牙周正畸聯(lián)合治療牙周病的療效分析
發(fā)布時間：2019-05-23 17:09
【摘要】：[目的]本研究通過對比牙周炎患者在單純性牙周治療前(T0)、單純性牙周治療后即牙周正畸聯(lián)合療前(T1)及牙周正畸聯(lián)合治療后(T2)的臨床牙周健康指數(shù)(松動度TM、牙周袋探診深度PD、臨床附著喪失CAL和探診出血BOP)、臨床牙冠長度、及采用CBCT測量牙周正畸聯(lián)合治療前后的牙根長度、牙槽嵴頂?shù)接匝拦琴|(zhì)界的距離及牙槽骨密度的變化,進(jìn)一步評價牙周病單純性牙周治療和牙周正.畸聯(lián)合治療的療效及相關(guān)影響因素,為臨床牙周病的治療提供指導(dǎo)。 [方淘選取輕、中度牙周病患者共20例,牙周治療前測量臨床牙周健康指數(shù)(松動度TM、牙周袋探診深度PD、臨床附著喪失CAL和探診出血BOP)、臨床牙冠長度及拍攝CBCT。經(jīng)過3個月牙周治療完成后測量以上指標(biāo)及拍攝CBCT。經(jīng)過評定牙周病進(jìn)入穩(wěn)定期,開始牙周正畸聯(lián)合治療。排齊整平消除咬牙合創(chuàng)傷約10個月后,再次測量以上指標(biāo)及拍攝CBCT。實驗中采用CBCT測量單純性牙周治療前和牙周正畸聯(lián)合治療前后牙槽嵴頂?shù)接匝拦琴|(zhì)界的距離、牙根長度及牙槽骨密度的變化,所得數(shù)值采用SPSS19.0軟件包進(jìn)行統(tǒng)計學(xué)分析。 [結(jié)果l 1、探診出血位點百分比：單純性牙周治療后,探診出血由55.9%±9.7%減小到45.0±10.7%。牙周正畸聯(lián)合治療后(T2)探診出血位點百分比減小到43.4%±11.4%。 2、松動度：單純性牙周治療后,松動度由治療前0.87±0.65減小到治療后0.31±0.47。牙周正畸聯(lián)合治療后(T2)增加到0.63±0.61。 3、牙周袋探診深度：單純性牙周治療后,牙周探診由治療前3.71±0.78mm減小到2.5±0.55mm,牙周正畸聯(lián)合治療后減小到2.23±0.55mm。 4、臨床附著喪失：單純性牙周治療后,由2.6±0.68mm減小到1.89±0.8lmm。牙周正畸聯(lián)合治療后,臨床附著喪失變化無統(tǒng)計學(xué)差異(p0.05)。 5、臨床牙冠長度：單純性牙周治療后,臨床牙冠長度由7.43±1.98mmm增加到牙周治療后(T1)7.8±1.95mm,牙周正畸聯(lián)合治療后繼續(xù)增加到8.48±1.81mm。 6、牙根長度：單純性牙周治療后及牙周正畸聯(lián)合治療后,牙根長度變化均無統(tǒng)計學(xué)差異(p0.05)。結(jié)果表明,牙周正畸聯(lián)合治療牙周病,未引起牙根吸收。 7、釉牙骨質(zhì)界到牙槽嵴頂距離：單純性牙周治療和牙周正畸聯(lián)合治療后釉牙骨質(zhì)界到牙槽嵴頂距離無統(tǒng)計學(xué)差異(p0.05),結(jié)果表明牙周正畸聯(lián)合治療牙周病未引起牙槽骨吸收。 8、牙槽骨密度：單純性牙周治療后,牙槽骨密度增加,牙槽嵴頂區(qū)由治療前333.10±47.77增加到345.52±53.23；根尖區(qū)由治療前310.26±45.56增加到327.25±76.37。牙周正畸聯(lián)合治療后,牙槽骨密度減小,牙槽嵴頂區(qū)由治療前345.52±53.23減小到318.64±62.26；根尖區(qū)由治療前327.25±76.37減小到276.35±39.29,下頜較上頜減小得多,中度牙周炎正畸治療后比輕度牙周炎正畸治療后牙槽骨密度減小得多。 9、薄扇型牙齦組和厚平型牙齦組牙周正畸聯(lián)合治療前后參數(shù)的變化：厚平型牙齦組牙周正畸聯(lián)合治療后探診深度減小0.28±0.47mmm,薄扇型牙齦組減小0.27±0.69mm,兩者減小差別不大。厚平型牙齦組治療前后臨床附著喪失變化無統(tǒng)計學(xué)意義,而薄扇型增加0.23±0.34mm。厚平型牙齦組牙周正畸聯(lián)合治療后探診出血位點數(shù)減少3.72±8.0%,薄扇型牙齦組減少1.68±6.2%。厚平型組松動度增加0.31±0.49,薄扇型組增加0.45±0.53。臨床牙冠長度厚平型組增加0.48±0.47mm,薄扇型組增加1.10±0.78mm。牙槽骨高度厚平型牙齦組變化無統(tǒng)計學(xué)意義,薄扇型增加3.1±0.71mm。牙槽骨密度厚平型組減小49.37±50.25,薄扇型組減小50.97+61.12。 [結(jié)論]1、牙周病經(jīng)牙周治療后,可以控制牙周病的進(jìn)一步發(fā)展,進(jìn)入靜止期。這時結(jié)合正畸治療,可以進(jìn)一步改善患者的牙周健康、提高咀嚼功能和改善美觀,且未引起牙根和牙槽骨的吸收。2、牙周正畸聯(lián)合治療后臨床牙冠長度增加,提示牙周正畸聯(lián)合治療牙周病,有可能引起牙齦萎縮的風(fēng)險,而且薄扇型牙齦比厚平型牙齦出現(xiàn)牙齦萎縮的風(fēng)險更高。3、單純性牙周治療后,牙槽骨密度增加,但是牙周正畸聯(lián)合治療后,牙槽骨密度減小,減小的程度與牙周病的嚴(yán)重程度有關(guān),下頜牙比上頜牙的牙槽骨密度減小得多,中度牙周病牙槽骨密度比輕度牙周病減小得多。
[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.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：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.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.5
【參考文獻(xiàn)】
相關(guān)期刊論文 前7條
1 管增娥;段銀忠;;兩種方法治療牙周病療效分析[J];實用診斷與治療雜志;2007年04期
2 袁建橋;張月蘭;劉林]，
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