嵴上纤维环切联合正畸治疗牙周炎致切牙扇形移位的初步研究

目的:通过嵴上纤维环切联合正畸治疗,观察对切牙病理性移位治疗前、后牙周支持组织临床测量指标的变化,对成人牙周病正畸的疗效进行评估.方法:牙周-正畸联合治疗21例患者唇向散开且两侧病损对称的52颗切牙,随机分为嵴上纤维环切组和非环切组,环切组进行嵴上纤维环切术后正畸治疗,测量牙周病临床指标,前牙区定位摄片观察牙槽骨高度,比较治疗前、后的变化.采用SPSS12.0软件包对治疗前、后嵴上纤维环环切组与非环切组患牙的PD、CAL、CEJAC和RL值进行配对t检验,对治疗前、后的SBI、TM计数进行Wilcoxon符号秩和检验.结果:牙周-正畸联合治疗后.2组松动度、出血指数、探诊深度和临床附着丧失及CEJ至牙槽嵴顶距离均降低,表明正畸治疗有助于牙周病临床参数的改善;牙根长度变化不明显,说明正畸压人未造成牙根吸收.与非环切组相比,环切组的CAL、TM的下降有显著差异(P<0.05),CEJAC的下降也有显著差异(P<0.01).结论:正畸治疗能令嵴上纤维环切术更有效地增加牙槽骨高度及牙周附着.     

牙周炎致错位前牙的正畸牙周联合治疗

目的　对牙周炎致唇向散开的前牙经环切离断牙槽嵴顶纤维后进行正畸治疗 ,观察其疗效。方法　正畸牙周联合治疗 16例患者唇向散开的上前牙 ,使用临床牙周健康指数分析、根尖片观察牙槽骨高度变化及模型分析的方法比较治疗前后的变化。结果　离断牙槽嵴顶纤维后正畸压入使牙槽骨高度平均增加 1 2mm ,前牙覆盖由 7 0mm减至 2 0mm ,覆由 4 0mm减至 2 0mm;牙周组织健康指数无明显变化。结论　经环切离断牙槽嵴顶纤维后 ,正畸压入治疗在矫正患牙咬合关系的同时可改善牙周组织状况 ,增加牙槽骨高度     

嵴上纤维环切辅助正畸压低牙周炎患牙的研究进展

随着人们对口腔健康及美观意识的提高,成年正畸患者逐渐增多,成年人的牙周状况较差,常有牙根暴露、附着丧失、松动度增加、前牙扇形移位等临床表现。近年来有研究报道,嵴上纤维环切术联合正畸治疗可以增加牙周炎患牙骨内根长、减少附着丧失、改善牙周炎患者的牙周状况和美观。本文就嵴上纤维环切术辅助牙周炎患牙正畸压低的背景、临床操作及效果作一综述。     

牙周病患者移位前牙的牙周正畸联合治疗

牙周病造成牙周组织的破坏,导致前牙的唇向散开、伸长、移位、覆覆盖加深等错畸形,严重影响患者的美观,并出现咬合创伤,而创伤又进一步加重牙周组织的破坏,长期以来,牙周和正畸医生都在探索对此理想的治疗方法[1～7]。本研究选择17例由于牙周病导致前牙错位的患者,采用牙周正畸联合治疗,通过临床及X线检查分析,评价该治疗方法的疗效。一、材料和方法1.病例资料:选择牙周病患者17例,其中男性6例,女性11例,年龄26～46岁,平均37.5岁。患者均因牙周病导致前牙唇向散开、移位。2.观察指标:为了全面评价牙周-正畸联合治疗的效果,所有因牙周病…     

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.     

