35例成人中重度牙周炎患者牙槽骨再生正畸的疗效评价

doi:10.19438/j.cjoms.2024.06.006

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (6): 553-557.doi: 10.19438/j.cjoms.2024.06.006

35例成人中重度牙周炎患者牙槽骨再生正畸的疗效评价

郭秋曼¹, 于洪波², 夏韫晖², 王博²

1.上海交通大学医学院附属第九人民医院牙周病科,2.口腔颅颌面科,上海交通大学口腔医学院, 国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室, 上海市口腔医学研究所,上海 200011

收稿日期:2024-09-09 修回日期:2024-10-14 出版日期:2024-11-20 发布日期:2024-12-11
通讯作者: 王博,E-mail：wb228@126.com
作者简介:郭秋曼（1982-）,女,硕士,主治医师,E-mail：sukeseki@126.com
基金资助:
EMEA and APAC 2022 Research Award Program From Align Technology（KQHX2023-02）

Effectiveness of augmented corticotomy assisted orthodontics in 35 adult patients with moderate to severe periodontitis

GUO Qiu-man¹, YU Hong-bo², XIA Yun-hui², WANG Bo²

1. Department of Periodontology, 2. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China

Received:2024-09-09 Revised:2024-10-14 Online:2024-11-20 Published:2024-12-11

摘要/Abstract

摘要： 目的： 定量评估伴下前牙区中重度牙周炎成人错畸形患者的牙槽骨再生正畸疗效。方法： 从上海交通大学医学院附属第九人民医院口腔颅颌面科2017年1月起就诊的连续病例中选择下前牙区中重度牙周炎且接受牙槽骨再生正畸治疗的35例成人患者的102颗下切牙作为研究对象。通过牙周专科检查及锥形束CT（cone-beam CT,CBCT）评价不同观察时间点术区的牙周软硬组织状况。采用SAS 9.1软件包对数据进行统计学处理。结果： 所有患者治疗结束面型及咬合关系良好,牙周炎症得到控制,术区未见牙根吸收。根尖水平骨增量效果好,1/2与3/4根长水平的唇侧骨厚度及唇、舌侧牙槽骨高度在治疗过程中维持稳定。结论： 牙槽骨再生正畸技术治疗伴中重度牙周炎成人错畸形,具有良好的临床应用前景。

关键词: 牙槽骨再生正畸, 成人, 中重度牙周炎, 牙槽骨缺损, 锥形束CT

Abstract: PURPOSE: To quantitatively evaluate the effect of augmented corticotomy assisted orthodontics in adult patients with moderate to severe periodontitis. METHODS: The sample comprised 102 mandibular incisors of 35 adult patients with moderate to severe periodontitis in mandibular anterior region who accepted augmented corticotomy assisted orthodontic treatment selected from consecutive patients at the Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital since Jan.2017. Periodontal soft and hard tissue measurements were appraised with the help of periodontal clinical assessment and cone-beam CT(CBCT) examination at different time points. SAS 9.1 software package was used for data analysis. RESULTS: Facial appearance aesthetics, fine occlusal relationships, and effectively controlled periodontal inflammation were realized for all patients after treatment; moderate to severe, favorable bone augmentation on the labial side at root apex level was achieved with minimal root resorption, bone thickness on the labial side at 1/2 and 3/4 root length level was maintained as well as vertical alveolar bone level on both labial and lingual sides. CONCLUSIONS: Augmented corticotomy assisted orthodontics is a promising approach for the treatment of adult patients with moderate to severe periodontitis.

Key words: Augmented corticotomy assisted orthodontics, Adult, Moderate to severe periodontitis, Alveolar defect, Cone-beam CT

中图分类号:

R783.5

郭秋曼, 于洪波, 夏韫晖, 王博. 35例成人中重度牙周炎患者牙槽骨再生正畸的疗效评价[J]. 中国口腔颌面外科杂志, 2024, 22(6): 553-557.

GUO Qiu-man, YU Hong-bo, XIA Yun-hui, WANG Bo. Effectiveness of augmented corticotomy assisted orthodontics in 35 adult patients with moderate to severe periodontitis[J]. China J Oral Maxillofac Surg, 2024, 22(6): 553-557.

