Private Practice Via Baldassarre Nardis, 67100 L'Aquila, Italy.
Department of Periodontology, School of Dentistry, Universidad Complutense, 28040 Madrid, Spain.
Int J Environ Res Public Health. 2020 Sep 9;17(18):6578. doi: 10.3390/ijerph17186578.
The aim of this study was to evaluate the changes in periodontal parameters solely using free gingival grafts during orthodontic treatment without any oral hygiene re-enforcement.
A total of 19 patients underwent periodontal examination before orthodontic treatment. Patients received oral hygiene instruction and professional hygiene therapy. Where needed; full periodontal treatment was completed. Only periodontally stable patients were included in the study. Periodontal indices and keratinized tissue were recorded at time 0 (T0) (delivery of orthodontic appliances), and at three months (T1) during orthodontic therapy; when surgery was performed. At T1; orthodontically treated sites with minimum keratinized tissue (≤1 mm) received a free gingival graft to enhance the band of keratinized tissue. At three months after surgery (T2), new measurements were recorded. The orthodontics-treated sites after three months (T1) were used as control. The same sites were used as a test three months after mucogingival correction (T2). Between T1 and T2; orthodontics was suspended; no professional oral hygiene was performed; and no additional oral hygiene instructions were given to the patient. No oral hygiene procedures were administered for 15 months (T3), when the final recordings were taken.
The results showed that there was a worsening of gingival index (GI) and plaque index (PI) of the treated sites between T0 and T1 during initial orthodontics treatment; whereas there was an improvement of the gingival inflammation at T2 when compared with T1. At T2; there was also a statistically significant improvement in GI and PI compared with T0. A T3 improvement in periodontal parameters was sustained. A non-parametric test (Wilcoxon signed-rank test) was used for statistical analysis.
Augmentation of the width of keratinized gingiva; as the sole treatment; favors the improvement of GI and PI during orthodontic therapy.
本研究旨在评估仅在正畸治疗中使用游离牙龈移植而不进行任何口腔卫生强化的情况下牙周参数的变化。
19 名患者在正畸治疗前接受牙周检查。患者接受口腔卫生指导和专业的洁治治疗。如有需要，完成全口牙周治疗。仅纳入牙周稳定的患者。在 0 时间（T0）（正畸矫治器交付）、正畸治疗期间的三个月（T1）和手术时记录牙周指数和角化组织。在 T1 时，接受游离牙龈移植以增强角化组织带的正畸治疗部位，角化组织最小（≤1mm）。术后三个月（T2）记录新的测量值。术后三个月（T2）的正畸治疗部位为对照。粘膜牙龈矫正后三个月（T2）的相同部位作为测试。在 T1 和 T2 之间，暂停正畸治疗，不进行专业口腔卫生，也不给患者额外的口腔卫生指导。15 个月（T3）时，即最后一次记录时，未进行任何口腔卫生措施。
结果显示，在初始正畸治疗期间，T0 至 T1 之间治疗部位的牙龈指数（GI）和菌斑指数（PI）恶化，而与 T1 相比，T2 时牙龈炎症改善。T2 时，GI 和 PI 与 T0 相比也有统计学显著改善。T3 时牙周参数的改善得以维持。采用非参数检验（Wilcoxon 符号秩检验）进行统计学分析。
游离牙龈移植作为唯一的治疗方法，增加角化龈的宽度有利于改善正畸治疗期间的 GI 和 PI。
