成人牙周病20例的正畸治疗

目的探讨正畸治疗对牙周病的治疗作用。方法通过对20例成人牙周病患者运用正畸及牙周联合治疗并对患牙牙周、牙槽骨情况进行对比观察,了解正畸治疗对成人牙周病患者的治疗作用,探讨治疗成功的关键因素。结果20例患者移位的牙齿得到了复位,前牙覆牙合覆盖关系正常、咬合关系及外貌均有明显改善。结论成人牙周病经过正畸治疗可以恢复牙列外形,达到美观及恢复咀嚼功能的目的。     

成人牙周病正畸治疗疗效分析

目的:探讨正畸治疗对成人慢性牙周病的治疗作用。方法:选择伴有前牙唇倾、牙间隙增宽、覆牙合覆盖增大的18例患有牙周病的错牙合畸形患者进行常规牙周治疗及正畸治疗,通过比较治疗前后患者的牙周、牙槽骨情况的变化来评价正畸治疗对患有牙周病的错牙合畸形患者的治疗作用。结果:18例患者平均疗程21个月,正畸治疗后牙齿稳定度增加、移位牙复位、牙周袋变浅或消失、牙龈无明显炎症,患者的错牙合畸形均达到个别正常牙合,结束时牙周情况较矫治前明显的改善。结论:正畸治疗改善了错牙合畸形患者的牙周环境和牙列功能,对牙周病的治疗有显著的作用,为成人牙周病的正畸治疗提供一定的参考依据。牙周病是多因素所致的慢性进展性疾病。牙周病患者因牙周支持组织的破坏吸收,常引起牙齿的松动、移位、伸长等,从而引起继发性的牙牙合畸形及咬合创伤。成人牙周病通常会伴有前牙唇侧漂移、牙间隙增宽,覆牙合覆盖增大等错牙合畸形,不仅影响咀嚼功能,还严重影响美观。正畸治疗成为牙周病治疗的重要手段之一,应用固定矫治器对牙周病致错牙合畸形的患者进行矫治,恢复相对理想的牙弓形态和咀嚼功能以及稳定的口腔环境,一直是学者们所关注的问题。临床笔者对18例因牙周病所致前牙散隙的错牙合畸形患者进行牙周及正畸联合治疗,取得满意疗效。     

牙周病正畸治疗中的误区

随着成人正畸患者的不断增加,正畸医生在临床工作中将面对越来越多的成人牙周病患者。牙周病患者因为牙周支持组织的破坏常会导致前牙唇向移位、散开,出现间隙,并形成创伤,进一步加剧牙周组织的丧失,最终导致患牙的脱落。同时前牙的形态和位置直接影响患者的美观,患者具有强烈的主观要求,希望能够得到治疗。为牙周病导致牙齿病理性移位的患者进行正畸治疗是广大正畸医生的任务和职责,这就要求我们对牙周病以及牙周病的正畸治疗有充分的理解和认识。但是,正畸医生在对成人牙周病患者的治疗中存在着一些模糊的理解,甚至是错误的概念。这些错…     

牙周病的正畸治疗

临床选择10例牙周病前牙移位形成牙列畸形的病例,在牙周病综合治疗控制炎症的基础上,采取Begg细丝弓固定矫正器和活动矫正器治疗,使移位的牙齿复位,并以牙舌面连续磨槽固定术固定松动牙齿。经复查,前牙覆(牙合)覆盖关系,牙间隙,咬(牙合)状况及颜面外貌均有明显改善。本文并对正畸治疗对牙周组织的影响进行讨论。     

牙周、正畸联合法治疗牙周病前牙移位的疗效观察

目的:通过对牙周炎病人移位前牙采取牙周、正畸联合治疗.观察治疗后3年疗效.方法:选择17例因牙周炎导致前牙错位的病人,采用牙周、正畸联合治疗.在治疗前、治疗结束时和治疗后3年,检查每位病人临床牙周袋探诊深度(PD)、探诊出血(BOP)、前牙覆(牙合)、覆盖等指标,x线片观察前牙间牙槽骨高度.结果:治疗前后牙覆(牙合)、覆盖、牙周健康指标均有显著改善,治疗前后具有显著性差异(P<0.01),3年后复查结果与治疗结束时无明显变化.前牙间平均牙槽骨高度治疗前后无显著性差异(P>0.05).结论:牙周正畸联合治疗能够矫正牙周病导致错位的前牙,并能稳定地改善牙周健康,维持牙槽嵴的高度.     

