自锁托槽与传统托槽矫治器对牙周健康影响的比较研究

目的 对比戴用自锁托槽与传统托槽矫治器后牙周指数的变化.材料和方法选取12～18岁正畸患者80例,按矫治器类型分为两组:实验组,40例采用AO公司生产的T3自锁托槽矫正的患者;对照组,采用杭州西湖公司生产的徐氏托槽矫正的患者40例.由同一牙周专科医师分别检测80例患者治疗前和治疗6个月的各项牙周指数(GI,PLI,SBI,PD).结果 治疗6个月后两组间牙周指数(GI,PLI,SBI,PD)差异无显著性.结论 自锁托槽矫治器不会更有利于牙周组织的健康,牙周的健康状况取决于患者的口腔卫生状况.     

自锁托槽矫治器对牙周健康的影响

目的观察自锁托槽对正畸患者牙周健康的影响。方法随机选择48例12～16岁错畸形患者,分为自锁托槽组和传统结扎式托槽组,前者使用3M公司Smartclip自锁托槽矫治器,后者使用GeminiMBT金属托槽矫治器。分别在戴矫治器后1、3、6个月检测下切牙牙龈指数(GI),菌斑指数(PLI),龈沟出血指数(SBI)。结果自锁托槽组牙周指数明显低于统结扎式托槽组。结论与传统结扎式托槽矫治器相比,自锁托槽矫治器更有利于牙周组织健康。     

自锁托槽与传统托槽对牙周环境影响的研究现状和进展

自锁矫治器功能上具备很多独特的优势,近些年被广泛应用于临床。自锁托槽依赖滑盖或弹簧夹固定弓丝,无需结扎丝或橡皮圈结扎。这一特殊结构是否更利于正畸患者的口腔卫生维护,引起国内外学者的高度关注。本文就自锁托槽与传统托槽对牙周环境影响研究现状及进展作一综述。     

无托槽隐形矫治器及自锁托槽矫治器对牙周炎患者牙周及龈下菌群的影响

目的： 观察无托槽隐形矫治器及自锁托槽矫治器矫正治疗对牙周炎患者牙周健康及龈下菌群的影响。方法： 收集接受正畸治疗的牙周炎患者110例,按照治疗方式分为隐形组和自锁托槽组。跟踪检查患者的牙周指数,包括探诊深度（PD）、牙龈指数（GI）、龈沟出血指数（SBI）、菌斑指数（PLI）、龈沟液炎症因子水平;采用VAS法评价矫治前、后牙周疼痛情况和矫治效果,PCR分析矫治后患者龈下菌斑中常见致病菌情况。采用SPSS 19.0软件包对数据进行统计学分析。结果： 矫治12个月及矫治结束后,自锁托槽组PLI显著高于隐形组（P<0.05）,PD、GI、SBI在2组间无显著差异。矫治后,隐形组患者的炎症因子水平显著低于自锁托槽组（P<0.05）。矫治后1 d,隐形组患者的疼痛指数显著低于自锁托槽组（P<0.05）。隐形组临床总有效率显著高于自锁托槽组（89.10% vs 76.36%）。矫治后,自锁托槽组龈下致病菌检出率及含量显著高于隐形组（P<0.05）。结论： 在牙周炎患者正畸治疗中,配戴无托槽隐形矫治器能有效抑制炎症反应及龈下致病菌增殖,更有利于牙周健康及口腔卫生维护。     