参考文献

[1] Pabari S, Moles DR, Cunningham SJ.Assessment of motivation and psychological characteristics of adult orthodontic patients[J]. Am J Orthod Dentofacial Orthop, 2011, 140(6): e263-e272.
[2] Bock JJ, Czarnota J, Hirsch C, et al.Orthodontic treatment need in a representative adult cohort[J]. J Orofac Orthop, 2011, 72(6): 421-433.
[3] Freitas LRP, Oliveira DD.Orthodontic retreatment: positive effects on the patient's self-esteem and quality of life[J]. Dental Press Jn Orthod, 2021, 26(5): e21bbo5.
[4] Chow L, Goonewardene MS, Cook R, et al.Adult orthodontic retreatment: a survey of patient profiles and original treatment failings[J]. Am J Orthod Dentofacial Orthop, 2020, 158(3): 371-382.
[5] Meyer-Marcotty P, Klenke D, Knocks L, er al. The adult orthodontic patient over 40 years of age: association between periodontal bone loss, incisor irregularity, and increased orthodontic treatment need[J]. Clin Oral Investig, 2021, 25(11): 6357-6364.
[6] Pattanaik S, Veeraraghavan VP, Dasari AK, et al.Orthodontic treatment in adults: challenges, outcomes, and factors affecting compliance and satisfaction[J]. J Orthod Sci, 2024,13: 14.
[7] Dhingra K, Vandana KL.Indices for measuring periodontitis: a literature review[J]. Int Dent J, 2011, 61(2): 76-84.
[8] Eke PI, Page RC, Wei L, et al.Update of the case definitions for population-based surveillance of periodontitis[J]. J Periodontol, 2012, 83(12): 1449-1454.
[9] American academy of periodontology task force report on the update tothe 1999 classification of periodontal diseases and conditions[J]. J Periodontol, 2015, 86(7): 835-838.
[10] Kirschneck C, Fanghänel J, Wahlmann U, et al.Interactive effects of periodontitis and orthodontic tooth movement on dental root resorption, tooth movement velocity and alveolar bone loss in a rat model[J]. Ann Anat, 2017, 210: 32-43.
[11] Rath-Deschner B, Nogueira A, Beisel-Memmert S, et al.Interaction of periodontitis and orthodontic tooth movement-an in vitro and in vivo study[J]. Clin Oral Investig, 2022, 26(1): 171-181.
[12] Towfighi PP, Brunsvold MA, Storey AT, er al. Pathologic migration of anterior teeth in patients with moderate to severe periodontitis[J]. J Periodontol, 1997, 68(10): 967-972.
[13] Ong G.Periodontal disease and tooth loss[J]. Int Dent J, 1998, 48(3 Suppl 1): 233-238.
[14] Kim SH, Kim I, Jeong DM, et al.Corticotomy-assisted decompensation for augmentation of the mandibular anterior ridge[J]. Am J Orthod Dentofacial Orthop, 2011, 140(5): 720-731.
[15] Ahn HW, Lee DY, Park YG, et al.Accelerated decompensation of mandibular incisors in surgical skeletal Class III patients by using augmented corticotomy: a preliminary study[J]. Am J Orthod Dentofacial Orthop, 2012, 142(2): 199-206.
[16] Ma HM, Lyu HM, Xu L, et al.Effect of augmented corticotomy-assisted presurgical orthodontic treatment on alveolar bone fenestration and dehiscence in skeletal Class III patients[J]. J Dent Sci, 2023, 18(3): 997-1007.
[17] Nagy P, Porzse V, Nemeth F, et al.Presentation of a novel surgical technique in periodontally accelerated osteogenic orthodontics. CBCT assessment of the buccal alveolar dimensional changes: a proof-of-concept report of four cases[J]. Quintessence Int, 2023, 54(5): 358-370.
[18] 王博, 沈国芳, 房兵, 等. 微手术正畸治疗骨性Ⅲ类错伴下前牙区牙槽骨发育不良的效果评价[J]. 上海口腔医学, 2012, 21(5): 535-540.
Wang B, Shen GF, Fang B, et al.Exploration for micro-osteotomy assisted orthodontic treatment of skeletal Class Ⅲ malocclusions with alveolar hypoplasia in the lower anterior region[J]. Shanghai Journal of Stomatology, 2012, 21(5): 535-540.
[19] Wang B, Shen G, Fang B, et al.Augmented corticotomy assisted surgical orthodontics decompensates lower incisors in Class Ⅲ malocclusionpatients[J]. J Oral Maxillofac Surg, 2014, 72(3): 596-602.
[20] Wang B, Shen G, Guo Q, et al.Long-term effects of augmented corticotomy-assisted orthodontics in patients with mandibular anterior alveolar defect[J]. J Craniofac Surg, 2019, 30(8): e737-e740.
[21] 王博, 于洪波, 夏韫晖, 等. 牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价[J]. 中国口腔颌面外科杂志, 2022, 20(5): 225-229.
Wang B, Yu HB, Xia YH, et al.Long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(5): 225-229.
[22] Amit G, Jps K, Pankaj B, et al.Periodontally accelerated osteogenic orthodontics (PAOO) - a review[J]. J Clin Exp Dent, 2012, 4(5): e292-e296.
[23] Verna C.Regional acceleratory phenomenon[J]. Front Oral Biol, 2016, 18: 28-35.
[24] Kumar P, Rampurawala AH, Patil AS.Effect of micro-osteoperforations (MOPs) on the rate of en masse orthodontic tooth retraction: a randomized controlled trial[J]. J Orofac Orthop, 2024, 85(3): 189-198.
[25] Shalev TH, Kurtzman GM, Shalev AH, et al.Continuous periosteal strapping sutures for stab-ilization of osseous grafts with resorbable membranes for buccal ridge augmentation: a technique report[J]. J Oral Implantol, 2017, 43(4): 283-290.
[26] Sheikh Z, Qureshi J, Alshahrani AM, et al.Collagen based barrier membranes for periodontal guided bone regeneration applications[J]. Odontology, 2017, 105(1): 1-12.
[27] Handelman CS. The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae[J]. Angle Orthod, 1996, 66(2): 95-109, 109-110.
[28] Vardimon AD, Oren E, Ben-Bassat Y.Cortical bone remodeling/tooth movement ratio during maxillary incisor retraction with tip versus torque movements[J]. Am J Orthod Dentofacial Orthop, 1998, 114(5): 520-529.
[29] Baysal A, Ucar FI, Buyuk SK, et al.Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography[J]. Korean J Orthod, 2013, 43(3): 134-140.
[30] Jäger F, Mah JK, Bumann A.Peridental bone changes after orthodontic tooth movement with fixed appliances: a cone-beam computed tomographic study[J]. Angle Orthod, 2017, 87(5): 672-680.
[31] Horiuchi A, Hotokezaka H, Kobayashi K.Correlation between cortical plate proximity and apical root resorption[J]. Am J Orthod Dentofacial Orthop, 1998, 114(3): 311-318.
[32] Sebbar M, Bourzgui F.Root resorption and orthodontic treatment[J]. Odontostomatol Trop, 2011, 34(135): 43-50.

