咬合调整对慢性牙周炎伴咬合创伤患者牙周治疗效果的影响
|
摘要
目的:比较全口龈下刮治及根面平整与咬合调整治疗的先后顺序及治疗时机的差异,对慢性牙周炎伴咬合创伤患者牙周治疗效果的影响。方法:将选取的60例中、重度慢性牙周炎伴咬合创伤患者随机分为3组;A组全口龈下刮治及根面平整(subgingival scaling and root planing,SRP)、咬合调整治疗同期进行;B组全口SRP治疗4周后行调合调整治疗;C组先对创伤牙位进行咬合调整治疗,4周后行全口SRP治疗。在0 d、4周、12周时搜集相关数据进行统计分析,比较3组治疗在不同时期牙周指数及咬合指数差异。结果:0 d时,3组病人的初始牙周指数及咬合指数差异无统计学意义。4周时,A、B两组的牙周指数较0 d时有改善(P<0.05),C组牙周指数的改变无统计学意义。A组及C组的咬合时间及咬合受力百分比较0 d时降低(P<0.05),B组无明显变化。12周时,A组牙周指数及咬合指数改善最明显。结论:单纯的咬合调整治疗不能改善慢性牙周炎患者的牙周炎症状况。慢性牙周炎伴咬合创伤患者,先控制牙周炎症再进行创伤牙位的调牙合治疗,同时调牙合治疗尽早完成有助于创伤牙位的牙周恢复。
Objective: To compare the effect of different procedure between SRP and occlusal adjustment on the treatment of chronic periodontitis with occlusal trauma. Methods: The 60 patients of chronic periodontitis with occlusion trauma were randomly divided into 3 groups,that group A were treated with SRP and occlusal adjusted in the same period,group B with SRP and then occlusal adjusted after 4 weeks,and group C were occlusal adjusted and then treated with SRP after 4 weeks. The periodontal index and occlusal index at 0,4 and 12 weeks were collected. Results: The difference of periodontal and occlusal index of the three groups were insignificance at the beginning. At the 4 weeks,the periodontal index of the group A and B were better than before,the change of occlusal index of the two groups were insignificance,and the occlusal index of group C were lower than before. At the 12 weeks,by the statistical comparison,the improved of the periodontal index and occlusal index of group A were more satisfactory than other groups. Conclusion: The simple occlusal adjustment can not improve periodontal inflammation in periodontitis with secondary occlusal trauma. The occlusal adjustment have more satisfied effect on the basis of inflammation controlled on chronic periodontitis with secondary occlusal trauma. Early occlusal adjustment therapy can provide stable occlusal relationship for traumatic tooth position,which can help the periodontal recovery of traumatic tooth position.
Objective: To compare the effect of different procedure between SRP and occlusal adjustment on the treatment of chronic periodontitis with occlusal trauma. Methods: The 60 patients of chronic periodontitis with occlusion trauma were randomly divided into 3 groups,that group A were treated with SRP and occlusal adjusted in the same period,group B with SRP and then occlusal adjusted after 4 weeks,and group C were occlusal adjusted and then treated with SRP after 4 weeks. The periodontal index and occlusal index at 0,4 and 12 weeks were collected. Results: The difference of periodontal and occlusal index of the three groups were insignificance at the beginning. At the 4 weeks,the periodontal index of the group A and B were better than before,the change of occlusal index of the two groups were insignificance,and the occlusal index of group C were lower than before. At the 12 weeks,by the statistical comparison,the improved of the periodontal index and occlusal index of group A were more satisfactory than other groups. Conclusion: The simple occlusal adjustment can not improve periodontal inflammation in periodontitis with secondary occlusal trauma. The occlusal adjustment have more satisfied effect on the basis of inflammation controlled on chronic periodontitis with secondary occlusal trauma. Early occlusal adjustment therapy can provide stable occlusal relationship for traumatic tooth position,which can help the periodontal recovery of traumatic tooth position.
引文
[1]Pereira LJ,Gazolla CM,Magalh2es IB,et al.Treatment of chronic periodontitis and its impact on mastication[J].J Periodontol,2011,82(2):243-250.
[2]Linhe J,Nyman S,Eicsson I.Clinical Periodontology and Implant Dentistry[M].3thed.Copenhagen.Blackwell Munksgaard,1991:279-295.
[3]王鹏程,唐杭瑞,许杰,等.牙周基础治疗对慢性牙周炎伴继发性咬合创伤患牙临床及咬合影响的随机对照研究[J].中华口腔医学杂志,2013,48(5):266-271.
[4]张明烨,王峰,杨瑞华,等.牙周基础治疗对慢性牙周炎伴继发性咬合创伤牙位龈沟液中IL-1β、RANKL-OPG系统的影响[J].中国实用口腔科杂志,2014,7(9):532-537.
[5]王鹏程,薛栋,丁茜,等.不同牙合治疗对伴有咬合创伤的慢性牙周炎患牙转归的临床研[J].口腔颌面修复学杂志,2017,18(3):147-151.