应用自锁托槽和传统结扎托槽矫治对牙周状况影响的比较

目的：比较自锁托槽和传统结扎托槽对正畸患者牙周状况的影响。方法收集12~16岁青少年正畸患者120例,根据托槽种类随机分为4组,每组30例,其中传统托槽组使用传统结扎托槽作为对照组,Smart?clip组、Bio?Quick组及Damon Q组使用3种不同自锁托槽作为试验组,于矫治前（T0）、矫治后1（T1）、3（T2）、6（T3）个月分别测量下颌切牙的菌斑指数、牙龈指数和探诊深度。结果 T0期和T1期,各组相关牙周指数较治疗前差异无统计学意义（P>0.05）;矫治后3、6个月,不论是自锁托槽组还是传统托槽组,菌斑指数和牙龈指数同T0、T1相比逐渐升高,且差异有统计学意义（P<0.05）,但牙周探诊深度仍无明显区别（P>0.05）。矫治后3个月,3个自锁托槽组的菌斑指数及牙龈指数明显低于传统托槽组,差异有统计学意义（P<0.05）。矫治后6个月,自锁托槽组的菌斑指数及牙龈指数同对照组相比也有显著降低（P<0.05）。但在不同矫治时期,不同种类自锁托槽牙周指数间比较差异无统计学意义（P>0.05）。结论与传统结扎托槽相比,自锁托槽在控制菌斑及牙龈出血方面存在优势,但对牙周袋深度的影响无明显差别。     

无托槽隐形矫治器与固定矫治器对牙周影响的研究

目的 本研究通过临床评估使用无托槽隐形矫治器与传统固定矫治器患者的牙周指数变化,比较两种矫治器对牙周健康的影响,判断隐形矫治器是否更有利于口腔卫生和牙周健康维护.方法 临床选取40名成人患者,分为隐形矫治组(Ⅰ组)和固定矫治组(F组),通过测量在其矫治前及佩戴后1、3、6个月中菌斑指数(Plaque Index,PLI)、牙龈指数(Gingiva-Index,GI)及龈沟出血指数(Sulcus Bleeding Index,SBI)等牙周指数变化,对比两种矫治器对牙周健康的影响.结果 隐形矫治组的PLI在治疗中明显低于固定矫治组,但GI及SBI除第一个月有差异外,后期无明显差别.佩戴矫治器后两组的各项指数均高于矫治前.结论 无托槽隐形矫治器在一定程度上仍有碍口腔卫生的维护,但优于传统的固定矫治器,在矫治过程中短期内仍会对牙周组织健康造成一定影响,与传统固定矫治器并无明显差别.     

无托槽隐形矫治器与固定矫治器对患者牙周健康影响的研究进展

近年来成人正畸患者数量日益增加,矫正治疗的同时对牙周健康的维护不可忽视。与传统固定矫治器相比,无托槽隐形矫治器因具有摘戴简单、美观舒适、便于口腔卫生清洁等特点备受广大患者青睐。本文分别从临床试验、微生物试验以及应力分布3个方面综述无托槽隐形矫治器和固定矫治器对牙周健康的影响,并对近年来有关的研究进展作一概述,为临床治疗中规避牙周风险提供依据。     

隐形矫治器、自锁托槽与传统托槽对成人正畸患者牙周指数及龈沟液炎性因子的影响

目的:研究隐形矫治器、自锁托槽及传统托槽对成人正畸患者牙周指数及龈沟液内炎性因子水平的影响.方法:90例成人正畸患者随机分为传统组、自锁组及隐形组(n=30),分别佩戴传统MBT托槽、Damon Q自锁托槽及Invisalign隐形矫治器,观察矫治前、矫治后1、3、6个月及矫治结束时患者菌斑指数(PLI)、探诊深度(PD)及龈沟液内白介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)的变化情况.结果:矫治后1～6个月,传统组及自锁组患者牙周指数及龈沟液内炎性因子水平持续升高(P＜0.05),6个月达最高峰,矫治后1个月自锁组与传统组比较无显著差异(P＞0.05),矫治后3个月至矫治结束自锁组牙周指数及炎性因子水平均明显低于传统组(P＜0.05).隐形组患者PLI、IL-1β及TNF-α在矫治后6个月较矫治前升高(P＜0.05),但矫治后各项指标均显著低于传统组及自锁组(P＜0.05).结论:自锁托槽在正畸矫治中后期对牙周组织的影响小于传统托槽,隐形矫治器及自锁托槽与传统托槽相比,在正畸矫治后各个时期均更利于牙周组织的健康.     

