too high were the risk factors of poor prognosis in patients with AGP treated with periodontal-orthodontic combined treatment (P<0.05). Conclusion: Compared with simple periodontal basic treatment, periodontal-orthodontic combined treatment can effectively improve the clinical symptoms of patients with AgP and control the local inflammatory response. At the same time, the upper and lower / anterior and posterior distribution position of the affected teeth, the deepest PD value of the affected teeth, the baseline value of alveolar bone height, PLI and abnormal root shape are the influencing factors of the prognosis of patients with AGP treated by periodontal orthodontic combination, which should be paid more attention to. |
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