35例成人中重度牙周炎患者牙槽骨再生正畸的疗效评价

Effectiveness of augmented corticotomy assisted orthodontics in 35 adult patients with moderate to severe periodontitis

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	吴炯睿, 陈梁, 高益鸣. 987例上颌窦间隔解剖CBCT分析[J]. 中国口腔颌面外科杂志, 2024, 22(6): 578-583.
[2]	郑彤, 姚侃, 钱轶峰, 孙红霞, 卢晓峰, 于雯雯. 成年打鼾人群患阻塞性睡眠呼吸暂停的危险因素分析[J]. 中国口腔颌面外科杂志, 2024, 22(2): 137-142.
[3]	王博, 于洪波, 夏韫晖, 房兵, 郭秋曼. 牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价[J]. 中国口腔颌面外科杂志, 2022, 20(3): 225-229.
[4]	范永晶, 金武龙, 王淑敏, 王姝. 234颗多生牙临床特征及继发影响分析[J]. 中国口腔颌面外科杂志, 2022, 20(3): 257-262.
[5]	陈建荣, 丁水清, 陈亮, 何佳嘉, 祁荣兴. 颞下颌关节紊乱的影像学特征：锥形束CT和MRI效能比较[J]. 中国口腔颌面外科杂志, 2022, 20(3): 273-276.
[6]	李慧萍, 刘秀明, 徐伟峰, 甄锦泽, 沈达, 张善勇. 环肌酸抑制大鼠牙周炎周围牙槽骨吸收的实验研究[J]. 中国口腔颌面外科杂志, 2022, 20(2): 111-116.
[7]	高志彪, 王磊, 肖霞, 高朵朵. 3种不同手术入路治疗成人髁突骨折效果分析[J]. 中国口腔颌面外科杂志, 2022, 20(2): 184-187.
[8]	盖云, 蒋芝月, 刘曙, 郑之峻. 青春期错畸形患者髁突位置与性别、颅面骨骼形态的相关性分析[J]. 中国口腔颌面外科杂志, 2022, 20(1): 42-47.
[9]	费晨艳, 江银华. 生长因子在牙槽骨组织再生中的应用与研究进展[J]. 中国口腔颌面外科杂志, 2021, 19(6): 568-572.
[10]	邹多宏, 刘昌奎, 薛洋, 胡开进, 杨驰, 张志愿. 帐篷钉技术在牙槽骨修复与再生中的临床应用及操作规范[J]. 中国口腔颌面外科杂志, 2021, 19(1): 1-5.
[11]	买买提·吐地, 哈尼克孜·莫明, 麦合布拜木·吐儿逊. 下颌颊棚区微螺钉解剖学植入区域位点锥形束CT测量分析[J]. 中国口腔颌面外科杂志, 2020, 18(1): 38-41.
[12]	沈宇清, 刘文娟, 孙健, 余优成, 周倩蓉, 徐艺. 不同分割阈值重建锥形束CT数字化牙模型的精度研究[J]. 中国口腔颌面外科杂志, 2019, 17(3): 221-224.
[13]	李敬华, 姜文静, 王艳辉, 李晓静, 柏娜. 下颌前牙唇侧骨壁厚度及倾斜角度对即刻种植术前设计的影响[J]. 中国口腔颌面外科杂志, 2019, 17(3): 230-234.
[14]	高维青, 陈毅, 王晶波, 樊林峰, 赵怀萍, 陶晓峰, 奚岩, 朱凌. 能谱锥形束CT减少口腔金属伪影的效果评价[J]. 中国口腔颌面外科杂志, 2018, 16(6): 523-527.
[15]	孙蕾, 赵其荣, 郑浩. 下颌近中阻生第三磨牙拔除方法与神经损伤危险因素分析[J]. 中国口腔颌面外科杂志, 2018, 16(5): 441-444.