引导组织再生术后患牙正畸治疗效果观察

目的 评价引导组织再生（GTR）术后患牙正畸治疗效果。方法 选择2009—2011年来锦州市口腔医院就诊的因牙周病导致个别牙严重错牙合畸形患者19例（患牙26颗）,GTR术后6个月开始正畸治疗,比较矫治前后患牙牙周状况。结果 19例患者经牙周-正畸治疗后,有17例达到矫治目标,牙周状况明显改善。与矫治前比较,矫治后的前牙牙槽骨高度略有增加,后牙牙槽骨高度有所降低,但差异无统计学意义（P > 0.05）。结论 GTR手术可使牙周-正畸治疗的安全性、疗效性及稳定性均得到提高。     

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。     

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目的 评价引导组织再生（GTR）术后患牙正畸治疗效果。方法 选择2009—2011年来锦州市口腔医院就诊的因牙周病导致个别牙严重错牙合畸形患者19例（患牙26颗），GTR术后6个月开始正畸治疗，比较矫治前后患牙牙周状况。结果 19例患者经牙周-正畸治疗后，有17例达到矫治目标，牙周状况明显改善。与矫治前比较，矫治后的前牙牙槽骨高度略有增加，后牙牙槽骨高度有所降低，但差异无统计学意义（P 〉 0.05）。结论 GTR手术可使牙周-正畸治疗的安全性、疗效性及稳定性均得到提高。     

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…     

成人牙周病患者正畸-牙周联合治疗的特点

随着经济生活条件的改善,成人正畸患者日趋增多。牙周炎患者因为牙周支持组织的破坏常会导致前牙扇形移位、散开,出现间隙,并形成创伤,进一步加剧牙周支持组织的丧失,最终导致牙齿脱落。     

Orthodontic movement into infrabony defects in patients with advanced periodontal disease: a clinical and radiological study

BACKGROUND: In cases of advanced periodontal disease with a pathologic flaring of frontal teeth, a combined periodontic-orthodontic therapy may be a reliable approach in order to solve both functional and esthetic problems. The aim of the present study was to evaluate the periodontal tissue alterations following periodontal surgery and orthodontic intrusion in migrated upper central incisors with intrabony defects. METHODS: Ten patients with advanced periodontal disease and an extruded maxillary central incisor infrabony defect at its mesial aspect and probing depth (PD) > or = 6 mm were included in the present study. At baseline, PD and clinical attachment level (CAL) were measured. The vertical and horizontal dimensions of the defects were assessed on standardized radiographs. Seven to 10 days after surgery the active orthodontic treatment started using the segmented arch technique, in order to intrude and move the teeth into the defects. Maintenance therapy was performed every 2 to 3 months until the orthodontic treatment was completed. RESULTS: At the end of treatment, mean PD reduction was 4.35 mm, with a residual mean PD of 2.80 mm. Mean CAL gain was 5.50 mm. The mean radiological vertical and horizontal bone fills were, respectively, 1.35 mm and 1.40 mm. All differences were of statistical significance (P<0.001). CONCLUSION: The present study showed that the combined orthodontic and periodontic therapy performed resulted in the realignment of extruded teeth with infrabony defects, obtaining a significant probing depth reduction, clinical attachment gain, and radiological bone fill.     

牙周炎患者前牙区压低后骨缺损形态的初步研究

目的本研究通过正畸压低排齐牙周炎患者伸长、移位的前牙,探讨正畸压低后前牙区的骨缺损形态。方法选取11例牙周炎患者的20颗伸长、移位的患牙,治疗前牙槽骨形态均为水平型骨吸收,正畸压低排齐患牙,采用Morita CT对压低排齐后的骨缺损形态进行评价。结果2名患者的近远中侧均出现了角型吸收,其余患者个别位点出现了角型吸收。结论压低单颗前牙在近、远中侧比较容易出现角型吸收;同时压低2颗或以上的牙齿,压低后一般仍为水平型吸收。     

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。     

Orthodontic movement in traumatically intruded teeth: a case report

Abstract  – Intrusive luxation of permanent mature teeth is one of the most serious injuries to the periodontal ligament in dental traumatology. Various treatment approaches are currently practised. The treatment of choice for traumatically intruded teeth was to combine orthodontic repositioning and endodontic treatment. This case report describes the treatment of a 50-year-old male patient, with four completely intruded mature permanent maxillary incisors. Orthodontic extrusion was initiated 1 week after the trauma. After 10 days, the crowns of the teeth were exposed to start endodontic therapy. Nine weeks after the injury and 8 weeks after the beginning of orthodontic extrusion, the intruded incisors were back about to their original position before the displacement occurred. All treatment management as well as a follow-up 8 years after the trauma are described.     

