Melsen B, Agerbaek N, Eriksen J, Terp S
Royal Dental College, Institute of Orthodontics, Denmark.
Am J Orthod Dentofacial Orthop. 1988 Aug;94(2):104-16. doi: 10.1016/0889-5406(88)90358-7.
The present study was performed to investigate the tissue reaction related to orthodontic intrusion of teeth with a reduced periodontium and further to evaluate the influence of oral hygiene on this reaction. In each of five Macaca fascicularis monkeys, periodontal tissue breakdown was induced around the premolars and the upper incisors by placing orthodontic elastic ligatures around the teeth. The breakdown procedure was continued until a minimum of four pockets could be measured on probing. Following removal of the elastics, a flap operation was performed. The pocket epithelium and granulation tissue were excised. During the surgical procedure, a notch was placed just above the bone. The teeth were divided postoperatively into four groups according to treatment: group 1 = flap operation, no oral hygiene program; group 2 = flap operation plus oral hygiene program three times per week; group 3 = flap operation plus intrusion, no oral hygiene program; and group 4 = flap operation plus intrusion plus oral hygiene. Groups 3 and 4 were subdivided into two observation periods. A total of 60 teeth corresponding to 120 approximate surfaces were studied. The animals were killed with perfusion; histologic sections were produced and stained alternatively with hematoxylin and eosin, and van Gieson's solution. The histologic analysis showed that new cementum formation and new collagen attachment were observed following the surgical procedure if the oral hygiene was maintained, but also demonstrated that the intrusion improved the quantity of new attachment if carried out under healthy conditions. New attachment was a consistent finding in group 4, but varied from 0.7 to 2.3 mm. In case of intrusion without oral hygiene, the results varied from moderate new attachment to an aggravation of the periodontal bone loss. On the basis of the results presented here, the combination of periodontal treatment and orthodontic intrusion seems to be a method by which improvement of the periodontal condition can be obtained, provided that both the biomechanical force system and the oral hygiene are kept under control.
本研究旨在调查与牙周组织减少的牙齿正畸压低相关的组织反应，并进一步评估口腔卫生对该反应的影响。在五只食蟹猴中，通过在牙齿周围放置正畸弹性结扎丝，在前磨牙和上颌切牙周围诱导牙周组织破坏。破坏过程持续进行，直到探诊时至少能测量到四个牙周袋。去除结扎丝后，进行翻瓣手术。切除牙周袋上皮和肉芽组织。在手术过程中，在骨上方做一个切口。术后根据治疗方法将牙齿分为四组：第1组 = 翻瓣手术，无口腔卫生计划；第2组 = 翻瓣手术加每周三次口腔卫生计划；第3组 = 翻瓣手术加压低，无口腔卫生计划；第4组 = 翻瓣手术加压低加口腔卫生。第3组和第4组再细分为两个观察期。共研究了对应于120个近似表面的60颗牙齿。通过灌注处死动物；制作组织学切片，并用苏木精和伊红以及范吉森溶液交替染色。组织学分析表明，如果保持口腔卫生，手术后可观察到新牙骨质形成和新胶原附着，而且还表明在健康条件下进行压低可改善新附着的量。新附着在第4组中是一个一致的发现，但范围为0.7至2.3毫米。在没有口腔卫生的压低情况下，结果从中度新附着到牙周骨丧失加重不等。根据此处给出的结果，牙周治疗和正畸压低相结合似乎是一种可以改善牙周状况的方法，前提是生物力学力系统和口腔卫生都得到控制。
