正畸—牙周聯(lián)合治療中重度牙周炎早期齦溝液骨鈣素水平的研究
發(fā)布時(shí)間：2019-07-06 15:38
【摘要】：牙周病的病因除菌斑微生物、局部刺激因素及自身免疫反應(yīng)造成的牙周組織破壞以外,過大的咬合力、異常的咬合力方向、早接觸、牙齒排列不齊等咬合問題都能加重牙周組織的破壞。當(dāng)牙周組織被破壞,牙槽骨高度降低,牙周支持力不足,牙齒特別是前牙會(huì)出現(xiàn)病理性牙移位,其中以前牙的扇形漂移為主,病理性的牙移位又會(huì)進(jìn)一步使牙承擔(dān)咬合創(chuàng)傷,形成惡性循環(huán),給患者造成心理和生理上的雙重影響。 牙周病是由細(xì)菌感染引發(fā)的疾病的觀點(diǎn)已得到了人們的公認(rèn)。牙周病的發(fā)展過程中,機(jī)體會(huì)針對(duì)病原微生物發(fā)生一系列免疫反應(yīng),同時(shí)會(huì)使局部的組織發(fā)生病理性改變。這些變化的產(chǎn)物會(huì)在齦溝液中表現(xiàn)出來。因此,通過對(duì)齦溝液中的宿主反應(yīng)產(chǎn)物、細(xì)菌產(chǎn)物以及組織破壞產(chǎn)物中尋找牙周病各時(shí)期的標(biāo)志是牙周病學(xué)研究的一個(gè)重要方面。 骨鈣素是成骨細(xì)胞產(chǎn)生并分泌的一種激素樣多肽,它可以激活前破骨細(xì)胞,從而加速誘導(dǎo)骨吸收細(xì)胞的分化,促進(jìn)骨的吸收速率,是代表骨代謝速率瞬間變化的一個(gè)特異且靈敏的生化指標(biāo)。 齦溝液中的骨鈣素水平反映了局部牙槽骨的變化和炎癥程度。因此,通過對(duì)齦溝液中骨鈣素水平的定量分析,可以檢測(cè)牙周炎患者的牙周組織受到正畸力后的反應(yīng),同時(shí)探究正畸治療對(duì)于牙槽骨的改建情況,為臨床治療提供一定的指導(dǎo)。 目的：通過檢測(cè)中重度牙周炎患者正畸治療早期牙周臨床指標(biāo)以及首次加力后齦溝液中骨鈣素水平的變化,研究其變化規(guī)律,為監(jiān)控正畸治療早期的牙周組織反應(yīng)提供實(shí)驗(yàn)依據(jù)。 方法：選擇15例中重度牙周炎患者為實(shí)驗(yàn)組,在牙周治療前、正畸治療前以及接受正畸治療后1個(gè)月、2個(gè)月分別檢測(cè)牙周臨床指標(biāo)(菌斑指數(shù),齦溝出血指數(shù),牙周袋探診深度),并用電化學(xué)發(fā)光法檢測(cè)牙周治療前、正畸治療前以及首次加力后1h、1d、2d、7d齦溝液中骨鈣素水平,同時(shí)選擇對(duì)照組15例牙周健康的正畸患者,對(duì)照組于正畸加力前記錄牙周臨床指標(biāo),并于正畸加力前、加力后1個(gè)月、2個(gè)月檢測(cè)齦溝液中骨鈣素水平。 結(jié)果：實(shí)驗(yàn)組患者通過牙周治療,各項(xiàng)牙周檢測(cè)指標(biāo)均低于治療前水平(P0.05),實(shí)驗(yàn)組患者在正畸治療過程中各項(xiàng)牙周臨床指標(biāo)與正畸治療前無明顯差異(P0.05)；實(shí)驗(yàn)組患者正畸加力后骨鈣素水平較加力前明顯升高(P0.05),24h達(dá)到峰值,7d降至加力前水平；對(duì)照組患者骨鈣素水平加力后明顯升高,24h達(dá)到峰值,7d降至加力前水平；實(shí)驗(yàn)組與對(duì)照組骨鈣素水平的變化規(guī)律一致。 結(jié)論：齦溝液中骨鈣素的濃度能夠反映牙周組織的炎癥程度,參與牙槽骨的改建,通過正畸—牙周聯(lián)合治療的方法治療中重度牙周炎可以改善患者牙周狀況,牙周炎并未因正畸治療而加重。
[Abstract]:In addition to plaque microorganisms, local stimulants and autoimmune reactions, excessive occlusal force, abnormal occlusal force direction, early contact, uneven arrangement of teeth and other occlusal problems can aggravate the destruction of periodontal tissue. When periodontal tissue is destroyed, alveolar bone height is reduced, periodontal support is insufficient, teeth, especially anterior teeth, will appear pathological tooth displacement, in which the fan drift of anterior teeth, pathological tooth displacement will further make teeth bear occlusal trauma, forming a vicious circle, resulting in dual psychological and physiological effects on patients. The idea that periodontal disease is caused by bacterial infection has been recognized. In the development of periodontal disease, the body will have a series of immune reactions against pathogenic microorganisms, and at the same time, it will cause pathological changes in local tissues. The products of these changes are shown in the gingival crevicular fluid. Therefore, it is an important aspect of periodontal disease research to find out the signs of periodontitis in the host reaction products, bacterial products and tissue destruction products in the gum crevicular fluid. Osteocalcin is a hormone-like polypeptide produced and secreted by osteoblasts, which can activate preosteoclasts and accelerate the differentiation of bone resorption cells and promote bone resorption rate. it is a specific and sensitive biochemical index that represents the transient change of bone metabolism rate. The level of osteocalcin in gingival crevicular fluid reflects the changes of local alveolar bone and the degree of inflammation. Therefore, through the quantitative analysis of osteocalcin level in gingival crevicular fluid, we can detect the response of periodontal tissue to orthodontic force in patients with periodontitis, and explore the reconstruction of alveolar bone by orthodontic treatment, so as to provide some guidance for clinical treatment. Objective: to study the changes of osteocalcin in gum crevicular fluid after orthodontic treatment in patients with moderate and severe periodontitis, and to provide experimental basis