不同矫治器与粘接方式对青少年男性固定矫治患者牙周健康影响的临床对照研究

A clinical controlled study on the effect of different appliances and bonding ways on periodontal health in adolescent male patients with fixed treatment

摘要:

目的：探讨不同矫治器、粘接方式对青少年男性固定矫治患者周健康的影响。方法：纳入120例男性固定矫治患者，年龄11~16岁，平均（12.92±1.40）岁，分为4组：传统矫治器直接粘接组30例（组1），传统矫治器间接粘接组30例（组2），自锁矫治器直接粘接组30例（组3），自锁矫治器间接粘接组30例（组4）。分别测量矫治前（T0）和矫治后1个月（T1）、2个月（T2）、3个月（T3）的出血指数（bleeding index，BI）、探诊深度（probing depth，PD）和附着丧失（attachment loss，AL）。结果：所有患者矫治后BI、PD均随时间明显上升（P=0.000）。自锁矫治器组BI、PD较传统矫治器组无明显差异（P>0.05）。自锁直接粘接组尖牙BI低于自锁间接粘接组（P=0.001），2组第一磨牙、侧切牙、中切牙BI对比均无差异（P值均大于两两比较校正检验水准0.008）；传统直接粘接组尖牙BI低于传统间接粘接组（P=0.000），两组第一磨牙、侧切牙、中切牙BI对比均无差异（P值均大于两两比较校正检验水准0.008）；而直接粘接组与间接粘接组PD比较并无差异（P>0.05）。结论：固定矫治后患者的牙周指数（BI、PD）均随时间上升，自锁矫治器对比传统矫治器在口腔维护方面不具有明显优势，直接粘接较间接粘接有利于青少年固定矫治患者牙周健康。

Abstract:

Objective：To investigate the influence of different bonding ways and appliances on periodontal health in adolescent male patients with fixed treatment. Methods：One hundred and twenty adolescent male patients with fixed treatment were enrolled. The me－dian age of patients was 12.9 years old（ranged from 11 to 16）. The patients were divided into four groups equally：conventional brackets with direct bonding group，conventional brackets with indirect bonding group，self-ligating brackets with direct bonding group and self-ligating brackets with indirect bonding group. The bleeding index（BI），probing depth（PD） and attachment loss（AL） of patients were examined before fixed treatment（T0） and one month（T1），two months（T2） and three months（T3） after the treatment，respectively. Results：The BI and PD of patients markedly increased over time after fixed treatment（P=0.000）. The BI and PD were not significantly different between patients with conventional brackets and patients with self-ligating brackets（P>0.05）. The BI of canines in patients with self-ligating brackets with direct bonding was lower than those with indirect bonding（P=0.001），and the BI of first mo－lars，lateral incisors and central incisors in the two groups were not statistically different（P>0.008）. The BI of canines in pa－tients with conventional brackets with direct bonding was lower than those with indirect bonding（P=0.000），and the BI of first molars，lateral incisors and central incisors in the two groups were not statistically different（P>0.008）. Meanwhile there was no statistical difference in PD between the two groups（P>0.05）. Conclusion：The BI and PD of patients increase over time after fixed treatment. The type of brackets is not the important factor for periodontal health in adolescent male patients with fixed treatment. Compared with indirect bonding，direct bonding is better for periodontal health in adolescent male patients with fixed treatment.