正畸治疗前患者牙周状况的评估及正畸时机选择

随着社会的发展,人们对美学的要求越来越高。正畸治疗作为口腔美学治疗的一种方式越来越受到人们的重视。正畸治疗主要通过对牙齿施加正畸力,引导牙周组织改建,从而改变牙齿在牙槽骨内的位置。正畸治疗可以改善由于牙列拥挤、牙齿异常排列等导致的咬合关系不良,从而达到牙周组织的长期稳定。我国牙周病患者数量庞大,有正畸需求的牙周病患者也在逐年增多。正畸治疗需要关注牙周健康,而牙周治疗与正畸治疗的关系也密不可分。本文对正畸治疗前牙周状况的评估标准、牙周病患者正畸治疗的时机选择以及治疗后牙周状况的维护进行叙述,从而帮助医生制定个性化治疗方案,以期获得平衡、稳定以及美观的治疗效果。     

正畸牵引在牙列拥挤伴严重牙周病治疗中的应用

目的：本文描述了通过正畸向牵引治疗下前牙拥挤伴严重牙周病患者的方法。方法：通过向牵引计划拔除的严重牙周病患牙从而增加局部硬组织骨量,为后续邻牙排齐提供足够的牙槽骨,改善术后软组织结构和形态。结果：12例患者牙齿排列整齐,间隙关闭,牙齿松动度无增加,龈缘整齐,X片显示排入拔牙间隙的牙齿牙周附着可。结论：通过牵引进入稳定期的牙周病患牙,可以增加局部牙槽骨高度,改善龈缘软组织外形,为后续邻牙排入提供好的牙周条件,达到牙列美观,龈缘整齐,治疗效果稳定的目的。     

正畸结合高强纤维夹板在牙周病治疗中的应用

目的：评价正畸结合超强玻璃纤维夹板治疗牙周病的临床效果。方法：14例成人牙周病继发牙[牙合]畸形患者,在控制牙周炎症的基础上,应用固定矫治技术进行牙[牙合]畸形的矫治,并采用超强玻璃纤维加树脂作为固定牙周夹板。结果：随访1～3年,牙齿排列整齐,前牙覆[牙合]覆盖关系正常,牙周状况明显改善,有效地巩固了牙[牙合]畸形的矫治效果,增强了美观。结论：正畸治疗是牙周病综合治疗的重要组成部分,可以恢复牙列外形,达到改善和恢复咀嚼功能的目的;超强纤维牙周夹板的应用可有效地保持错[牙合]畸形的矫治效果,保存松动患牙。     

牙周病的固定正畸治疗体会

牙周病引起牙齿松动移位而继发牙列畸形在临床上较多见,尤其在前牙表现前牙飘移、唇向移位,出现牙间隙增宽,覆(牙合)覆盖加大。颜面表现开唇露齿,影响美观及咀嚼功能。通过正畸治疗,可使松动移位牙复位,改变牙的受力方向,消除创伤(牙合),分散(牙合)力,有利于组织愈合。作者用固定矫正器矫治牙周病患者18例,疗效满意,总结如下。 临床资料 病例资料:自1992年以来经牙周常规治疗控制炎症后作正畸治疗。其中男性5例,女性13例,年龄最大     

牙周夹板固定与非固定的临床疗效观察

本文通过牙周夹板固定和非固定两种方法治疗牙周病,经过两年的临床观察,统计分析两种方法的优劣。材料及方法门诊选取67名患者,临床上确诊为成人牙周炎,年龄在18～60岁之间,经基础治疗控制炎症后患牙仍有松动的一组前牙或者个别牙,牙槽骨吸收超过根长的1/2～3/4,包括牙周病前牙移位,经正畸治疗已基本复位的Ⅱ°～Ⅲ°松动的患牙。有牙髓症状的要进行牙髓治疗。调牙合解除早接触。将患牙随机分为两组:一组采用牙周夹板固定,另一组不采用夹板固定。其余维持治疗两组相同。牙周夹板固定方法:前牙采用钢丝“8”字结扎,光敏树脂固定,后牙采用牙合…     