for monitoring periodontal tissue response in the early stage of orthodontic treatment by detecting the clinical indexes of periodontitis in the early stage of orthodontic treatment and the changes of osteocalcin level in gingival crevicular fluid after the first force. Methods: fifteen patients with moderate and severe periodontitis were selected as experimental group. Periodontal clinical indexes (plaque index, gingival crevicular bleeding index, periodontal bag probing depth) were measured before periodontal treatment, before orthodontic treatment and 1 month and 2 months after orthodontic treatment, and osteocalcin levels in gingival crevicular fluid were measured before periodontal treatment, before orthodontic treatment and 1 day, 2 days and 7 days after orthodontic treatment. At the same time, 15 healthy orthodontic patients in the control group were selected. The periodontal clinical indexes were recorded before the orthodontic force, and the osteocalcin level in the gingival crevicular fluid was measured before the orthodontic force, 1 month and 2 months after the orthodontic force. Results: the periodontal test indexes of the experimental group were lower than those before orthodontic treatment (P 0.05), but there was no significant difference between the experimental group and the orthodontic treatment (P 0.05). The osteocalcin level of the experimental group was significantly higher than that before orthodontic treatment (P 0.05), reached the peak at 24 h, and decreased to the pre-orthodontic level at 7 d. The osteocalcin level in the control group increased significantly after adding strength, reached the peak at 24 h and decreased to the pre-loading level on the 7th day, and the change of osteocalcin level in the experimental group was consistent with that in the control group. Conclusion: the concentration of osteocalcin in gingival crevicular fluid can reflect the degree of inflammation in periodontal tissue and participate in the reconstruction of alveolar bone. The treatment of moderate and severe periodontitis by orthodontic and periodontal treatment can improve the periodontal condition of patients, and periodontitis is not aggravated by orthodontic treatment.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.5
本文編號(hào)：2511131
[Abstract]:In addition to plaque microorganisms, local stimulants and autoimmune reactions, excessive occlusal force, abnormal occlusal force direction, early contact, uneven arrangement of teeth and other occlusal problems can aggravate the destruction of periodontal tissue. When periodontal tissue is destroyed, alveolar bone height is reduced, periodontal support is insufficient, teeth, especially anterior teeth, will appear pathological tooth displacement, in which the fan drift of anterior teeth, pathological tooth displacement will further make teeth bear occlusal trauma, forming a vicious circle, resulting in dual psychological and physiological effects on patients. The idea that periodontal disease is caused by bacterial infection has been recognized. In the development of periodontal disease, the body will have a series of immune reactions against pathogenic microorganisms, and at the same time, it will cause pathological changes in local tissues. The products of these changes are shown in the gingival crevicular fluid. Therefore, it is an important aspect of periodontal disease research to find out the signs of periodontitis in the host reaction products, bacterial products and tissue destruction products in the gum crevicular fluid. Osteocalcin is a hormone-like polypeptide produced and secreted by osteoblasts, which can activate preosteoclasts and accelerate the differentiation of bone resorption cells and promote bone resorption rate. it is a specific and sensitive biochemical index that represents the transient change