正畸-牙周联合治疗中重度牙周炎早期牙周状况及龈沟液骨钙素水平变化的研究

目的检测中重度牙周炎患者正畸早期牙周临床指标及首次加力后龈沟液骨钙素水平的变化,了解其变化规律,为监控正畸早期的牙周反应提供实验依据。方法选择15例中重度牙周炎患者为实验组,在牙周治疗前和正畸治疗前、治疗后1个月、2个月分别检测牙周临床指标(PLI,BI,PD),并采用电化学发光法检测牙周治疗前,正畸治疗前,首次加力后1、24、48、168 h龈沟液骨钙素水平(OC),同时与对照组15例牙周健康的正畸患者相应指标对照。结果实验组牙周治疗后牙周临床指标均低于治疗前水平(P<0.05),正畸治疗后各牙周临床指标与治疗前无明显差异(P>0.05);实验组正畸加力后OC较加力前明显升高(P<0.05),24 h达到峰值,168 h降至加力前水平,其变化规律与对照组一致。结论正畸-牙周联合治疗可改善患者牙周状况,骨钙素在中重度牙周炎患者正畸早期过程中参与牙槽骨的改建。

The changes of periodontal clinical parameters and osteocalcin level in GCF during the initial stage of the integrated orthodontic and periodontal treatment of moderate to severe periodontal patients

Objective To monitor the periodontal status during the initial stage of orthodontic therapy in moderate to severe periodontal patients by detection of periodontal clinical parameters in the initial stage of orthodontic therapy and osteocalcin level in GCF after the first stress application.Methods 15 patients,with moderate to severe periodontitis,were selected as the experimental group.The PLI,BI and PD were examined by electrochemical luminescence at pre-treatment,1st month and 2nd month after the treatment respectively,while the OC level in GCF were examined before orthodontic treatment,1,24,48,and 168 hours after the first stress application.The indices of the control group,formed by 15 orthodontic patients who had healthy periodontal status,were compared.Results After the periodontal treatment,the periodontal clinical levels of the experimental group were lower than pre-treatment levels(P<0.05),while those after orthodontic treatment were not significantly different from before(P>0.05).The level of OC in the experimental group after the first stress application was significantly higher than that after the orthodontic treatment(P<0.05),and peaked at 24th hour,but went down to pre-treatment level at 168th hour,which was the same as that of the control group.Conclusion Integrated orthodontic and periodontal treatment can improve the periodontal status in moderate to severe periodontal patients.Osteocalcin should be involved in bone remodeling in earlier orthodontic treatment.