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。

Effect of invisible appliance without bracket and self-locking bracket appliance on periodontal and subgingival flora in patients with periodontitis

PURPOSE: To observe the effect of non-bracket invisible appliance and self-locking bracket appliance on periodontal health and subgingival flora in patients with periodontitis. METHODS: One hundred and ten patients with periodontitis who received orthodontic treatment were divided into invisible group and self-locking bracket group. The periodontal index including probing depth (PD), gingival index (GI), sulcular bleeding index (SBI) and plaque index (PLI) ,and the levels of inflammatory factors in the gingival crevicular fluid were examined. Visual analogue scale (VAS) was used to evaluate periodontal pain before and after correction, and the curative effect was evaluated. The status of common pathogenic bacteria in the subgingival plaque of patients after correction was detected by PCR. The data were analyzed with SPSS19.0 software package. RESULTS: Twelve months after treatment and at the end of treatment, PLI of the self-locking bracket group was significantly higher than the invisible group(P<0.05), but PD, GI and SBI between the two groups had no significant difference. After correction, the inflammatory factors in the invisible group were significantly lower than those in the self-locking bracket group(P<0.05). At 1d after treatment, pain index in the invisible group was significantly lower than the self-locking group(P<0.05). The clinical total effective rate of the invisible group was significantly higher than the self-locking group (89.10% vs 76.36%). After treatment, the detection rate and the content of subgingival pathogenic bacteria in the self-locking bracket group were significantly higher than the invisible group(P<0.05). CONCLUSIONS: During orthodontic treatment of periodontitis, wearing non-bracket invisible appliance can effectively inhibit inflammatory response and proliferation of subgingival pathogens, which is more conducive to the maintenance of periodontal health and oral hygiene.