摘要
目的 评价龈下刮治、根面平整与调（牙合）对合并继发性咬合创伤的牙周炎患牙力学状况及牙周临床指标改善的影响，以期为临床提供参考。方法将18例慢性牙周炎合并咬合创伤患者按咬合时间测定值大小分层区组随机分为A、B两组，每组9例；0d时（基线），A组先实施全口龈下刮治＋根面平整治疗，B组实施咬合创伤牙位调（牙合）治疗；第28天，A组接受咬合创伤牙位调（牙合）治疗，B组接受全口龈下刮治＋根面平整治疗。调（牙合）在T—ScanIII型咬合分析系统指导下完成。在0、28、56d检查A、B两组全口牙周探诊深度、附着丧失、出血指数、咬合创伤牙位咬合时间及咬合受力百分比。采用SPSS18．0统计软件对基线时A、B两组间牙周临床指标及咬合指标差异、各组内治疗前后牙周临床指标与咬合指标变化、两组在28、56d牙周临床指标与咬合指标变化值的差异进行配对t检验，检验水准为双侧α=0．05。结果基线时A组与B组全口平均探诊深度、附着丧失、出血指数差异均无统计学意义（P〉0．05）；A组与B组咬合创伤牙位平均探诊深度、附着丧失、出血指数差异均无统计学意义（P〉0．05）；同时，A、B组间咬合创伤牙位咬合时间[分别为（1．29±0．39）、（1．34±0．35）S1、咬合受力百分比[分别为（6．8±2．1）％及（7．4±1．7）％]差异均无统计学意义（P〉0．05）。龈下刮治＋根面平整前后咬合创伤牙位牙周临床指标及咬合时间均显著降低（P〈0．05）；A、B两组单纯调哈前后纳入牙位牙周临床指标差异均无统计学意义（P〉0．05）。终点时，A、B两组牙周临床指标较基线的改变值差异均无统计学意义（P〉0．05）；咬合时间、咬合受力百分比相比基线的改变值A组[分别为（0．85±0．41）s、（2．2±2．2）％]均显著大于B组[（0．70±0．38）s、（1．5±1．6）％]（P〈0．05）。调袷完成后A组咬合创伤牙位咬合时间变化值[（0．21±0．11）s]显著小于B组[（0．67±0．37）s]（P〈0．05）。结论单独调（牙合）并不能有效改善牙周炎症；龈下刮治＋根面平整可以改善咬合创伤牙位的咬合时间；在炎症控制的基础上进行调袷对咬合状况的改善更加稳定，咬合状况改善程度更加明显。
Objective To evaluate the effect of subgingivaI sealing/root planning （SRP） and occlusal adjustment on clinical and oeclusal parameters in teeth with chronic periodontitis and secondary ocelusal trauma. Methods Eighteen patients with chronic periodontitis and occlusal trauma were included and randomly divided into group A and group B. On day 0, group A was treated by full-mouth subgingival scaling and root planning, and group B was treated by oeclusal adjustment in occlusal trauma site. On day 28, group A was treated by occlusal adjustment in occlusal trauma site, and group B was treated by full-mouth subgingival scaling and root planning. Probing depth（ PD）, attachment loss （AL）, bleeding index （BI） were evaluated on 0,28 and 56 d, and the occlusal time （OT） and the percentage of occlusal force were evaluated on 0,28 and 56 d in occlusal trauma site. The data was statistically analyzed. Results In baseline, the PD[（4.42 ± 1.41） mm vs （4.36 ± 1.38） mm],AL[（2.75 ± 1.32） mm vs （2.63 ±1.37 ） mm and BI [ （ 2. 20± 0. 81 ） vs （ 2.24 ±0. 89 ） ] of the full-mouth showed no significant difference between the two groups （ P 〉 0. 05 ）. There was no significant difference in PD [ （ 5.21 ±1.21 ） mm vs （5.08±1. 12） mm] ,AL[ （4. 94 ± 1.47） mm vs （4.89± 1.32） mm],BI[（2.61 ±0.92） vs 2.50± 0. 79） ] ,OT[ （1.29±0. 39） s vs （1.34 ＋0. 35） s] and the percentage ofoeclusal force[ （6. 8 ±2. 1）% vs （7.4 ± 1.7 ） % ] in oeclusal trauma site between the two groups （ P 〉 0. 05 ）. After SRP therapy, the PD, AL, BI and OT were significantly decreased （ P 〈 0. 05 ）. The clinical parameters exhibited no significant difference after only occlusal adjustment（P 〉 0. 05 ）. On 56 d, the reduction in clinical parameters was not significantly different between the two groups （ P 〉 0. 05 ） , however the reduction of OT and the change of the percentage of oeelusal force in group A [ （0. 85 ± 0. 41 ） s, （2. 2 ±2. 2）% ] were more significant than those in group B [ （0. 70 ± 0. 38 ） s ; （ 1.5 ±1.6 ） % ] （ P 〈 0. 05 ）. After occlusal adjustment, the increase of OT in group A[ （0. 21 ±0. 11） s] was lower than that in group B[ （0. 67 ±0. 37） s] through the 2g-day observation period （ P 〈 0. 05 ） Conclusions Occlusal adjustment alone is inadequate for control and management of periodontitis. SRP therapy can eliminate the inflammation and decrease the OT of tooth with ocelusal trauma. The combination of SRP and occlusal adjustment may achieve more stable results.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2013年第5期266-271,共6页
Chinese Journal of Stomatology
关键词
牙周炎
牙龈下刮治术
咬合创伤
调[牙合]
Periodontitis
Sulgingival curettage
Oeelusal trauma
Oeclusal adjustment