of bone metabolism rate. The level of osteocalcin in gingival crevicular fluid reflects the changes of local alveolar bone and the degree of inflammation. Therefore, through the quantitative analysis of osteocalcin level in gingival crevicular fluid, we can detect the response of periodontal tissue to orthodontic force in patients with periodontitis, and explore the reconstruction of alveolar bone by orthodontic treatment, so as to provide some guidance for clinical treatment. Objective: to study the changes of osteocalcin in gum crevicular fluid after orthodontic treatment in patients with moderate and severe periodontitis, and to provide experimental basis for monitoring periodontal tissue response in the early stage of orthodontic treatment by detecting the clinical indexes of periodontitis in the early stage of orthodontic treatment and the changes of osteocalcin level in gingival crevicular fluid after the first force. Methods: fifteen patients with moderate and severe periodontitis were selected as experimental group. Periodontal clinical indexes (plaque index, gingival crevicular bleeding index, periodontal bag probing depth) were measured before periodontal treatment, before orthodontic treatment and 1 month and 2 months after orthodontic treatment, and osteocalcin levels in gingival crevicular fluid were measured before periodontal treatment, before orthodontic treatment and 1 day, 2 days and 7 days after orthodontic treatment. At the same time, 15 healthy orthodontic patients in the control group were selected. The periodontal clinical indexes were recorded before the orthodontic force, and the osteocalcin level in the gingival crevicular fluid was measured before the orthodontic force, 1 month and 2 months after the orthodontic force. Results: the periodontal test indexes of the experimental group were lower than those before orthodontic treatment (P 0.05), but there was no significant difference between the experimental group and the orthodontic treatment (P 0.05). The osteocalcin level of the experimental group was significantly higher than that before orthodontic treatment (P 0.05), reached the peak at 24 h, and decreased to the pre-orthodontic level at 7 d. The osteocalcin level in the control group increased significantly after adding strength, reached the peak at 24 h and decreased to the pre-loading level on the 7th day, and the change of osteocalcin level in the experimental group was consistent with that in the control group. Conclusion: the concentration of osteocalcin in gingival crevicular fluid can reflect the degree of inflammation in periodontal tissue and participate in the reconstruction of alveolar bone. The treatment of moderate and severe periodontitis by orthodontic and periodontal treatment can improve the periodontal condition of patients, and periodontitis is not aggravated by orthodontic treatment.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.5
【參考文獻(xiàn)】
相關(guān)期刊論文 前9條
1 施捷,周彥恒,傅民魁;牙周炎致錯(cuò)位前牙正畸牙周聯(lián)合治療的CT研究[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2003年06期
2 吳嬰;;放射免疫分析與電化學(xué)發(fā)光法測(cè)定血清FT_3、FT_4結(jié)果分析[J];放射免疫學(xué)雜志;2010年01期
3 張軍瑞;陳健;劉仲明;;電化學(xué)發(fā)光免疫檢測(cè)技術(shù)研究進(jìn)展[J];分析化學(xué);2010年08期
4 呂學(xué)琴;馬雅靜;;電化學(xué)發(fā)光免疫分析法與酶聯(lián)免疫吸附、膠體金測(cè)定低濃度HBsAg的效果評(píng)價(jià)[J];國際檢驗(yàn)醫(yī)學(xué)雜志;2013年09期
5 楊宗橋;付敏;付善書;;電化學(xué)發(fā)光法與放射免疫法測(cè)定血清甲胎蛋白的比較[J];檢驗(yàn)醫(yī)學(xué)與臨床;2012年05期
6 侯晉,段小紅,吳軍正,汪衛(wèi)國;持續(xù)性靜壓力對(duì)成骨樣細(xì)胞MC3T3-E1生物學(xué)特性的影響[J];臨床口腔醫(yī)學(xué)雜志;2004年01期
7 馬永勝;;放射免疫分析與電化學(xué)發(fā)光法檢測(cè)血清HCG效果研究[J];大家健康(學(xué)術(shù)版);2013年21期
8 孫靖臨,孟煥新;齦溝液中骨鈣素含量與牙周炎的關(guān)系[J];中華口腔醫(yī)學(xué)雜志;2002年05期
9 陳國軍;;電化學(xué)發(fā)光免疫分析法和酶聯(lián)免疫吸附法檢測(cè)人類免疫缺陷病毒抗體的效果分析[J];中國醫(yī)藥指南;2012年36期
，本文編號(hào)：2511131
本文鏈接：http://sikaile.net/yixuelunwen/kouq/2511131.html
最近更新
教材專著
