牙周序列治疗在成人牙周炎患者正畸过程中疗效观察

目的：通过观察牙周菌斑中组成成分的变化,评价牙周序列治疗在成人牙周炎患者正畸过程中的作用。方法：选择47例伴有轻、中度牙周炎的成人正畸治疗患者,在正畸治疗前1个月开始牙周序列治疗并持续至正畸治疗结束,记录正畸治疗前（基线对照）和治疗后1、3、6、12月以及正畸治疗结束时的各项牙周临床指标－－菌斑指数（PLI）、牙龈指数（GI）、牙龈出血指数（SBI）、牙周袋深度（PD）、临床牙周附着丧失（CAL）;同时,每次刮取患者16、21、24、36、41、44共6颗指数牙牙周袋中牙菌斑,提取细菌DNA,利用qRT－PCR技术比较患者牙菌斑中主要细菌（牙龈卟啉单胞菌Pg、具核梭杆菌Fn、福赛坦氏菌Tf、伴放线放线杆菌Aa）检出率有无差异。结果：配合牙周序列治疗,成人牙周炎患者正畸治疗过程中与治疗结束时各项牙周检查指标（PLI、GI、SBI、PD、CAL）较治疗前有明显改善（P＜0．05）,牙菌斑中Pg、Fn、Tf、Aa检出率较治疗前明显降低（P＜0．05）;与正畸治疗前比较,正畸治疗结束时患者牙菌斑中Pg检出率约降低8．5％,Fn检出率约降低21．3％,Tf检出率约降低23．4％,Aa检出率约降低36．2％。结论：成人牙周炎患者在正畸治疗前及治疗过程中同时进行牙周序列治疗可促进牙周疾病的愈合,改善患者口腔中细菌微生物的生态系统。     

成人牙周炎正畸治疗前后的牙周变化

目的探讨成人牙周炎患者进行正畸治疗前后的牙周变化。方法39例牙周炎患者进行正畸治疗,治疗前后检查各项临床指数,在SPSS10.0统计软件包下进行统计学处理,评价治疗后的效果。结果牙周炎患者经牙周基础治疗和正畸治疗后各项牙周检查指标较治疗前差别均有统计学意义（P〈0.01）;31例患者疗效良好,6例患者正畸治疗后好转。结论正畸治疗有利于成人牙周炎患者牙周组织的愈合和患齿的固定,有利于牙周炎的长期维护疗效。     

牙周炎致错位前牙正畸治疗后牙根吸收的临床研究

目的：观察牙周炎导致的唇向散开前牙经正畸治疗后牙根吸收情况,并与牙周健康的正畸患者进行比较。方法：选择安氏Ⅰ或Ⅱ1前牙散在间隙的成人牙周炎患者和牙周健康的成人正畸患者各12例,均无需拔牙,采用MBT直丝弓固定矫治,应用Nemoceph头影测量软件测量矫治前后前牙的牙冠与牙根比值,并作配对t检验,判断其牙根吸收程度。结果：矫治后两组均有轻度牙根吸收（P〈0.05）,牙周炎组牙根吸收程度较牙周健康组大,但二组间差别无统计学意义。结论：牙周炎患者和牙周健康患者正畸治疗后牙根均有一定程度吸收,但是可接受的。牙周炎患者通过正畸关闭前牙散在间隙并不会加重牙根吸收。     

伴口呼吸及错牙合畸形慢性牙周炎牙周序列治疗观察

目的:探讨前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者接受牙周序列治疗的临床疗效。方法:选择2007年9月~2008年9月在大连市口腔医院牙周黏膜科就诊的前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者10例,进行牙周序列治疗(基础治疗、牙周手术治疗、正畸治疗和牙周支持治疗),历时5年以上。在治疗前、正畸治疗后1~3年采用Florida探针检查记录前牙区探诊深度(PD)、附着丧失(CAL)、牙齿松动度(TM)、探诊出血(BOP)等临床指标,并进行统计分析。在治疗前和正畸治疗后1～3年拍摄曲面断层片。结果:正畸治疗后1～3年前牙区PD、CAL均较治疗前有明显降低,BOP阳性位点较治疗前明显减少,差异均有统计学意义(P<0.01);TM较治疗前无明显变化,差异无统计学意义。治疗后3年较治疗后1年和2年,PD、CAL下降,BOP阳性位点减少,但差异均无统计学意义。结论:前牙区牙龈增生伴张口呼吸、错牙合畸形的慢性牙周炎患者进行历时5年以上牙周序列治疗,临床疗效良好且稳定     

