口腔医学研究

口腔医学研究 ›› 2018, Vol. 34 ›› Issue (11): 1223-1227.DOI: 10.13701/j.cnki.kqyxyj.2018.11.018

• 口腔正畸学研究 • 上一篇    下一篇

三种正畸矫治器对牙周炎症及龈沟液炎性因子影响的长期研究

左志刚1, 李洪发1, 徐津2, 郑朝1, 武杰1, 刘大勇3*   

  1. 1. 天津医科大学口腔医院正畸科 天津 300070;
    2. 天津医科大学口腔医院牙周科 天津 300070;
    3. 天津医科大学口腔医院牙体牙髓科 天津 300070
  • 收稿日期:2018-04-09 出版日期:2018-11-28 发布日期:2018-11-23
  • 通讯作者: 刘大勇,E-mail:dayongliutj@163.com
  • 作者简介:左志刚(1982~ ),男,河北人,主治医师,硕士,主要从事正畸牙齿移动和骨改建相关研究。
  • 基金资助:
    国家自然科学基金(编号:81371109)

Long-term Effects of Three Orthodontic Appliances on Periodontal Inflammation and Inflammatory Factors in Gingival Crevicular Fluid

ZUO Zhi-gang1, LI Hong-fa1, XU Jin2, ZHENG Zhao1, WU Jie1, LIU Da-yong3*   

  1. 1. Department of Orthodontics, Stomatological Hospital of Tianjin Medical University, Tianjin 300070, China;
    2. Department of Periodontology, Stomatological Hospital of Tianjin Medical University, Tianjin 300070, China;
    3. Department of Endodontics, Stomatological Hospital of Tianjin Medical University, Tianjin 300070, China.
  • Received:2018-04-09 Online:2018-11-28 Published:2018-11-23

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摘要： 目的:比较无托槽隐形矫形器、自锁托槽和传统金属托槽矫治器对患者口腔卫生的长期影响。方法:选择2015年3月~2015年12月我院正畸科就诊并行矫治的30例牙列拥挤患者,平均年龄(21.20±2.15)岁。患者彻底清理牙菌斑与牙结石后分别使用隐形矫治器(Invisalign,隐适美)、自锁托槽矫治器(DAMON Q)、传统金属托槽矫治器(Victory Series),在治疗开始后0、1、3、6、12、18、24个月采集患者牙龈指数、龈沟出血指数、牙石指数、软垢指数,并测量龈沟液中IL-1β和TNF-α的浓度。结果:基线时各组的性别、年龄、安氏分类与牙周指数差别均无统计学意义(P＞0.05)。治疗3个月后,各组的牙周指数均较基线时有所上升(P＜0.05),除软垢指数外其他指数均未发现明显差异(P＞0.05),6~12个月时自锁托槽与传统托槽组的牙周指数显著高于隐形组(P＜0.05)。18个月后,3组的牙龈指数与龈沟出血指数差别无统计学意义(P＞0.05)。0~9月3组的IL-1β和TNF-α表达均明显上升(P＜0.05),9个月后隐形组的表达趋于稳定,差别无统计学意义(P＞0.05),自锁托槽组、传统托槽组9~12月的表达最高,随后逐步下降,到24个月时与隐形组差别无统计学意义(P＞0.05)。结论:本研究观察了3种矫治器对口腔卫生的长期影响,证实无托槽隐形矫治器在矫正前期有助于口腔卫生保持,而正畸开始18个月后,3种矫治器对口腔卫生的影响差别不明显。

关键词: 正畸, 无托槽隐形矫治器, 隐适美, 自锁托槽, 牙周指数, 炎性因子

Abstract: Objective: To compare the long-term effects of orthodontic brackets without brackets, self-ligating brackets, and traditional metal bracket appliances on patients' oral hygiene. Methods: 30 patients with orthodontics treatment in our hospital from March 2015 to December 2015 were selected. The average age was 21.20±2.15 years old. After the patient completely cleaned up plaque and calculus, Invisalign, DAMON Q, and the traditional metal bracket appliance (Victory Series) were used. After 1, 3, 6, 12, 18, and 24 months, the patients' gingival index, sulcus bleeding index, calculus index, debris index, and gingival crevicular fluid IL-1β and TNF-α were measured. Results: There was no significant difference in gender, age, Angle class distinction, and periodontal index between the groups (P>0.05). After 3 months of treatment, the periodontal index of each group increased compared with baseline (P<0.05). No significant difference was found except for the debris index (P>0.05). From 6 to 12 months, The periodontal index of the lock bracket and the traditional bracket group was significantly higher than that of the invisible group (P<0.05). After 18 months, there was no significant difference in the gin－ gival index and sulcus bleeding index between three groups (P>0.05). The expression of IL-1β and TNF-α in the three groups from January to September was significantly increased (P<0.05). After 9 months, the expression of the invisible group tended to be stable, and the difference was not statistically significant (P>0.05). The expressions of the trough group and the traditional bracket group were higher from September to December and then decreased gradually. There was no significant difference between the trough and the invisible group after 24 months (P>0.05). Conclusion: This study observed the long-term effects of three appliances on oral hygiene, confirming that the invisible appliance with or without brackets contributes to oral hygienic preservation during the initial correction period. However, after 18 months of orthodontic treatment, the effect is not obvious.

Key words: Orthodontics, Invisible appliance, Invisalign, Self-ligating brackets, Periodontal index, Inflammatory factors