Pandis N, Vlahopoulos K, Madianos P, Eliades T
Private practice, Corfu.
Eur J Orthod. 2007 Oct;29(5):471-6. doi: 10.1093/ejo/cjm042.
The purpose of this study was to evaluate the periodontal tissues of patients with mandibular fixed retention for long or short periods of time. A total of 64 individuals were selected for this study using the following inclusion criteria: long-term lingual fixed retention; identical type of lingual fixed retainer bonded with the same materials; no cavities, restorations, or fractures of the mandibular anterior teeth; absence of habits and occlusal interferences; and canine guidance bilaterally. The resultant sample comprised 32 patients (mean age 25 years) who had been in retention for a mean period of 9.65 years (range 9-11 years) and an equal number retained for a period between 3 and 6 months. Plaque, gingival, and calculus indices, probing pocket depth, marginal recession, and bone level at the mandibular six anterior teeth were recorded for both groups. Demographic, clinical, and radiographic data were investigated with conventional descriptive statistics. Comparisons of the different variables between the two participant groups (long- and short-term retention) were carried out using a Mann-Whitney test for indices (plaque, gingival, and calculus), and a Fisher's exact test (two sided) for the remaining variables. No significant difference was found with respect to the plaque and gingival indices and bone level between the two groups. The long-term group presented higher calculus accumulation, greater marginal recession, and increased probing depth (P < 0.05). The results of this study raise the question of the appropriateness of lingual fixed retainers as a standard retention plan for all patients regardless of their attitude to dental hygiene. They also emphasize the importance of individual variability and cautious application of retention protocols after a thorough consideration of issues related to the anatomy of tissues and oral hygiene.
本研究的目的是评估下颌固定保持器佩戴时间长短不同的患者的牙周组织情况。本研究共选取了64名个体,入选标准如下:长期舌侧固定保持;使用相同材料粘结相同类型的舌侧固定保持器;下颌前牙无龋洞、修复体或骨折;无不良习惯和咬合干扰;双侧双侧双侧为双侧尖牙引导。最终样本包括32名患者(平均年龄25岁),他们平均保持了9.65年(范围9至11年),另一组数量相同的患者保持时间为3至6个月。记录两组下颌六颗前牙的菌斑、牙龈和牙石指数、探诊袋深度、边缘退缩和骨水平。采用传统描述性统计方法对人口统计学、临床和影像学数据进行研究。使用Mann-Whitney检验比较两组参与者(长期和短期保持)之间不同指数变量(菌斑、牙龈和牙石),其余变量采用Fisher精确检验(双侧)。两组之间在菌斑、牙龈指数和骨水平方面未发现显著差异。长期保持组牙石堆积更多、边缘退缩更大、探诊深度增加(P<0.05)。本研究结果提出了一个问题,即舌侧固定保持器作为所有患者的标准保持方案是否合适,而不考虑他们对口腔卫生的态度。研究结果还强调了个体差异的重要性,以及在充分考虑与组织解剖结构和口腔卫生相关问题后谨慎应用保持方案的重要性。