Gürgan Cem A, Işeri Haluk, Kişnişci Reha
Department of Periodontology, School of Dentistry, University of Ankara, Turkey.
Eur J Orthod. 2005 Aug;27(4):324-32. doi: 10.1093/ejo/cji011.
The aim of this clinical prospective study was to evaluate the alterations that occurred in the gingival dimensions of canine teeth following dentoalveolar distraction (DAD) during a 12 month follow-up period.The study sample comprised 36 maxillary canines of 18 growing or adult subjects with a mean age of 16.94 years (13.08-25.58 years) at the start of treatment. Full retraction of the canines was achieved in 10.36 +/- 1.93 days (range 8-14 days) at a rate of 0.8 mm/day using a custom-made intraoral rigid tooth-borne distraction device. Before surgery (pre-DAD), immediately after removal of the device (post-DAD), and at 1, 6, and 12 months post-DAD, the plaque index (PI), gingival index (GI), pocket depth (PD) and width of keratinized gingiva were recorded and the width of attached gingiva was calculated. The alterations in clinical measurements among different evaluation periods were analysed by Friedman and repeated measure ANOVA tests. There were significant differences between pre- and post-DAD for PD measurements for all sites, with the highest at the distal site. The palatal sites likewise showed significant differences at the 1, 6, and 12 month follow-up periods compared with the post-DAD period. The buccal sites showed no significant changes at any time point. The width of keratinized gingiva also showed no significant change during the follow-up period, while the width of attached gingiva was significant only between the pre- and post-DAD periods (P < 0.01). On the basis of the above findings, it could be concluded that DAD is an innovative technique with no unfavourable long-term effects on the gingival tissues of rapidly retracted canine teeth.
这项临床前瞻性研究的目的是评估在12个月的随访期内,牙牙槽骨牵张术(DAD)后犬齿牙龈尺寸发生的变化。研究样本包括18名生长发育期或成年受试者的36颗上颌犬齿,治疗开始时的平均年龄为16.94岁(13.08 - 25.58岁)。使用定制的口腔内刚性牙支持式牵张装置,以每天0.8毫米的速度,在10.36±1.93天(范围8 - 14天)内实现了犬齿的完全内收。在手术前(DAD前)、拆除装置后即刻(DAD后)以及DAD后1、6和12个月,记录菌斑指数(PI)、牙龈指数(GI)、牙周袋深度(PD)和角化龈宽度,并计算附着龈宽度。通过Friedman检验和重复测量方差分析测试分析不同评估期临床测量值的变化。所有部位PD测量值在DAD前后有显著差异,远中部位差异最大。与DAD后相比,腭侧部位在1、6和12个月随访期也显示出显著差异。颊侧部位在任何时间点均无显著变化。随访期间角化龈宽度也无显著变化,而附着龈宽度仅在DAD前后有显著差异(P < 0.01)。基于上述发现,可以得出结论,DAD是一种创新技术,对快速内收的犬齿牙龈组织没有不利的长期影响。