双链法与微种植体支抗配合直丝弓矫治技术对正畸牙牙间隙关闭影响的对比观察

目的 探讨双链法矫治正畸牙牙间隙关闭的价值。方法 前瞻性纳入2014年6月—2017年6月承德医学院附属医院口腔科72例不同上下颌牙列间隙的正畸患者,按数字表法随机分为研究组和对照组,每组36例。对照组患者采用微种植体支抗配合直丝弓矫治技术治疗,研究组患者采用双链法治疗;分别记录两组患者牙间隙关闭所需的时间、牙周指标和并发症等情况。结果 研究组和对照组患者牙间隙关闭时间分别为(4.19±0.76)、(5.34±0.56)个月,差异有统计学意义(t=7.309, P＜0.01);尖牙牙冠远中舌向扭转率分别为5.56%(2/36)、27.78%(10/36),差异有统计学意义(χ²=6.400, P＜0.05)。矫治前和矫治后6个月:研究组患者牙龈指数(GI)分别为0.53±0.11、0.83±0.47,对照组分别为0.54±0.17、0.85±0.49,各组患者矫治前后GI差异均有统计学意义(t=3.729、3.586,P值均＜0.01);研究组龈沟探诊深度(SPD)分别为(2.25±0.43) mm、(2.87±0.47) mm,对照组分别为(2.17±0.37) mm、(2.82±0.54) mm,各组患者矫治前后SPD差异均有统计学意义(t=5.840、5.958, P值均＜0.01);研究组龈沟出血指数(SBI)分别为0.67±0.36、1.23±0.35,对照组分别为0.64±0.38、1.15±0.21,各组患者矫治前后SBI差异均有统计学意义(t=6.692、7.048, P值均＜0.05);研究组菌斑指数(PLI)分别为0.81±0.43、1.62±0.43,对照组分别为0.86±0.21、1.17±0.25,各组患者矫治前后PLI差异均有统计学意义(t=8.288、5.697, P值均＜0.05)。治疗前后两组间GI、SPD、SBI 差异均无统计学意义(P值均＞0.05);而矫治后6个月PLI研究组明显优于对照组,差异有统计学意义(t=5.428, P＜0.01)。研究组并发症发生率2.78%(1/36),对照组为13.89%(5/36),差异有统计学意义(χ²=22.500, P＜0.01)。结论 在正畸治疗中,使用双链法可缩短正畸牙间隙关闭的时间,有利于牙周组织的健康,减少了并发症的发生率,值得临床的推广。

Comparative study of double chain method and micro implant anchorage with straight wire appliance on orthodontic tooth gap closure

Objective To explore the effect of double chain method support on the closure of orthodontic tooth gap.Methods From June 2014 to June 2017, 72 patients of orthodontic patients with different maxillary and mandibular dentition clearances were randomly selected in Department of Stomatology, Affiliated Hospital of Chengde Medical College. The patients were randomly divided into the research group and the control group (n=36) according to the digital table. The control group patients all implants using micro technology with straight wire bow correction. The patients in the study group were treated with double chain method. The time required for tooth gap closure, periodontal index and complications in the two groups was recorded.Results The mean time of the closing time of tooth extraction clearance in the research group and in the control group were (4.19±0.76) and (5.34±0.56) months. The research group was shorter than the control group (t=7.309, P＜0.01). The reverse rate of the further tongue in the crown of fang in the two groups were 5.56%(2/36) and 27.78%(10/36). The research group was lower than the control group (χ²=6.400, P＜0.05) . The gingival index (GI)of the research group before and after 6 months treatment were 0.53±0.11 and 0.83±0.47, respectively. The control group was 0.54±0.17 and 0.85±0.49, respectively. Compared with pre-treatment, the GI in two groups were significantly improved after treatment for 6 months, the difference was statistically significant (t=3.729、3.586, all P values＜0.01). The SPD of the research group before and after 6 months treatment were (2.25±0.43) mm and(2.87±0.47) mm, respectively. The control group was (2.17±0.37) mm and(2.82±0.54)mm, respectively. Compared with pre-treatment, the SPD in two groups were significantly improved after treatment for 6 months, the difference was statistically significant (t=5.840, 5.958, P＜0.05). The SBI of the research group before and after 6 months treatment was 0.67±0.36 and 1.23±0.35, respectively. The control group was 0.64±0.38 and 1.15±0.21, respectively. Compared with pre-treatment, the SBI in two groups were significantly improved after treatment for 6 months, the difference was statistically significant (t=6.692, 7.048, all P values＜0.05). The PLI of the research group before and after 6 months treatment was 0.81±0.43 and 1.62±0.43, respectively. The control group was 0.86±0.21 and 1.17±0.25, respectively. Compared with pre-treatment, the PLI in two groups were significantly improved after treatment for 6 months, the difference was statistically significant (t=8.288, 5.697, all P values＜0.05). Between the two groups of the GI, SPD, SBI were not significantly improved before and after treatment (all P values＞0.05),while the research group of the PLI index was significantly better than control group,the difference was statistically significant (t=5.428, all P values＜0.01). The incidence of complications in the research group was 2.78%(1/36),the control group was 13.89%(5/36),the difference was statistically significant(χ²=22.500, P＜0.01).Conclusions In orthodontic therapy, double chain method to close the orthodontic tooth gap has shorten the time, it is good for the health of periodontal tissue and reduce the incidence of complications.So it is worthy of clinical promotion.