自锁托槽矫治器的应用

自锁托槽矫治器的构造和临床特点与传统的矫治器有很大差异,具有减小正畸矫治的摩擦力、缩短矫治时间和椅旁操作时间等优点。本文从自锁托槽的构造、摩擦力、对牙周健康的影响及对牙齿的控制等几方面作一综述。     

自锁托槽和无托槽隐形矫治器对正畸患者牙周组织炎症状态的影响

目的 探讨自锁托槽和无托槽隐形矫治器对正畸患者牙周组织炎症状态的影响。方法 选取104例错畸形患者，根据患者自愿原则采用无托槽隐形矫治器和自锁托槽矫治器，各52例，评估两组粘戴托槽前及粘戴托槽24 h后的口腔咬合功能[去皮花生仁的咀嚼次数(MT)，并计算咀嚼效能(ME)、最大咬合力(MF)、最大合力时间(MFT)、咬合速率(SO)]，对比两组矫治前及矫治6个月后的牙周指数[牙龈指数(GI)、龈沟探诊深度(SPD)、龈沟出血指数(SBI)、菌斑指数(PLI)]、龈沟液中白细胞介素1β(IL-1β)、肿瘤坏死因子(TNF-α)水平和天门冬氨酸转氨酶(AST)及碱性磷酸酶(ALP)含量。结果 两组粘戴托槽24 h后的ME、MT、MF及SO值较粘戴托槽前有显著性降低(P<.05)，MFT值较粘戴托槽前有显著性升高(P<.05)，无托槽组矫治6个月后的GI、SPD、SBI及PLI值较矫治前无明显差异(P>0.05)，而自锁托槽组较矫治前有显著提高(P<.05)，无托槽组上述指标变化幅度显著小于自锁托槽组(P<.05)；两组矫治6个月后的龈沟液中IL-1β、TNF-α、AST及ALP含量水平较矫治前有显著提升(P<.05)，但无托槽组显著低于自锁托槽组(P<.05)。结论 无托槽隐形矫治器用于正畸治疗中，能明显改善患者粘戴托槽后的咬合功能，改善牙周组织健康状态，并有效减少龈沟液中IL-1β、TNF-α、AST及ALP过量分泌，以缓解牙周组织炎症状态。     

Effects of self-ligating and conventional brackets on halitosis and periodontal conditions

Objective:To evaluate the effects of fixed orthodontic treatment with steel-ligated conventional brackets and self-ligating brackets on halitosis and periodontal health.Materials and Methods:Sixty patients, at the permanent dentition stage aged 12 to 18 years, who had Angle Class I malocclusion with mild-to-moderate crowding were randomly selected. Inclusion criteria were nonsmokers, without systematic disease, and no use of antibiotics and oral mouth rinses during the 2-month period before the study. The patients were subdivided into three groups randomly: the group treated with conventional brackets (group 1, n  =  20) ligated with steel ligature wires, the group treated with self-ligating brackets (group 2, n  =  20), and the control group (group 3, n  =  20). The periodontal records were obtained 1 week before bonding (T1), immediately before bonding (T2), 1 week after bonding (T3), 4 weeks after bonding (T4), and 8 weeks after bonding (T5). Measurements of the control group were repeated within the same periods. The volatile sulfur components determining halitosis were measured with the Halimeter at T2, T3, T4, and T5. A two-way repeated measures of analysis of variance (ANOVA) was used to compare the groups statistically.Results:No statistically significant group × time interactions were found for plaque index, gingival index, pocket depth, bleeding on probing, and halitosis, which means three independent groups change like each other by time. The risk of tongue coating index (TCI) being 2 was 10.2 times higher at T1 than at T5 (P < .001). Therefore, the probability of higher TCI was decreased by time in all groups.Conclusions:The self-ligating brackets do not have an advantage over conventional brackets with respect to periodontal status and halitosis.     