牙周炎累及牙的正畸治疗(附典型病例报告)

牙周炎累及牙用正畸进行治疗时 ,其移动特征与常规正畸牙移动有较大区别[1] 。这类病人的治疗方案 ,必须由牙周病、正畸及口腔修复科医师共同参与制定。如患者牙周生物反应状况及口腔卫生情况处于可控制状态 ,则正畸治疗的介入很有可能取得成功[2 4 ] 。有报告指出 ,对有正畸治疗适应证的牙周炎患牙 ,在正畸介入前 ,必须进行根面及牙龈准备[5] ,即牙周袋必须消除或控制在最小范围 ,以避免炎症造成进行性的破坏[6] 。有人对患有牙周炎但在正畸治疗前已接受充分牙周病治疗的成人患者进行正畸治疗后的跟踪调查 ,结果证实正畸介入没有对牙周附…     

对伴有牙列拥挤牙周病的治疗体会

目的:探讨牙周炎伴牙列拥挤病人在常规牙周治疗和正畸治疗后的牙周改善情况。方法:对55例伴牙列拥挤、创伤等的牙周炎病人进行常规牙周治疗和正畸治疗,比较治疗前后病人的菌斑指数、软垢指数和牙石指数。结果:菌斑指数、软垢指数和牙石指数在单一牙周治疗后6个月与治疗前无显著性差异(P>0.05),而正畸治疗和牙周治疗6个月后与治疗前比较有非常显著性差异(P<0.05)。结论:对伴有牙列拥挤的牙周病,必须通过正畸来改善牙周环境,才能有效治疗。     

牙周-正畸联合治疗对成人牙周病患者切牙区的美学重建研究

目的 评估牙周-正畸联合治疗对成人牙周病患者切牙区美学重建的作用。方法 选择13例患者接受牙周基础治疗及正畸治疗,在全口洁治后获得统一基线,在牙周基础治疗后3个月及正畸治疗结束对13例患者的102颗切牙进行牙周临床检查,比较治疗前后的差异。检查项目包括：探诊深度（PD）,每颗牙检查6个位点,102颗切牙共612个位点;探诊出血（BOP）,每颗牙检查颊、舌两个位点,共204个位点;龈乳头指数（PI）和龈乳头高度（PH）,共128个龈乳头。结果 牙周基础治疗3个月后,79.58%（487/612）的位点PD≤3 mm,88.73%（181/204）的位点BOP阴性,较基线时[分别为26.31%（161/612）和22.06%（45/204）]明显改善。正畸治疗前,仅8个龈乳头的PI为Ⅲ级,龈乳头完全充盈牙间隙,21个为Ⅱ级;正畸治疗结束后,51个龈乳头的PI达到Ⅲ级,68个龈乳头的PI达到Ⅱ级。PH由正畸治疗前的（1.69±0.57） mm增加到治疗后的（2.84±0.62） mm,治疗前后的差异有统计学意义（P<0.05）。结论 牙周-正畸联合治疗有利于成人牙周病患者切牙区的美学重建。     

一例重度广泛型侵袭性牙周炎的牙周-正畸-修复联合治疗

目的：本文报道对1例重度广泛型侵袭性牙周炎伴继发性咬合紊乱的精神病患者采用较保守的牙周-正畸-修复联合治疗的疗效。摘要：1例因重度牙周炎及安氏11类错殆导致前牙重度前倾的女性患者．想要保留牙齿并拒绝种植修复。此病例提示牙周、正畸及修复多学科的联合治疗可以显著改善功能和外观。牙周综合治疗先于其他治疗．而其他学科治疗中、治疗后的牙周维护和随访起到了关键作用。     

成人牙周病的正畸治疗

目的探讨正畸治疗对成人牙周病的治疗作用。方法通过对28例患有牙周病的错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畸形患者的治疗作用。结果28例患者的错畸形得到矫正达到个别正常,矫正结束时牙周情况较矫治前明显改善。结论正畸治疗为错畸形患者创造了健康的牙周环境和功能良好的牙列,对牙周病的治疗有显著作用。     

