正畸治疗对于牙周病患者的疗效分析

Analysis of the Efficacy of Orthodontic Treatment in Patients with Periodontal Disease

摘要: 目的：本研究的目的是评价正畸治疗对牙周病成人患者牙周参数的影响。方法：回顾性选取2022年04月至2023年04月在我院治疗的76例牙周受损的成人患者，根据是否进行正畸治疗分为两组，试验组(正畸组) 36例，平均年龄29.37 ± 5.21岁；对照组(单纯牙周治疗组) 40例，平均年龄30.26 ± 5.33岁。试验组开始牙周治疗联合正畸治疗，对照组仅实行单纯牙周治疗。在正畸治疗前(T1)和正畸治疗后(T2) 2个时间间隔评估和比较两组的临床参数：牙菌斑指数[PI]、牙龈指数[GI]、探诊出血[BOP]、探诊深度[PD]、临床附着水平[CAL]。在T1使用口腔颌面锥形束CT (CBCT)记录放射学参数牙槽骨水平[ABL]和治疗后的并发症发生率。比较了两种不同治疗方式的有效性和安全性。结果：组内分析显示，两组的所有临床和放射学牙周参数均有统计学意义的改善(P < 0.05)。组间比较，两组间牙周参数改善差异无统计学意义(P > 0.05)。亚组分析显示，两组的中度和重度牙周炎部位的数量都有所减少，试验组的ABL比对照组有更大的提高。结论：牙周稳定后的正畸治疗对成年正畸患者的牙周健康有很好的疗效，是更适合牙周病患者的一种治疗方案。

Abstract: Objective: The aim of this study is to evaluate the effect of orthodontic treatment on periodontal parameters in adult patients with periodontal disease. Methods: Retrospectively, 76 adult patients treated in our hospital from April 2022 to April 2023 were divided into two groups based on orthodontic treatment: 36 in the test group (orthodontic group) with a mean age of 29.37 ± 5.21 years; 40 in the control group (simple periodontal treatment group) with a mean age of 30.26 ± 5.33 years. The test group started the periodontal treatment combined with the orthodontic treatment, and the control group only performed the periodontal treatment alone. The clinical parameters were evaluated and compared between the two groups before (T1) and and after (T2): dental plaque index [PI], gingival index [GI], bleeding on probing [BOP], probing depth [PD], and clinical attachment level [CAL]. The radiological parameters alveolar bone level [ABL] and postoperative complication rates were recorded using oral and maxillofacial cone beam CT (CBCT) at T1. The efficacy and safety of the two different treatment modalities were compared. Results: Within-group analysis showed a statistically significant improvement in all clinical and radiological periodontal parameters in both groups (P < 0.05). In Between-group comparison, there was no significant difference in improvement of periodontal parameters between the two groups (P > 0.05). Subgroup analysis showed a reduction in the number of moderate and severe periodontitis sites in both groups and a greater improvement in ABL in the test group than in the control group. Conclusion: Orthodontic treatment after periodontal stabilization has good results on the periodontal health of adult orthodontic patients and is a more suitable treatment option for patients with periodontal disease.