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??With the development of technology and improvement of living standards in recent years??some periodontal patients have an increasing need for orthodontic treatment to improve oral health and appearance??which include not only children and adolescents with congenital malocclusion??but also the adult patients with the labial displacement of anterior teeth caused by periodontal disease and adjacent tooth displacement caused by teeth missing. This paper makes a review from 3 aspects??the relationship between periodontal disease and orthodontic treatment??principles and methods of orthodontic treatment in patients with periodontal disease??periodontal status of the patients after orthodontic treatment.     

The use of a resin-bonded fixed splint in periodontally compromised mandibular anterior teeth: a case report

In the treatment of patients with severe periodontal disease, it is becoming possible to re-establish a healthy and well-functioning dentition through interdisciplinary dental teamwork. This article presents a case using a resin-bonded splint for stabilizing periodontally compromised mandibular anterior teeth after orthodontic treatment. A 30-year-old woman came to the authors with severe periodontitis, which had resulted in spacing of the anterior teeth and tipping of the posterior teeth. Periodontal-orthodontic treatment was combined with prosthodontic reconstruction, and a resin-bonded splint extending from canine to canine was placed for postorthodontic stabilization of the periodontally compromised teeth. No debonding of the splint occurred, and no further periodontal invasion was found in this case after 4 years of follow-up.     

成年牙周病患者矫治前后牙槽骨高度变化的研究

目的 通过测量矫治前后牙槽骨高度的变化,探讨成人牙周病患者正畸治疗的特点,为成人牙周病的正畸治疗提供一定的临床参考.方法 选择成人牙周病患者15例,矫治前后拍摄全颌曲面断层片.分别测量上下颌中切牙至第一磨牙远中各个牙槽骨的高度.采用SPSS11.5统计软件对矫治前后各牙间牙槽骨高度进行配对t检验.结果 除上下前牙间牙槽骨高度增高之外,矫治后较矫治前各牙间牙槽骨的高度均有降低,但均无统计学差异(P＞0.05).结论 成人牙周病患者正畸治疗要加强口腔卫生的监督,定期进行牙周检查及治疗,正畸矫治中使用适宜的力量可以减少牙槽骨高度的丧失,并使有垂直骨吸收的牙槽骨高度有所恢复,达到较为满意的疗效.     

Effects of malocclusions and orthodontics on periodontal health: evidence from a systematic review

Many patients seek orthodontic treatment for esthetic improvement. These patients mostly present with mal-alignment of the anterior teeth. The positive effects of orthodontic treatment on their appearance and self-esteem are easy to envision. However, does orthodontic treatment provide dental health benefits in addition to the esthetic benefits? Do malocclusions harm the periodontium? Is correcting malocclusions with orthodontic treatment beneficial for periodontal health? The purpose of this study is to present evidence available on this topic. Two systematic reviews were conducted to address these questions: does a malocclusion affect periodontal health, and does orthodontic treatment affect periodontal health? Inclusion and exclusion criteria were established for both reviews, and an electronic search and a hand search were conducted. Several papers were included in both reviews, but the overall quality of the studies was weak. The first review found a correlation between the presence of a malocclusion and periodontal disease. Subjects with greater malocclusion have more severe periodontal disease. This may be dependent on oral health status. One should keep in mind that an association does not necessarily mean causation. The second review identified an absence of reliable evidence on the effects of orthodontic treatment on periodontal health. The existing low-quality evidence suggests that orthodontic therapy results in small detrimental effects to the periodontium. The results of both reviews do not warrant recommendation for orthodontic treatment to prevent future periodontal problems, except for specific unusual malocclusions.     