[6]赵庆扬,李建民,张晓东,等.牙周基础治疗影响慢性牙周炎伴咬合创伤患牙转归的临床分[J].中国临床新医学,2017,10(5):437-439.
[7]Jin LJ,Cao CF.Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis[J].J Clin Periodontol,1992,19(2):92-97.
[8]刘志利,刘伟.龈下刮治与根面平整术对慢性牙周炎伴咬合创伤患牙转归的影响[J].宁夏医科大学学报,2014,36(8):922-924.
[9]王鹏程.牙周基础治疗影响慢性牙周炎伴咬合创伤患牙转归的临床研究[D].西安:第四军医大学,2013.
[10]贾洪诚,王璇.应用T-ScanⅢ型系统分析牙周基础治疗前后咬合变化的临床研[J].实用口腔医学杂志,2015(4):484-487.
[11]Hakkarainen K.Relative influence of scaling and root planing and occlusal adjustment on sulcular fluid flow[J].J Periodontol,1986,57(11):681.
[12]Jin LJ,Cao CF.Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis[J].J Clin Periodontol,1992,19(2):92-97.
[13]Lindhe J,Svanberg G.Influence of trauma from occlusion on progression of experimental periodontitis in the beagle dog[J].J Clin Periodontol,1974,1(1):3-14.
[14]Polson AM,Meitner SW,Zander HA.Trauma and progression of marginal periodontitis in squirrel monkeys.III Adaption of interproximal alveolar bone to repetitive injury[J].J Periodont Res,1976,11(5):290-298.
[15]Philip L.A permanent method of recording occlusal contacts[J].J Prosthet Dent,1985,53(5):748-749.
[16]Hirano S,Okuma K,Hayakawa I.In vitro study on accuracy and repeatability of the T-Scan II system[J].Kokubyo Gakkai Zasshi,2002,69(3):194-201.
[17]Garcia CA,Gonzalez SO,Garrido Garcia VC.Analysis of two methods for occlusal contact registration with the T-Scan system[J].J Oral Rehabil,1997,24(6):426.
[2]Linhe J,Nyman S,Eicsson I.Clinical Periodontology and Implant Dentistry[M].3thed.Copenhagen.Blackwell Munksgaard,1991:279-295.
[3]王鹏程,唐杭瑞,许杰,等.牙周基础治疗对慢性牙周炎伴继发性咬合创伤患牙临床及咬合影响的随机对照研究[J].中华口腔医学杂志,2013,48(5):266-271.
[4]张明烨,王峰,杨瑞华,等.牙周基础治疗对慢性牙周炎伴继发性咬合创伤牙位龈沟液中IL-1β、RANKL-OPG系统的影响[J].中国实用口腔科杂志,2014,7(9):532-537.
[5]王鹏程,薛栋,丁茜,等.不同牙合治疗对伴有咬合创伤的慢性牙周炎患牙转归的临床研[J].口腔颌面修复学杂志,2017,18(3):147-151.
[6]赵庆扬,李建民,张晓东,等.牙周基础治疗影响慢性牙周炎伴咬合创伤患牙转归的临床分[J].中国临床新医学,2017,10(5):437-439.
[7]Jin LJ,Cao CF.Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis[J].J Clin Periodontol,1992,19(2):92-97.
[8]刘志利,刘伟.龈下刮治与根面平整术对慢性牙周炎伴咬合创伤患牙转归的影响[J].宁夏医科大学学报,2014,36(8):922-924.
[9]王鹏程.牙周基础治疗影响慢性牙周炎伴咬合创伤患牙转归的临床研究[D].西安:第四军医大学,2013.
[10]贾洪诚,王璇.应用T-ScanⅢ型系统分析牙周基础治疗前后咬合变化的临床研[J].实用口腔医学杂志,2015(4):484-487.
[11]Hakkarainen K.Relative influence of scaling and root planing and occlusal adjustment on sulcular fluid flow[J].J Periodontol,1986,57(11):681.
[12]Jin LJ,Cao CF.Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis[J].J Clin Periodontol,1992,19(2):92-97.
[13]Lindhe J,Svanberg G.Influence of trauma from occlusion on progression of experimental periodontitis in the beagle dog[J].J Clin Periodontol,1974,1(1):3-14.
[14]Polson AM,Meitner SW,Zander HA.Trauma and progression of marginal periodontitis in squirrel monkeys.III Adaption of interproximal alveolar bone to repetitive injury[J].J Periodont Res,1976,11(5):290-298.
[15]Philip L.A permanent method of recording occlusal contacts[J].J Prosthet Dent,1985,53(5):748-749.
[16]Hirano S,Okuma K,Hayakawa I.In vitro study on accuracy and repeatability of the T-Scan II system[J].Kokubyo Gakkai Zasshi,2002,69(3):194-201.
[17]Garcia CA,Gonzalez SO,Garrido Garcia VC.Analysis of two methods for occlusal contact registration with the T-Scan system[J].J Oral Rehabil,1997,24(6):426.