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[侵袭性牙周炎伴错牙合畸形患者牙周正畸治疗长期疗效的相关影响因素]

[Influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis and malocclusion].

作者信息

Shen X, Shi J, Xu L, Meng H X

机构信息

Center of Stomatology, China-Japan Friendship Hospital, Beijing 100029, China.

Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2020 Feb 9;55(2):86-92. doi: 10.3760/cma.j.issn.1002-0098.2020.02.003.

Abstract

To investigate the influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP). A retrospective analysis was conducted in 25 AgP patients, who have received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology. Changes in the ratio of the residual alveolar bone height (RBH) was measured at three time points: baseline (T0), post orthodontic treatment (T1), and the last re-visit 3 years after orthodontic treatment (T2). Root abnormity was evaluated by observing periapical radiographs, and its relationship with alveolar bone loss after orthodontic treatment was analyzed. A multi-level analysis on factors related to the clinical outcome (alveolar bone height change) was performed. Totally 693 teeth of 25 patients at T0 and T1 and 368 teeth of 14 patients at T2 were investigated. During the periodontal-orthodontic treatment, the RBH was mainly influenced by root abnormity (estimation value -2.392), tooth position (estimation value for upper teeth vs. lower teeth 3.139, and anterior teeth vs. posterior teeth -3.469) and the baseline RBH at T0 (estimation value -0.391) (0.05). Teeth with root abnormity, teeth in mandibular and anterior area, and teeth with higher RBH showed less change in T1-T0 RBH values. In the long-term follow-up, RBH was mainly influenced by tooth position (estimation value for upper teeth vs. lower teeth 3.735, and anterior teeth vs. posterior teeth -5.318), the baseline RBH and probing depth (PD) at T0. Teeth in mandibular and anterior area, teeth with higher RBH (estimation value -0.498) and PD (estimation value -1.594) (0.05) showed less change in T0-T2 RBH values. During orthodontic treatment, teeth with abnormal root, lower teeth, anterior teeth, and teeth with high RBH were unfavorable factors for bone gain. In the long-term observation, lower teeth, anterior teeth, teeth with high RBH and PD at first visit were unfavorable factors for bone gain.

摘要

探讨侵袭性牙周炎(AgP)患者牙周正畸治疗长期疗效的相关影响因素。对25例在北京大学口腔医学院接受牙周正畸治疗的AgP患者进行回顾性分析。在三个时间点测量残余牙槽骨高度(RBH)比值的变化:基线期(T0)、正畸治疗后(T1)以及正畸治疗后3年的最后一次复诊(T2)。通过观察根尖片评估牙根异常情况,并分析其与正畸治疗后牙槽骨丧失的关系。对与临床结局(牙槽骨高度变化)相关的因素进行多水平分析。共调查了25例患者在T0和T1时的693颗牙齿以及14例患者在T2时的368颗牙齿。在牙周正畸治疗期间,RBH主要受牙根异常(估计值-2.392)、牙位(上牙与下牙的估计值3.139,前牙与后牙的估计值-3.469)以及T0时的基线RBH(估计值-0.391)影响(P<0.05)。牙根异常的牙齿、下颌及前部区域的牙齿以及RBH较高的牙齿在T1-T0的RBH值变化较小。在长期随访中,RBH主要受牙位(上牙与下牙的估计值3.735,前牙与后牙的估计值-5.318)、T0时的基线RBH和探诊深度(PD)影响。下颌及前部区域的牙齿、RBH较高(估计值-0.498)和PD较高(估计值-1.594)的牙齿在T0-T2的RBH值变化较小(P<0.05)。在正畸治疗期间,牙根异常的牙齿、下牙、前牙以及RBH较高的牙齿是骨增量的不利因素。在长期观察中,下牙、前牙、初次就诊时RBH较高和PD较高的牙齿是骨增量的不利因素。

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