Debris and friction of self-ligating and conventional orthodontic brackets after clinical use

Objective:To compare the degree of debris and friction of conventional and self-ligating orthodontic brackets before and after clinical use.Materials and Methods:Two sets of three conventional and self-ligating brackets were bonded from the first molar to the first premolar in eight individuals, for a total of 16 sets per type of brackets. A passive segment of 0.019 × 0.025-inch stainless steel archwire was inserted into each group of brackets. Frictional force and debris level were evaluated as received and after 8 weeks of intraoral exposure. Two-way analysis of variance and Wilcoxon signed-rank test were applied at P < .05.Results:After the intraoral exposure, there was a significant increase of debris accumulation in both systems of brackets (P < .05). However, the self-ligating brackets showed a higher amount of debris compared with the conventional brackets. The frictional force in conventional brackets was significantly higher when compared with self-ligating brackets before clinical use (P < .001). Clinical exposure for 8 weeks provided a significant increase of friction (P < .001) on both systems. In the self-ligating system, the mean of friction increase was 0.21 N (191%), while 0.52 N (47.2%) was observed for the conventional system.Conclusion:Self-ligating and conventional brackets, when exposed to the intraoral environment, showed a significant increase in frictional force during the sliding mechanics. Debris accumulation was higher for the self-ligating system.     

Clinical and microbiological parameters in patients with self-ligating and conventional brackets during early phase of orthodontic treatment

Objective:To determine the effect of different bracket designs (conventional brackets and self-ligating brackets) on periodontal clinical parameters and periodontal pathogens in subgingival plaque.Material and Methods:The following inclusion criteria were used: requirement of orthodontic treatment plan starting with alignment and leveling, good general health, healthy periodontium, no antibiotic therapy in the previous 6 months before the beginning of the study, and no smoking. The study sample totaled 38 patients (13 male, 25 female; mean age, 14.6 ± 2.0 years). Patients were divided into two groups with random distribution of brackets. Recording of clinical parameters was done before the placement of the orthodontic appliance (T0) and at 6 weeks (T1), 12 weeks (T2), and 18 weeks (T3) after full bonding of orthodontic appliances. Periodontal pathogens of subgingival microflora were detected at T3 using a commercially available polymerase chain reaction test (micro-Dent test) that contains probes for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola.Results:There was a statistically significant higher prevalence of A actinomycetemcomitans in patients with conventional brackets than in patients with self-ligating brackets, but there was no statistically significant difference for other putative periodontal pathogens. The two different types of brackets did not show statistically significant differences in periodontal clinical parameters.Conclusion:Bracket design does not seem to have a strong influence on periodontal clinical parameters and periodontal pathogens in subgingival plaque. The correlation between some periodontal pathogens and clinical periodontal parameters was weak.     

自锁托槽与传统托槽导致正畸牙根吸收的锥形束CT比较

目的:比较被动自锁托槽与传统直丝弓托槽造成牙根根尖外吸收量的差异,分析被动自锁托槽与牙根吸收的关系.方法:将50例患者随机分为2组,每组25例,分别应用被动自锁托槽或传统直丝弓托槽(0.022系统)进行矫治.治疗前、后拍摄锥形束CT(CBCT),测量上切牙的牙根根尖外吸收量.采用SPSS17.0软件包对2组牙根根尖外吸收量的差异进行t检验.结果:被动自锁托槽和传统直丝弓托槽治疗结束后,上颌切牙牙根吸收量无显著差异(P＞0.05).结论:被动自锁托槽和传统直丝弓托槽都会造成一定量的牙根吸收,但两者造成的牙根根尖外吸收量差异无显著性,不能认为被动自锁托槽会诱发更多的牙根吸收.     

Canine retraction rate with self-ligating brackets vs conventional edgewise brackets

Objective:To compare the rates of retraction down an archwire of maxillary canine teeth when bracketed with a self-ligating bracket was used on one side and a conventional bracket on the other.Materials and Methods:In 43 patients requiring maxillary premolar extraction, a self-ligating bracket (Damon3, SmartClip) was used on the maxillary canine on one side and a conventional bracket (Victory Series) on the other. The teeth were retracted down a 0.018-inch stainless steel archwire, using a medium Sentalloy retraction spring (150 g). The rates of retraction were analyzed using a paired t-test.Results:The mean movement per 28 days for the conventional bracket was 1.17 mm. For the Damon bracket it was 0.9 mm and for the SmartClip bracket it was 1.10 mm. The differences between the conventional and self-ligating brackets were statistically significant: paired t-test, SmartClip, P < .0043; Damon3, P < .0001).Conclusion:The retraction rate is faster with the conventional bracket, probably because of the narrower bracket width of the self-ligating brackets.     

