白秋野 李宏斌

【关键词】 牙周炎 正畸治疗 骨代谢 局部炎症反应

[Abstract] Objective： To investigate the changes of bone metabolism and local inflammation response of patients with periodontitis before and after orthodontic treatment. Method： A total of 80 patients with periodontitis treated with orthodontic treatment in our hospital from October 2016 to February 2020 were chosen as the observation group， 80 patients without periodontitis treated with orthodontic treatment at the same time were chosen as the control group. Then the bone metabolism indexes （gingival crevicular fluid RANKL， OPG and ALP） and local inflammation response indexes [gingival crevicular fluid pro-inflammatory factors （TNF-α， IL-1 β and IL-6） and anti-inflammatory factors （IL-4 and IL-10）] of two groups before treatment and at 1， 4 and 12 week after treatment were detected and compared. Result： The gingival crevicular fluid bone metabolism indexes of two groups before treatment compared， there were no statistically significant differences （P>0.05）; the gingival crevicular fluid bone metabolism indexes of two groups at 1， 4 and 12 week after treatment continuously increased， and the RANKL of the observation group were significantly higher than those of the control group， other indexes were significantly lower than those of the control group， there were statistically significant differences （P<0.001）. The gingival crevicular fluid inflammation response indexes of the observation group before the treatment and at 1， 4 and 12 week after treatment continuously increased， and the indexes of the control group increased first and decreased afterward， the gingival crevicular fluid inflammation response indexes of the observation group were significantly higher than those of the control group，there were statistically significant differences （P<0.001）. Conclusion： The changes of bone metabolism and local inflammation response of patients with periodontitis before and after orthodontic treatment are obvious， and the periodontitis of patients with orthodontic treatment should be paid more attention.

[Key words] Periodontitis Orthodontic treatment Bone metabolism Local inflammation response

First-author’s address： Benxi Central Hospital， Benxi 117000， China

doi：10.3969/j.issn.1674-4985.2021.21.034

受多方面因素的影響，正畸治疗在临床的受认可程度及应用率均持续升高，因此与之相关的研究也不断增多，其中关于牙周炎患者正畸治疗的研究亦不少见，而牙周炎的存在对正畸治疗患者的影响普遍存在[1-2]，且影响的涉及面较广，此类影响普遍对正畸治疗效果及牙周状态造成影响[3-5]，但是相关的细致影响仍相对不足，包括对局部骨代谢及炎症反应的影响研究不足。因此本研究就牙周炎正畸治疗患者治疗前后骨代谢及局部炎症反应的变化情况进行探究，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年10月-2020年2月本院收治的80例牙周炎正畸治疗患者为观察组，选取同时期的80例无牙周炎的正畸治疗患者为对照组。纳入标准：年龄≥16岁;性别不限;符合正畸治疗指征;观察组轻中度牙周炎，对照组牙周健康。排除标准：骨质疏松;精神异常;合并慢性基础疾病;合并创伤等可导致炎性应激情况。该研究已经伦理学委员会批准，患者及家属均知情同意并签署知情同意书。

1.2 方法 两组患者均按照常规正畸治疗方案进行治疗。在此基础上，分别于治疗前及治疗1、4、12周时采集两组龈沟液标本，采集后即刻送检，由两名经验丰富者进行操作检测，检测指标为骨代谢指标（龈沟液RANKL、OPG及ALP）及局部炎症反应指标[龈沟液促炎因子（TNF-α、IL-1β及IL-6）及抑炎因子（IL-4、IL-10）]，均采用酶联免疫法进行定量检测，严格按照相关标准及要求进行操作检测，尽量避免误差。……