Ⅱ型糖尿病患者的牙周状况及对糖化血红蛋白(HbAIc)的影响

目的 观察Ⅱ型糖尿病患者患牙周炎经过牙周基础治疗后，牙周状况以及糖化血红蛋白(HbAIc)的变化：方法：选择已确诊的Ⅱ型糖尿病同时患牙周炎的患者33例，进行牙周基础治疗，比较治疗前及治疗后4周的牙周状况和HbAIc水平。结果：患者经过牙周基础治疗后、探诊出血指数、探诊深度明显减轻；重度牙周炎患者经治疗后4周，HbAIc明显降低；中度及轻度牙周炎患者治疗前后HbAIc无明显改变。结论：成人牙周炎的糖尿病患者牙周基础治疗后短期效果是满意的，牙周治疗可降低糖化血红蛋白的水平.     

Parodontites sévères et orthodontie : évaluation des résultats à long terme

Clinical manifestations of severe periodontitis are very often associated with tooth migration. The aim of this retrospective study is to evaluate dental bone support before orthodontic-periodontal treatment, at immediate postoperative, and long-term postoperative and to compare these results with those obtained from periodontal treatment alone. Fifteen patients (11 women and four men), all with severe periodontitis, mean age 42.8 years (22–61), were followed for an average of 16 years (11–32). Comparison was made between periodontal–orthodontic treatment (Group 1) and periodontal treatment alone (Group 2). Alveolar bone height was measured at T0 (before treatment), T1 (immediate postoperative) and T2 (long-term postoperative). Assessment was performed by means of digitized radiography using Image J Software from the National Institute of Health. The average postoperative observation period between T0 (before treatment) and T2 (long-term results) was 16 years (11 to 32). Results showed an overall bone apposition in groups (1 and 2) immediately after treatment (T1), then at long-term (T2). No statistical difference was observed between both groups (1 and 2). In conclusion: an overall bone gain was observed in both treatment groups (periodontal–orthodontic and periodontal alone). The orthodontic treatment combined with periodontal treatment never compromised the benefits of periodontal treatment alone. On the opposite, it appeared to be quite beneficial.     

Investigations on the Influencing of the Subgingival Microflora in Chronic Periodontitis

AIM: The aim of the present study was to investigate changes in the subgingival flora in adults with chronic periodontitis undergoing orthodontic fixed appliance therapy. PATIENTS AND METHODS: In seven adult patients who had undergone nonantibiotic periodontal pretreatment, the subgingival bacteria were subjected to microbiological examination and the number of periodontopathogenic organisms was determined before (T1: prior to treatment being started), during (T2: 6 weeks after orthodontic treatment was started) and after the end of orthodontic treatment (T3: 6 weeks after removal of the fixed appliances). RESULTS AND CONCLUSION: During the fixed appliance therapy (metal brackets, NiTi archwires, stainless steel archwires), a marked reduction was observed in the total bacteria count from the subgingival pocket despite the clinical periodontal parameters remaining almost unchanged. However, the total count of some highly pathogenic bacteria rose again slightly after the end of treatment. We attribute the marked improvement in the periodontopathogenic bacteria spectrum under fixed appliance therapy with metal brackets, NiTi archwires and stainless steel archwires to metal corrosion entailing the release of primarily nickel ions, which have a toxic effect on bacteria and thus enable the regeneration of the physiological bacterial flora. In none of the patients was a deterioration of the periodontal status observed during and after fixed appliance therapy.     

Effect of orthodontic treatment on periodontal health of periodontally compromised patients:: A randomized controlled clinical trial

ObjectivesTo evaluate the effect of fixed orthodontic treatment on periodontal parameters in periodontally compromised adult orthodontic patients.Materials and MethodsThis was a prospective, randomized, controlled clinical trial. Thirty-six periodontally compromised adult patients (mean age: 29.67 ± 4.8 years) were randomly allocated to either test (perio-ortho) or control group (perio). After periodontal stabilization in both groups, orthodontic treatment was started in the test group, whereas the control group remained on periodontal maintenance only. Evaluation and comparison of clinical parameters (plaque index [PI]; gingival index [GI]; bleeding on probing [BOP]; probing depth [PD]; clinical attachment level [CAL]) of both groups was assessed at three time intervals: T0 (base line), T1 (at start of orthodontic treatment), and T2 (1 year after start of orthodontic treatment). Radiological parameters (alveolar bone levels [ABL]) were recorded using CBCT at T1 and T2.ResultsIntragroup analysis showed statistically significant improvement in all clinical and radiological periodontal parameters in both groups (P ≤ .05). Intergroup comparison revealed improvement in the periodontal parameters was not statistically significant between the groups (P ≥ .05). Subgroup analysis showed reduction in the number of moderate and severe periodontitis sites in both groups with significant more gains in ABL in the test group compared to the control group.ConclusionsOrthodontic treatment after periodontal stabilization does not have any detrimental effect on periodontal health in adult periodontally compromised orthodontic patients and may add to the benefits achieved by periodontal treatment alone.     

