Abstract:

Objective　To investigate the effect of invisible appliances without brackets on periodontal health in patients with periodontitis and malocclusion deformity. Methods　A total of 100 patients with periodontitis and malocclusion deformity treated at Hospital of Stomatology, Air Force Military Medical University from January 2022 to January 2024 were selected for the randomized controlled trail. The patients were divided into a control group and an observation group by the random number table method, with 50 cases in each group. There were 28 males and 22 females in the control group; they were (32.15±3.94) years old; their disease course was (25.45±4.16) months. There were 30 males and 20 females in the observation group; they were (32.52±3.88) years old; their disease course was (25.62±4.08) months. The control group were treated with straight wire appliances, and the observation group with invisible appliances without brackets. The therapeutic effects, periodontal health indicators [probing depth (PD), clinical attachment level (CAL), plaque index (PLI), and sulcus bleeding index (SBI)], gingival crevicular fluid inflammatory factors [interleukin-1β (IL-1β), interleukin-6 (IL-6), human matrix metalloproteinase 8 (MMP-8), and tumor necrosis factor-α (TNF-α)], appearance and function satisfaction, and incidence rates of complications were compared between the two groups. t and χ² tests were applied. Results　The total effective rate in the observation group was higher than that in the control group [96.00% (48/50) vs. 80.00% (40/50)], with a statistical difference (χ²=6.222; P=0.012). Before the treatment, there were no statistical differences in the PD, CAL, PLI, SBI, and levels of IL-1β, IL-6, MMP-8, and TNF-α between the two groups (all P>0.05). After the treatment, the PD, CAL, PLI, SBI, and levels of IL-1β, IL-6, MMP-8, TNF-α in the observation group were lower than those in the control group [(2.28±0.26) mm vs. (2.60±0.32) mm, (3.72±0.45) mm vs. (4.38±0.62) mm, (2.38±0.44) vs. (2.84±0.50), (1.80±0.27) vs. (2.12±0.34), (10.62±2.06) ng/L vs. (17.15±3.84) ng/L, (5.75±1.42) ng/L vs. (8.45±2.14) ng/L, (2 008.62±50.12) ng/L vs. (2 416.71±56.15) ng/L, and (15.55±2.12) ng/L vs. (25.87±3.17) ng/L], with statistical differences (t=5.487, 6.091, 4.883, 5.211, 10.596, 7.433, 38.339, and 19.135; all P<0.05). After the treatment, the aesthetic satisfaction of the observation group was higher than that of the control group [98.00% (49/50) vs. 82.00% (41/50)], with a statistical difference (χ²=7.111; P=0.008). The incidence rate of complications in the observation group was lower than that in the control group [2.00% (1/50) vs. 16.00% (8/50)], with a statistical difference (χ²=4.395; P=0.036). Conclusion　Invisible appliances without brackets for patients with periodontitis and malocclusion deformity can improve the therapeutic effect and their periodontal health, control the inflammatory factors in gingival crevicular fluid after treatment, reduce the occurrence of complications, and obtain satisfactory appearance, so it is worth being generalized.

Key words:

Periodontitis, Malocclusion deformity, Invisible appliances without brackets, Orthodontic effect, Periodontal health

摘要：

目的　探讨无托槽隐形矫治器对牙周炎伴错牙合畸形患者的矫治效果及对牙周健康的影响。方法　前瞻性研究，选取2022年1月至2024年1月在空军军医大学口腔医院治疗的牙周炎伴错牙合畸形患者100例作为研究对象，按照随机数字表法分为对照组（50例）和观察组（50例）。对照组男28例、女22例，年龄（32.15±3.94）岁，病程（25.45±4.16）个月，采取直丝弓矫治器矫治；观察组男30例、女20例，年龄（32.52±3.88）岁，病程（25.62±4.08）个月，采取无托槽隐形矫治器矫治。对比两组矫治效果、口腔健康指标［探诊深度（PD）、临床附着水平（CAL）、菌斑指数（PLI）、龈沟出血指数（SBI）］、龈沟液炎症因子［白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、人基质金属蛋白酶-8（MMP-8）、肿瘤坏死因子-α（TNF-α）］、外观功能满意度及并发症发生情况。统计学方法采用t检验、χ²检验。结果　观察组总有效率为96.00%（48/50），高于对照组的80.00%（40/50），差异有统计学意义（χ²=6.222，P=0.012）。治疗前，两组患者PD、CAL、PLI、SBI及IL-1β、IL-6、MMP-8、TNF-α水平比较，差异均无统计学意义（均P>0.05）；治疗后，观察组PD、CAL、PLI、SBI及IL-1β、IL-6、MMP-8、TNF-α水平均低于对照组［（2.28±0.26）mm比（2.60±0.32）mm、（3.72±0.45）mm比（4.38±0.62）mm、（2.38±0.44）分比（2.84±0.50）分、（1.80±0.27）分比（2.12±0.34）分、（10.62±2.06）ng/L比（17.15±3.84）ng/L、（5.75±1.42）ng/L比（8.45±2.14）ng/L、（2 008.62±50.12）ng/L比（2 416.71±56.15）ng/L、（15.55±2.12）ng/L比（25.87±3.17）ng/L］，差异均有统计学意义（t=5.487、6.091、4.883、5.211、10.596、7.433、38.339、19.135，均P<0.05）。观察组矫治后美观满意度为98.00%（49/50），高于对照组的82.00%（41/50），差异有统计学意义（χ²=7.111，P=0.008）。观察组并发症发生率为2.00%（1/50），低于对照组的16.00%（8/50），差异有统计学意义（χ²=4.395，P=0.036）。结论　无托槽隐形矫治器治疗牙周炎伴错牙合畸形患者可提高矫治效果，改善牙周健康，控制矫治后的龈沟液炎症因子水平，减少并发症发生，提高治疗满意度，值得推广。

关键词:

牙周炎, 错牙合畸形, 无托槽隐形矫治器, 矫治效果, 牙周健康