辛越 李广文 丁鑫 孙汉堂

[摘要]目的：探討无托槽隐形矫治器与直丝弓矫治器治疗牙周炎继发错牙合畸形的疗效及对牙周健康和炎症因子的影响。方法：选取2018年3月-2019年3月笔者医院收治的98例牙周炎继发错牙合畸形患者。根据随机数字法及患者意愿分为对照组和观察组，每组49例。对照组采用直丝弓矫治器，观察组采用无托槽隐形矫治器。观察两组临床疗效、牙周指标、牙周炎症状况及并发症发生情况。结果：治疗后，两组总有效率比较，差异无统计学意义（P>0.05）;观察组菌斑指数（PLI）、牙龈指数（GI）、探诊深度（PD）及龈沟出血指数（SBI）均低于对照组（P<0.05）;观察组肿瘤坏死因子-α（TNF-α）、白介素-1β（IL-1β）、IL-5及IL-8水平均低于对照组（P<0.05）;观察组并发症总发生率8.16%，低于对照组的22.45%（P<0.05）。结论：无托槽隐形矫治器治疗牙周炎继发错牙合畸形与直丝弓矫治器具有相当疗效，但其更利于维护牙周健康，对牙周炎症状况的影响更小，且并发症少，值得临床推广应用。

[关键词]牙周炎继发错牙合畸形;无托槽隐形矫治器;直丝弓矫治器;牙周健康;炎症因子

[中图分类号]R783.5    [文献标志码]A    [文章编号]1008-6455（2020）12-0137-03

Effect of Bracketless Invisible Appliance in the Treatment of Periodontitis Secondary Malocclusion and Influence on Periodontal Health

XIN Yue，LI Guang-wen，DING Xin，SUN Han-tang

（Department of Ophthalmology and Otorhinolaryngology，961 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army，Qiqihar 161000， Heilongjiang，China）

Abstract：Objective To investigate the effects of bracketless invisible appliance and straight wire appliance in the treatment of periodontitis secondary malocclusion and its influence on periodontal health and inflammatory factors.  Methods  Total of 98 patients with periodontitis secondary malocclusion in our hospital from March 2018 to March 2019 were selected. According to the random number method and patient's wishes， the patients were divided into the two groups： the control group（n=49） and the observation group （n=49）. The control group was treated with straight wire appliance， and the observation group was treated with bracketless invisible appliance. The clinical effect，periodontal index， periodontitis and complications of the two groups were observed.  Results After treatment， there was no significant difference in the total effective rate between the observation group and the control group （P>0.05）. The plaque index （PLI）， gingival index （GI）， probing depth （PD）， and sulcus bleeding index （SBI） of the observation group were lower than those of the control group， and the differences were all statistically significant （P<0.05）. The levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-5 and IL-8 in the observation group were lower than those in the control group， and the differences were all statistically significant （P<0.05）.The total incidence of complications in the observation group was 8.16%， which was lower than the total incidence of complications in the control group of 22.45%， and the differences were all statistically significant （P<0.05）. Conclusion  The bracketless invisible appliances for the treatment of periodontitis secondary malocclusion have similar efficacy to straight wire appliances， but they are more conducive to maintaining periodontal health， have less impact on periodontal inflammation， and have fewer complications， which worthes of clinical promotion and application.

Key words： periodontitis secondary malocclusion; bracketless invisible appliance;straight wire appliance;periodontal health;inflammatory factors

牙周炎是发生于牙周组织的慢性炎症，可因牙石堆积、食物残留及菌斑滋生等多种因素引起，导致牙齿移位、松动或脱落。随着疾病的发展，可进一步继发错牙合畸形，严重影响患者牙齿的日常功能及外貌美观[1-2]。因此，对牙周炎继发错牙合畸形患者进行矫正具有重要意义。直丝弓矫治器是将平直弓丝插入托槽，通过托槽定位牙齿的矫治器，具有定位精准、快捷简便及费用低等优点，具有明显的矫治效果，被广泛应用于临床[3-4]。随着计算机辅助技术的发展，无托槽隐形矫治器在临床上取得了令人满意的效果。无托槽隐形矫治器是应用无色透明的活动矫牙装置，通过三维重建制定科学合理的方案得以移动牙齿，其外形美观，摘戴便捷，且无需弓丝和托槽[5-7]。然而……