正畸治疗中阻生牙助萌术1例

目的 以正畸治疗中阻生牙助萌术为例,探讨正畸患者的牙周手术设计中应注意的问题。诊治过程：25岁男性患者,牙龈呈炎症表现,牙列不齐,右上颌侧切牙阻生。前牙深覆牙合,双侧第一磨牙及尖牙远中关系,右上颌中切牙和尖牙间存在间隙。前期通过正畸治疗排齐牙列,并开辟右上颌侧切牙处的间隙。在完成牙周基础治疗的前提下,设计偏腭侧切口,在有效暴露阻生牙的前提下尽可能保存所有软组织,同时根据正畸牙移动的目标位置行骨增量和软组织增量,术后牵引并排齐右上颌侧切牙。结果 通过合理的牙周手术设计,本病例在正畸过程中保持了牙周软硬组织的健康。结论 正畸患者的牙周手术设计应同时关注正畸需求和牙周健康。     

Dental abnormalities, bone graft quality, and periodontal conditions in patients with unilateral cleft lip and palate at different phases of orthodontic treatment.

OBJECTIVES: To evaluate the dental and periodontal condition of patients with unilateral cleft lip and palate (UCLP) before orthodontic treatment and evaluate whether the dental and periodontal condition of these patients during and after orthodontic treatment was jeopardized by the duration of the orthodontic and surgical treatment. DESIGN: Seventy-five individuals with UCLP (52 males, 23 females), between ages 8 and 20 years, participated in a retrospective study during their final follow-up visit with regard to dental abnormalities, such as hypodontia, external root resorption, crown and root malformation, and supernumerary teeth. Alveolar bone height and periodontal attachment loss on the cleft side were also screened before or after bone grafting and at different stages of orthodontic treatment. RESULTS: Hypodontia of the lateral incisor was found in more than 50% of the patients on the cleft side. Second premolars and/or lateral incisors outside the cleft area were missing in 27.2% of the patients. In 32%, malformations of the teeth near the cleft were noticed. In general, the teeth around and in the cleft of the patients showed normal septal bone heights and a healthy periodontium. Sixty of the 75 patients received a bone graft to restore the interrupted alveolar process. In 93.3% of these patients, the cleft was grafted before the eruption of the canine. CONCLUSION: The periodontium of the teeth in and around the cleft in patients with UCLP observed during and after orthodontic treatment can cope relatively well with the long orthodontic treatment and combined surgical interventions. The children, who had not yet started treatment, also showed enough bone support and no periodontal problems of the teeth besides the cleft. Early secondary bone grafting seems to give optimal periodontal results.     

Healing of gingival recession following orthodontic treatment: a 30-year case report

This case report describes the healing of gingival recessions on mandibular incisors resulting from orthodontic treatment of a deep bite malocclusion at a 30-year follow-up observation. The marked improvement in the severe recessions was a consequence of the elimination of the direct trauma, orthodontic intrusion of the affected teeth, and subsequent creeping attachment over time. No periodontal treatment was performed before or after orthodontic treatment.     

Some periodontal tissue reactions to orthodontic tooth movement in monkeys

The purpose of the experiment reported was to study soft tissue changes at teeth which were orthodontically moved into areas with varying thickness and quality of periodontal tissues. The maxillary central incisors and first premolars in 5 adult monkeys were used as experimental teeth. 6 months prior to the start of the orthodontic treatment phase, the maxillary second premolars were extracted. By surgical means, areas with varying width of the keratinized gingiva were established in the incisor and premolar region. Following a clinical baseline examination which involved assessments of gingival width, location of the gingival margin in relation to cemento-enamel junction and probing attachment level, fixed orthodontic appliances were inserted in order to bodily move the two contral incisors in labial direction through the alveolar bone envelope and the first premolars in distal direction into contact with the first molars. Orthodontic forces were applied for a period of 3-4 months. The lateral incisors and first molars were selected as non-moved control teeth. After the experimental teeth had been retained in their new positions for 1 month, the clinical examination was repeated. Tissue blocks containing test and control specimens were subsequently dissected and prepared for microscopic analysis. The analysis included histometric assessments of loss of connective tissue attachment and height of alveolar bone. The results showed that at every second labially moved incisor, the gingival margin had become displaced in apical direction. The degree of displacement, however, was small and only at 2 teeth accompanied by loss of connective tissue attachment. Throughout the study, these particular teeth also showed obvious signs of gingival inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)