Charles Clifford Dental Hospital, Sheffield, United Kingdom.
Am J Orthod Dentofacial Orthop. 2013 Aug;144(2):176-84. doi: 10.1016/j.ajodo.2013.03.016.
The aim of this study was to investigate differences in the periodontal outcomes of palatally displaced canines (PDC) exposed with either an open or a closed surgical technique.
A multicenter, randomized controlled trial was undertaken in 3 hospitals in the United Kingdom, involving 2 parallel groups. Patients with unilateral PDC were randomly allocated to receive either an open or a closed surgical exposure. Periodontal health was assessed 3 months after removal of fixed appliances. Parameters measured included clinical attachment levels, recession, alveolar bone levels, and clinical crown height.
Data from 62 participants (closed, 29; open, 33) were analyzed. There was no difference between PDC exposed with an open vs a closed surgical technique (mean difference, 0.1 mm; 95% confidence interval [CI], -0.2-0.5). There was, however, a statistical difference in mean attachment loss between the operated and unoperated (contralateral) canines (mean difference, 0.5 mm; 96% CI, 0.4-0.7; P <0.001). Twenty of the 62 subjects had some recession on the palatal aspect of the operated canine, whereas only 4 subjects had some visible root surface on the palatal aspect on the unoperated side (P = 0.001).
There is a periodontal impact when a unilateral PDC is exposed and aligned. This impact is small and unlikely to have clinical relevance in the short term; however, the long-term significance is unknown. When the open and closed techniques were compared, no difference in periodontal health was found.
本研究旨在探讨使用开放式或闭合式手术技术暴露腭向错位牙(PDC)的牙周结果差异。
在英国的 3 家医院进行了一项多中心、随机对照试验,涉及 2 个平行组。将单侧 PDC 的患者随机分配接受开放式或闭合式手术暴露。固定矫治器去除后 3 个月评估牙周健康状况。测量的参数包括临床附着水平、牙龈退缩、牙槽骨水平和临床冠高。
对 62 名参与者(闭合组 29 名,开放组 33 名)的数据进行了分析。开放式与闭合式手术技术暴露 PDC 之间无差异(平均差异 0.1mm;95%置信区间 [CI],-0.2-0.5)。然而,在手术和未手术(对侧)犬牙之间,附着丧失的平均差异存在统计学意义(平均差异 0.5mm;96%CI,0.4-0.7;P<0.001)。62 名受试者中有 20 名在手术犬牙的腭侧有一定程度的牙龈退缩,而只有 4 名受试者在未手术侧的腭侧有可见的根面(P=0.001)。
单侧 PDC 暴露和排齐会对牙周产生影响。这种影响很小,短期内可能没有临床意义;然而,长期意义尚不清楚。当比较开放式和闭合式技术时,在牙周健康方面没有发现差异。