正畸结合牙龈环切术治疗牙周炎致前牙病理性移位的初步研究

目的　通过正畸和牙周基础、牙龈环切术联合治疗因牙周炎导致前牙病理性移位的患者 ,观察治疗后牙周组织的改变。方法　牙周炎导致前牙病理性唇向散开移位患者经牙周基础治疗后 ,对需压入的前牙进行牙龈环切术 ,再开始正畸加力。使用牙周临床检查、常规根尖片、前牙区CT来观察比较正畸治疗前后患牙的牙龈出血、探诊深度、牙槽骨高度和附着水平的变化。结果　结合牙龈环切的正畸治疗后患牙牙槽嵴顶高度增加 ,产生新附着。结论　正畸结合牙周系统治疗和牙龈环切术矫治牙周炎所致前牙唇向散开移位患者 ,可以排齐牙列、关闭散开的间隙 ,并促使牙周改善 ,形成新附着     

成年牙周病患者矫治前后前牙牙槽骨高度的变化

目的通过矫治前后前牙牙槽骨高度的变化，探讨成人牙周病患者正畸治疗的特点，为成人牙周病的正畸治疗提供一些临床参考。方法选择成人牙周病患者10例，矫治前后拍摄定位片。分别测量上下颌尖牙至尖牙间每个前牙间牙槽骨的高度。采用SPSS统计软件对矫治前后上下颌尖牙至尖牙间每个前牙间牙槽骨的高度进行配对t检验。结果矫治后上下颌尖牙至尖牙间每个前牙间牙槽骨的高度均有降低，但统计学无差异。结论成人牙周病患者正畸治疗要加强口腔卫生的监督，及时进行牙周治疗，正畸使用轻力可以减少牙槽骨的丧失而达到较为满意的疗效。     

Orthodontic therapy in patients with juvenile periodontitis: clinical and microbiologic effects

The correction of malocclusions in juvenile periodontitis (JP) patients completing periodontal therapy is a problem of increasing clinical concern to orthodontists, since many teeth with severe alveolar bone loss in these patients can now be successfully treated without extraction. In this report, fixed edgewise orthodontic therapy was carried out after the completion of periodontal therapy on four JP patients. The orthodontic therapy included extensive intrusion of teeth severely affected by JP. Phase-contrast microscopic analysis of subgingival plaque from orthodontically treated teeth was used to monitor longitudinally the effects of fixed orthodontic bands on the subgingival flora and also to monitor the efficacy of topical and systemic antimicrobial therapy aimed at suppression of suspected periodontopathic bacteria. Orthodontic movement was completed on most periodontally compromised teeth without significant evidence of additional deterioration in periodontal status. However, within the first 6 months of orthodontic band placement, all patients had significant increases in the number of spirochetes and motile rods in their subgingival flora. Three of the patients also developed high levels of crevicular polymorphonuclear leukocytes around orthodontically treated teeth, indicating significant subgingival inflammation. Intensive antimicrobial measures, including topical inorganic salt applications and systemic tetracycline, were helpful in limiting clinical inflammation and subgingival colonization by periodontopathogens during orthodontic therapy. The results demonstrate that successful orthodontic repositioning can be carried out in treated JP patients. In addition, bacteriologic monitoring and chemotherapeutic suppression of periodontal pathogens may be valuable in the prevention of further destructive periodontal disease activity in periodontitis patients undergoing orthodontic therapy.     

牙周-正畸联合治疗牙周炎致前牙扇形移位疗效观察

目的：评价牙周-正畸联合治疔牙周炎致前牙扇形移位的临床效果。方法：对21例因牙周炎造成前牙扇形移位的患者,经牙周基础治疗,牙周炎症基本控制后,用方丝弓固定正畸方法内收并排齐扇形移位的前牙,同时配合牙周护理及凋精等措施,消除炎症及殆创伤,建立正常的咬合关系。共治疗74颗牙,治疗前后分别记录患牙牙周袋、牙槽骨吸收情况。所得数据采用Ridit分析及X^2检验。结果：经1～2a随访,40岁以下患者牙周袋情况有非常显著改善（P〈0．01）,牙槽骨吸收也有显著改善（P〈0．05）,治疗效果满意。结论：牙周-正畸联合治疗能有效控制牙周炎症．消除he创伤,排齐牙列,并使治疗效果达到长期稳定,但应注意患者年龄不宜超过40岁。