Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Eur J Orthod. 2023 Jul 31;45(4):418-429. doi: 10.1093/ejo/cjad003.
Literature is scarce on malocclusion prevalence and orthodontic treatment need (OTN) in subjects with stage III-IV periodontitis. Study aims were to assess prevalence of primary and secondary malocclusions in subjects with stage III-IV periodontitis and OTN based on pathologic tooth migration (PTM) and occlusal trauma of anterior teeth (AT).
One hundred and twenty-one subjects with stage III-IV periodontitis were examined. A comprehensive periodontal-orthodontic examination was performed. Exclusion criteria: age <30 years, removable prosthetics, uncontrolled diabetes, pregnancy/lactation, and oncologic disease.
Class II malocclusion was found in 49.6% (Class II div 1-20.7%, Class II div 2-9.9%, subdivision Class II-19.0%), Class I-31.4%, Class III-10.7%, no malocclusion-8.3% of subjects. PTM was observed in 74.4% of maxillary and 60.3% of mandibular AT. Spacing and extrusion were the main types of PTM of AT. Odds ratio for PTM of maxillary AT was 9.3 in cases with >30% of sites with clinical attachment loss ≥5 mm (P = 0.001). Spacing of maxillary AT was influenced by periodontitis, Class III malocclusion, and lost teeth. Tongue habit had impact on spacing of mandibular AT. Dental Health Component of Index of Orthodontic Treatment Need yielded that OTN was found in >50% and OTN due PTM, occlusal trauma and impaired function in 66.1% of subjects.
The most prevalent malocclusion was Class II. Spacing and extrusion were prevalent types of PTM of AT. OTN was found in more than half of the subjects. The study highlights the need for preventive measures for PTM in subjects with stage III-IV periodontitis.
关于牙周炎 III-IV 期患者的错颌畸形患病率和正畸治疗需求（OTN），文献报道较少。本研究旨在基于病理性牙齿移位（PTM）和前牙咬合创伤（AT）评估牙周炎 III-IV 期患者的原发性和继发性错颌畸形的患病率和 OTN。
共检查了 121 例牙周炎 III-IV 期患者。进行了全面的牙周正畸检查。排除标准：年龄 <30 岁、可摘义齿、未控制的糖尿病、妊娠/哺乳期、以及恶性肿瘤疾病。
49.6%（Class II div 1-20.7%，Class II div 2-9.9%，subdivision Class II-19.0%）、31.4%的 Class I、10.7%的 Class III、8.3%的患者存在错颌畸形。上颌 AT 的 PTM 发生率为 74.4%，下颌 AT 的 PTM 发生率为 60.3%。AT 的 PTM 主要类型为间隙和伸长。上颌 AT 的 PTM 比值比（OR）为 9.3，在临床附着丧失（CAL）≥5mm 的位点>30%的情况下（P=0.001）。上颌 AT 的间隙与牙周炎、III 类错颌畸形和失牙有关。舌习惯对上颌 AT 的间隙有影响。正畸治疗需求指数的口腔健康组成部分显示，超过 50%的患者存在 OTN，66.1%的患者存在因 PTM、咬合创伤和功能受损引起的 OTN。
最常见的错颌畸形是 II 类。AT 的 PTM 主要类型为间隙和伸长。超过一半的患者存在 OTN。该研究强调了牙周炎 III-IV 期患者需要预防 PTM。
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