骨缺损的再生治疗与正畸牙齿移动相结合。

Regenerative therapy of osseous defects combined with orthodontic tooth movement.

作者信息

Attia Mai Shafik, Shoreibah Eatemad A, Ibrahim Samir A, Nassar Hamdy A

机构信息

Department of Oral Medicine, Periodontology, Oral Diagnosis and Radiology, Faculty of Dental Medicine-Girls' Branch, Al Azhar University, Cairo, Egypt.

出版信息

J Int Acad Periodontol. 2012 Jan;14(1):17-25.

PMID:22479985

Abstract

BACKGROUND

Combined orthodontic/regenerative therapy can resolve complex clinical problems and enhance bone formation. The purpose of this study was to evaluate the effectiveness of different times of initiating the active orthodontic tooth movement on the regenerative potential of the intrabony defects.

METHODS

Fifteen adult patients with at least three intrabony defects and malocclusion were included. A total of 45 defects were divided into three groups and treated in a split mouth design. The defects were treated with combined orthodontic regenerative therapy with immediate application of orthodontic tooth movement or delayed application of orthodontic tooth movement (test groups) or with regenerative therapy alone (control group). The following hard and soft tissue measurements were recorded prior to initial surgery and after six months and one year: probing depth (DP), clinical attachment level (CAL), bone density (BD) and bone fill (BF).

RESULTS

The most significant results were greater for the group treated with combined orthodontic/regenerative therapy with immediate orthodontic tooth movement. The measures for PD reduction and clinical attachment level gain were 4 +/- 0.8 and 5.1 +/- 1.4 mm respectively for immediate application of orthodontic tooth movement, and 3.7 +/- 0.9 and 4.3 +/- 0.6 mm with delayed application of orthodontic movement two months later. Moreover, immediate orthodontic tooth movement showed the most significant increase in bone density and bone fill, which reached 74.2 +/- 14.2 and 3.7 +/- 1.1 mm respectively at the end of the study period.

CONCLUSION

This study evaluated the effect of orthodontic tooth movement on enhancement of periodontal regenerative outcomes. The results demonstrated that a significant improvement in clinical and radiographic parameters was observed. When comparing the different groups, a statistically significant difference was found with immediate application of orthodontic tooth movement.

摘要

背景

正畸/再生联合治疗可解决复杂的临床问题并促进骨形成。本研究的目的是评估不同时间开始进行正畸牙齿移动对骨内缺损再生潜力的有效性。

方法

纳入15例患有至少三处骨内缺损且有咬合不正的成年患者。总共45处缺损被分为三组，并采用分口设计进行治疗。这些缺损采用正畸再生联合治疗，立即进行正畸牙齿移动或延迟进行正畸牙齿移动（试验组），或仅采用再生治疗（对照组）。在初次手术前、六个月和一年后记录以下软硬组织测量值：探诊深度（DP）、临床附着水平（CAL）、骨密度（BD）和骨填充（BF）。

结果

正畸/再生联合治疗且立即进行正畸牙齿移动的组取得的结果最为显著。立即进行正畸牙齿移动时，探诊深度减少和临床附着水平增加的测量值分别为4±0.8和5.1±1.4毫米，两个月后延迟进行正畸移动时分别为3.7±0.9和4.3±0.6毫米。此外，立即进行正畸牙齿移动时骨密度和骨填充增加最为显著，在研究期末分别达到74.2±14.2和3.7±1.1毫米。