CAJ | 학술논문

目的观测骨性Ⅲ类错(牙合)正畸-正颌联合治疗患者行改良骨皮质切开术前及术后牙周临床指标的变化,评估手术的安全性,以期为临床提供参考.方法纳入全身和牙周健康的骨性Ⅲ类错(牙合)正畸-正颌联合治疗患者9例,男性2例,女性7例,年龄18～30岁,观测前牙和前磨牙共72颗,216个位点,于排齐牙列后关闭间隙前行改良(超声)骨皮质切开术,并植入磷酸三钙骨材料.观察菌斑指数、探诊深度、出血指数、角化龈宽度、牙龈退缩及牙龈生物型等牙周指标,比较术前及术后1、2、4、8周时各项指标的变化.结果探诊深度、出血指数术前与术后各观测时间点相比差异均无统计学意义(P＞0.05);菌斑指数手术前后中位数均为0;牙龈退缩手术前后中位数均小于2 mm,术前薄龈型牙齿占74％ (53/72),厚龈型牙齿占26％ (19/72).术后1、2、4周时角化龈宽度[分别为(5.7±1.3)、(5.8±1.3)、(5.6±1.4) mm]均显著大于术前[(5.1±1.4) mm] (F=12.087,P =0.000),术后8周时角化龈宽度为(5.1 ±1.2) mm,与术前相比差异无统计学意义(P=0.658).结论初步证明在骨性Ⅲ类错(牙合)正畸-正颌联合治疗中改良骨皮质切开术对牙周组织是安全的.
목적 관측골성Ⅲ류착(아합)정기-정합연합치료환자행개량골피질절개술전급술후아주림상지표적변화,평고수술적안전성,이기위림상제공삼고.방법 납입전신화아주건강적골성Ⅲ류착(아합)정기-정합연합치료환자9례,남성2례,녀성7례,년령18～30세,관측전아화전마아공72과,216개위점,우배제아렬후관폐간극전행개량(초성)골피질절개술,병식입린산삼개골재료.관찰균반지수、탐진심도、출혈지수、각화간관도、아간퇴축급아간생물형등아주지표,비교술전급술후1、2、4、8주시각항지표적변화.결과 탐진심도、출혈지수술전여술후각관측시간점상비차이균무통계학의의(P＞0.05);균반지수수술전후중위수균위0;아간퇴축수술전후중위수균소우2 mm,술전박간형아치점74％ (53/72),후간형아치점26％ (19/72).술후1、2、4주시각화간관도[분별위(5.7±1.3)、(5.8±1.3)、(5.6±1.4) mm]균현저대우술전[(5.1±1.4) mm] (F=12.087,P =0.000),술후8주시각화간관도위(5.1 ±1.2) mm,여술전상비차이무통계학의의(P=0.658).결론 초보증명재골성Ⅲ류착(아합)정기-정합연합치료중개량골피질절개술대아주조직시안전적.
Objective To evaluate the effect of modified corticotomy on periodontal parameters in the treatment of Class Ⅲ surgical patients facilitated by accelerated osteogenic orthodontics.Methods Nine Class Ⅲ surgical patients at the age of 18-30 (7 females and 2 males) who were systematically and periodontally healthy were involved in the study,including 72 teeth and 216 sites.The modified corticotomy (piezotome) and bone graft (tricalcium phosphate,TCP) in maxillary anterior area were conducted after aligning and leveling the dental arch to facilitate the closing of space in upper dentition.Measurements such as plaque index (PLI),probing depth (PD),bleeding index (BI),recession (REC),keratinized gingiva width (KEG),biotype (BIO) were recorded pre-operation,1,2,4 and 8 weeks post-operation.Results The differences of PD,BI and REC before and after operation were not statistically significant (P ＞ 0.05).The median value of PLI before and after operation was 0.The percentage of thin biotype and thick biotype teeth was 74％(53/72) and 26％(19/72) pre-operation respectively.The difference of KEG between pre-operation[(5.1 ± 1.4) mm] and 8 weeks post-operation [(5.1 ± 1.2) mm] was not statistically significant(P =0.658),but the mean value of KEG in other post-operation groups [1 week:(5.7 ± 1.3)mm,2 weeks:(5.8 ± 1.3) mm,4 weeks:(5.6 ± 1.4) mm] was significantly higher than those of pre-operation(F =12.087,P =0.000).Conclusions Modified corticotomy in the treatment of Class Ⅲ surgical patients facilitated by accelerated osteogenic orthodontics is safe to periodontium.