咬合调整对牙周炎正畸治疗患者牙周状况的影响

目的：观察咬合调整对牙周病患者正畸治疗前后牙周状况改变的影响。方法选择成人牙周病正畸患者47例,按照正畸治疗中是否进行咬合调整分为观察组和对照组,对所有患者正畸治疗前、后及治疗后6个月随访时进行牙周状况的检查评估,并作统计学分析。结果观察组患者在治疗后及随访时的牙周探诊深度（PD）、临床附着丧失（CAL）、出血指数（BI）均较治疗前有明显降低,牙齿松动度（TM）也较治疗前有明显减小,而在随访时与治疗后相比较,PD和CAL的变化也有统计学意义（P<0.05）,松动度也有明显减小。对照组患者治疗后的PD、BI及随访时的BI均较治疗前有明显降低,随访时的牙齿松动度较治疗前明显减低,与治疗后比较也有明显变化。组间同期比较,观察组在随访时的PD和CAL与对照组有明显差异,在治疗后及随访时的TM也与对照组间存在明显差异。结论在牙周炎错(牙合)患者的正畸治疗中,及时进行咬合调整,能去除病理性(牙合)因素,消除咬合创伤,恢复咬合平衡,有利于牙周组织的改建及修复。     

Orthodontic treatment in periodontally compromised patients: 12-year report

This work describes the therapeutic protocol of combined orthodontic-periodontal treatment and evaluates the effectiveness of surgical and nonsurgical periodontal therapy in the maintenance of a healthy periodontal status after the orthodontic treatment. Surgical periodontal treatment was performed in 267 patients affected by severe periodontal disease, and 128 patients had nonsurgical treatment. For each patient the mean value of probing depth (mPPD) and the rate of positive bleeding on probing (%BoP) of the teeth involved in the orthodontic movement were registered before the start of the periodontal treatment, at the end of the orthodontic treatment, and 2, 4, 6, 10, and 12 years after the end of the orthodontic treatment. Comparison between pretreatment and posttreatment values and between pretreatment and follow-up values showed a decrease in mPPD and %BoP that was of statistical significance. The difference between posttreatment and follow-up values was not statistically significant. These results suggest that orthodontic treatment is no longer a contraindication in the therapy of severe adult periodontitis. In these cases orthodontics improve the possibilities of saving and restoring a deteriorated dentition.     

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。     

Periodontal disease and cancer patients undergoing chemotherapy

Objective: The aim of this study was to evaluate periodontal status after periodontal treatment in patients with different malignant solid tumours submitted to chemotherapy. Methods: Fifty-four patients with newly diagnosed early-stage solid tumour malignancy treated by surgery and eligible for adjuvant chemotherapy were enrolled in this study. Clinical periodontal parameters obtained by a single calibrated examiner were evaluated before chemotherapy (T0), 21 days after chemotherapy (T1) and 210 days after chemotherapy (T2). Patients were grouped into healthy or periodontally diseased subjects. All patients received oral hygiene instructions, and the diseased patients received periodontal treatment at baseline. Comparisons between the groups were performed using the McNemar test (P > 0.05) and the Wilcoxon test with Bonferroni correction (P < 0.02) using spss software. Results: Of 54 patients enrolled in the study, two did not present to the third assessment (T2). The prevalence of periodontitis was 35.2% at baseline and no significant difference was found in the follow-up assessments. There was a statistically significant reduction in probing depth (PD), plaque index (PI) and bleeding on probing (BOP) between baseline and follow-up assessments. The attachment level (AL) did not vary significantly between the different follow-up periods (P ≥ 0.06). Conclusions: Periodontal treatment was effective in reducing PI, BOP and PD and in maintaining AL in periodontitis cancer patients undergoing chemotherapy.Key words: Chemotherapy, cancer patients, periodontitis, periodontal treatment