摘要
目的 探究正畸联合牙周夹板治疗牙周炎所致前牙扇形移位的疗效及其影响因素.方法 本研究为回顾性分析,纳入2018年8月至2023年8月期间中南大学湘雅医学院附属海口医院收治的80例牙周炎所致前牙扇形移位患者,依据治疗方案的不同分为对照组和研究组,每组各40例.两组患者均接受牙周基础治疗,对照组行牙周夹板治疗,研究组行正畸联合牙周夹板治疗.比较两组患者治疗前、治疗6个月和12个月后的临床疗效、牙周指标[牙龈指数(GI)、附着丧失(AL)、牙周探诊深度(PD)、改良龈沟出血指数(mSBI)、改良菌斑指数(mPLI)以及松动度]、咀嚼功能和美观度.根据治疗12个月后的疗效将所有患者分为预后良好组(n=58)和预后不良组(n=22),对长期疗效的影响因素进行单因素分析和多因素Logistic回归分析.结果 研究组总有效率为85.00％,显著高于对照组(60.00％),差异有统计学意义(P＜0.05).治疗6、12个月后,研究组的GI、AL、PD、mSBI、mPLI以及松动度均低于对照组,差异均有统计学意义(P＜0.05).治疗6、12个月后,研究组的咀嚼功能评分高于对照组,前牙覆盖度和牙槽骨高度均低于对照组,差异均有统计学意义(P＜0.05).单因素分析显示,年龄、牙周炎病程、牙周炎严重程度、合并糖尿病、口腔卫生习惯和吸烟史为影响牙周炎所致前牙扇形移位患者行正畸联合牙周夹板治疗长期疗效的主要因素(P＜0.05).多因素Logistic回归分析显示,牙周炎病程、牙周炎严重程度、合并糖尿病、口腔卫生习惯以及吸烟史均为影响牙周炎所致前牙扇形移位患者行正畸联合牙周夹板治疗长期疗效的独立危险因素(P＜0.05).结论 口腔正畸联合牙周夹板治疗对牙周炎所致前牙扇形移位临床疗效确切,可显著改善患者牙周指数、咀嚼功能和美观度,值得临床推广;其长期疗效受牙周炎病程、牙周炎严重程度、合并糖尿病、口腔卫生习惯以及吸烟史等因素的影响,提示医患在临床诊疗中要针对性地干预和规避.
Abstract
Objective To investigate the efficacy of orthodontic combined with periodontal splint in the treatment of Anterior displaced in-cisors caused by periodontitis and analyse the influential factors of longterm efficacy.Methods This study was a retrospective analysis that includ-ed 80 patients with anterior tooth fan-shaped displacement caused by periodontitis admitted to Haikou Affiliated Hospital of Central South Univer-sity Xiangya School of Medicine from August 2018 to August 2023.They were divided into the control group and the study group based on different treatment plans,with 40 cases in each group.Both groups of patients received basic periodontal treatment,the control group received periodontal splint treatment,and the study group received orthodontic combined periodontal splint treatment.The clinical efficacy,periodontal index[gingival index(GI),attachment loss(AL),probing depth(PD),modified sulcus bleeding index(mSBI),modified plaque index(mPLI)and mobility],chewing function,and aesthetics of the two groups of patients were compared before treatment,6 months and 12 months after treatment.Based on the efficacy after 12 months of treatment,all patients were divided into a good prognosis group(58 cases)and a poor prognosis group(22 cases).Univariate analysis and multivariate logistic regression analysis were conducted on the influencing factors of long-term efficacy.Results The total efficacy of the research group was 85.00％,which was higher than that of the control group(60.00％),the difference was statistically significant(P＜0.05).After 6 and 12 months of treatment,the GI,AL,PD,mSBI,mPLI,and looseness of the study group were lower than those of the control group,and the differences were statistically significant(P＜0.05).The univariate analysis showed that age,periodontitis course,peri-odontitis severity,concurrence of diabetes mellitus,oral hygiene habits and smoking history were the risk factors(P＜0.05).Multiple logistic regression analysis showed that periodontitis course,periodontitis severity,concurrence of diabetes mellitus,oral hygiene habits and smoking histo-ry were the independent risk factors(P＜0.05).Conclusion Orthodontic combined with periodontal splint has a exact curative effect in the treatment of anterior displaced incisors caused by periodontitis,which can significantly improve the periodontal indexes,masticatory function and aesthetics and is worth clinical expansion,periodontitis course,periodontitis severity,concurrence of diabetes mellitus,oral hygiene habits and smoking history are the independent risk factors,the doctors and patients should interfere and aviod targeted during diagnosis and treatment.
基金项目
海南省自然科学基金(2021)(821RC727)
维普
万方数据