Periodontal condition of the mandibular anterior dentition in patients with conventional and self-ligating brackets

Authors – Pandis N, Vlachopoulos K, Polychronopoulou A, Madianos P, Eliades T Objectives – To explore whether the use of self‐ligating brackets is associated with better values for periodontal indices because of the lack of elastomeric modules and concomitantly, reduced availability of retentive sites for microbial colonization and plaque accumulation. Setting and Sample Population – Private practice of the first author. Patients were selected using the following inclusion criteria: age range 12–17 years, fixed appliances on both arches, aligned mandibular arch, and absence of oral habits and anterior crossbites. Materials and Methods – Prospective cohort investigation. Participants were grouped for bracket type, thus 50 patients formed the conventional bracket cohort and 50 patients the self‐ligating bracket cohort. Both cohorts were followed with the purpose to examine periodontal status. Average length of follow‐up was 18 months. This time period was considered adequate for a proportion of study participants to experience the outcome of interest. Outcome variables were plaque index, gingival index, calculus index, and probing depth for the two bracket cohorts. Results – No difference was found in the indices recorded between the two bracket cohorts studied. Conclusion – Under the conditions as applied in this study, the self‐ligating brackets do not have an advantage over conventional brackets with respect to the periodontal status of the mandibular anterior teeth.     

Comparison of root resorption between self-ligating and conventional preadjusted brackets using cone beam computed tomography

Objective:To compare the magnitude of external apical root resorption (EARR) of incisors in patients undergoing the initial phase of orthodontic treatment with two sets of brackets.Materials and Methods:According to the results of the power analysis for sample size calculation, 19 Angle Class I patients (anterior crowding: 3 to 5 mm; mean age: 20.6 years) were included in the study and randomly divided into two groups: group I (n  =  11, self-ligating brackets) and group II (n  =  8, conventional preadjusted brackets). The degree of EARR was detected in 152 upper and lower incisors by using cone-beam computed tomography (CBCT) scans and a three-dimensional program (Dolphin 11.5, Dolphin Imaging & Management Solutions, Chatsworth, Calif) with 25% level of sensitivity. The CBCT scans were obtained before (T1) and 6 months after initiation of treatment (T2). Differences between and within groups were analyzed by nonpaired and paired t-test, respectively, with 5% significance level.Results:Significant differences were found for both groups between T1 and T2. However, no differences in the degree of EARR were detected between the groups studied.Conclusions:Although EARR has occurred in all teeth evaluated, the bracket design (self-ligating or conventional) did not demonstrate any influence on the results observed.     

Treatment time,outcome, and anchorage loss comparisons of self-ligating and conventional brackets

Objective:To compare the treatment time, outcome, and anchorage loss among orthodontic patients treated by self-ligating brackets (SLBs) and conventional brackets (CBs).Materials and Methods:A retrospective cohort study compared 34 patients (SLB group) treated by SmartClip brackets (3M Unitek, Monrovia, Calif) to 35 patients (CB group) treated by conventional preadjusted Victory series brackets (3M Unitek) and ligated by stainless steel wire ligatures. Pretreatment (T1) and posttreatment (T2) lateral cephalograms were traced and analyzed using Pancherz sagittal-occlusion analysis to obtain skeletal and dental changes in the maxilla and the mandible. The dental cast models were assessed by the Peer Assessment Rating (PAR) Index for the treatment outcomes.Results:The mean treatment time for SLBs (19.19 months) did not show a statistically significant difference from 21.25 months of CBs; the treatment time and pretreatment PAR scores were strongly correlated. There was no difference in anchorage loss between the SLB and CB groups. There were significant dental and skeletal changes among adolescent orthodontic patients regardless of the bracket used. The lingual inclination of the mandibular incisors in the CB group was 3.62° more than in the SLB group (P < .01).Conclusions:The treatment time and anchorage loss are not influenced by the type of bracket used. There are significant dental and skeletal changes among adolescent orthodontic patients regardless of the bracket used. There is significantly greater lingual inclination of mandibular incisors in the CB group than in the SLB group.