Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
Department of Dental Medical Center, China-Japan Friendship Hospital, Beijing, China.
Am J Orthod Dentofacial Orthop. 2021 May;159(5):644-652. doi: 10.1016/j.ajodo.2019.11.026. Epub 2021 Feb 16.
Patients with severe periodontitis typically present with pathologic tooth migration. To improve esthetics and masticatory function, orthodontic treatment is required. Research on periodontal orthodontic treatment has been sparse, particularly from the microbial perspective. Hence, we analyzed the microbial and clinical changes in patients with well-controlled periodontitis in the early stage of orthodontic treatment.
Ten patients with well-controlled periodontitis were asked to collect saliva before and 1 and 3 months after appliance placement (T0, T1, and T2, respectively) and underwent clinical examinations before and 1, 3, and 6 months after appliance placement (T0, T1, T2, and T3, respectively). The microbial community of saliva was analyzed by 16S rRNA gene sequencing. Gingival index, the plaque index, and the probing pocket depth were clinically assessed.
The plaque index significantly increased from T0 to T1 and decreased at T2 and T3. The probing pocket depth and gingival index increased slightly at T2, but not significantly, in both the high-risk site and low-risk site. The alpha and beta diversity increased at T1. The microbial community structure was similar at T0 and T2. The relative abundance of core genera and periodontal pathogens was stable during the initial 3 months of orthodontic treatment.
The orthodontic appliance promoted plaque accumulation and altered the microbial community of patients with well-controlled periodontitis during the first month of orthodontic treatment. The microbial community returned to the basal composition at 3 months after appliance placement, and the periodontal inflammation during the 6-months orthodontic treatment was under control.
患有严重牙周炎的患者通常会出现病理性牙齿迁移。为了改善美观和咀嚼功能，需要进行正畸治疗。牙周正畸治疗的研究较少，特别是从微生物角度来看。因此，我们分析了正畸治疗早期牙周状况得到良好控制的患者的微生物和临床变化。
要求 10 名牙周状况得到良好控制的患者在佩戴矫治器前（T0）和佩戴后 1 个月（T1）和 3 个月（T2）分别收集唾液，并在佩戴矫治器前（T0）和佩戴后 1 个月（T1）、3 个月（T2）和 6 个月（T3）进行临床检查。通过 16S rRNA 基因测序分析唾液中的微生物群落。临床评估牙龈指数、菌斑指数和探诊袋深度。
菌斑指数从 T0 到 T1 显著增加，在 T2 和 T3 降低。T2 时，探诊袋深度和牙龈指数略有增加，但在高风险部位和低风险部位均无显著差异。T1 时 alpha 和 beta 多样性增加。T0 和 T2 时微生物群落结构相似。在正畸治疗的前 3 个月，核心属和牙周致病菌的相对丰度保持稳定。
正畸矫治器在正畸治疗的第一个月促进了菌斑的积累，并改变了牙周状况得到良好控制的患者的微生物群落。在佩戴矫治器 3 个月后，微生物群落恢复到基础组成，在 6 个月的正畸治疗期间，牙周炎症得到控制。
