Abstract:

Objective　To investigate the effect of micro-implant anchorage on gingival crevicular fluid chemokines and subgingival flora in orthodontic treatment. Methods　A retrospective study was conducted on 128 patients who received orthodontic treatment in The 73rd Group Army Hospital of the Chinese People's Liberation Army from January 2021 to May 2022. They were divided into a control group (64 cases) and an observation group (64 cases) according to the different anchorage. There were 28 males and 36 females in the control group, aged (23.14±4.98) years; there were 32 males and 32 females in the observation group, aged (22.97±5.12) years. The control group was treated with orthodontic method with external arch reinforcement anchorage, and the observation group was treated with micro implant anchorage technology. The therapeutic effects and masticatory efficiencies of the two groups were compared. The mRNA levels of CX3CL1, CXCL2, CCL4, and CCL7 in the gingival crevicular fluid were compared between the two groups before treatment and after 1 and 4 weeks of treatment. The common pathogens in the subgingival plaque were analyzed by polymerase chain reaction (PCR). t test and χ² test were used for statistical analysis. Results　The success rate of treatment in the observation group was 89.06% (57/64), which was higher than that in the control group [65.63% (42/64)], with a statistically significant difference between the two groups (χ²=10.031, P=0.002). The mRNA levels of CX3CL1, CXCL2, CCL4, and CCL7 in the observation group after 1 and 4 weeks of treatment were higher than those in the control group [(35.13±9.75) pg/nl vs. (27.26±6.71) pg/nl, (37.63±10.14) pg/nl vs. (33.56±9.87) pg/nl, (1.87±0.13) pg/nl vs. (1.26±0.12) pg/nl, (2.23±0.22) pg/nl vs. (1.45±0.16) pg/nl, (1.87±0.23) pg/nl vs. (1.36±0.17) pg/nl, (2.36±0.32) pg/nl vs. (1.74±0.18) pg/nl, (1.69±0.32) pg/nl vs. (1.46±0.11) pg/nl, (2.35±0.42) pg/nl vs. (1.61±0.21) pg/nl], with statistically significant differences (t=5.319, 2.301, 27.583, 22.939, 14.235, 13.509, 5.438, and 12.607; all P<0.05). After treatment, the detection rate of subgingival pathogen Tannerella forsythensis (Tf) in the observation group was significantly lower than that in the control group [12.50% (8/64) vs. 29.69% (19/64)], with a statistically significant difference (χ²=5.680, P=0.017). Conclusion　Micro-implant anchorage has good curative effect in the treatment of oral deformity, can effectively reduce the content of chemokines in the gingival crevicular fluid, and reduce the subgingival flora, which is suitable for clinical application.

Key words: Orthodontics, Micro-implant anchorage, Gingival crevicular fluid chemokines, Subgingival flora

摘要： 目的　探讨口腔正畸治疗中微型种植体支抗治疗对患者龈沟液趋化因子和龈下菌群的影响。方法　选取2021年1月至2022年5月在陆军第七十三集团军医院接受口腔正畸治疗的患者128例进行回顾性研究，根据选用支抗不同分为对照组（64例）和观察组（64例）。对照组男28例，女36例，年龄（23.14±4.98）岁；观察组男32例，女32例，年龄（22.97±5.12）岁。对照组采用口外弓加强支抗正畸法，观察组采用微型种植体支抗技术。比较两组治疗效果、咀嚼效率，比较两组患者治疗前及治疗1、4周后龈沟液趋化因子CX3CL1、CXCL2、CCL4、CCL7 mRNA水平，采用聚合酶链反应（PCR）分析治疗后患者龈下菌斑中常见致病菌情况。统计学方法采用t检验、χ²检验。结果　观察组的治疗成功率为89.06%（57/64），高于对照组的65.63%（42/64），两组比较差异有统计学意义（χ²=10.031，P=0.002）。观察组患者治疗后1、4周CX3CL1、CXCL2、CCL4、CCL7 mRNA水平均高于对照组［（35.13±9.75）pg/nl比（27.26±6.71）pg/nl、（37.63±10.14）pg/nl比（33.56±9.87）pg/nl、（1.87±0.13）pg/nl比（1.26±0.12）pg/nl、（2.23±0.22）pg/nl比（1.45±0.16）pg/nl、（1.87±0.23）pg/nl比（1.36±0.17）pg/nl、（2.36±0.32）pg/nl比（1.74±0.18）pg/nl、（1.69±0.32）pg/nl比（1.46±0.11）pg/nl、（2.35±0.42）pg/nl比（1.61±0.21）pg/nl］，差异均有统计学意义（t=5.319、2.301、27.583、22.939、14.235、13.509、5.438、12.607，均P<0.05）。治疗后观察组的牙龈下致病菌福塞斯坦氏菌（Tf）检出率显著低于对照组［12.50%（8/64）比29.69%（19/64）］，差异有统计学意义（χ²=5.680，P=0.017）。结论　微型种植体支抗治疗口腔畸形的疗效好，能够有效减少龈沟液趋化因子的含量，并减少龈下菌群，适合应用于临床。

关键词: 口腔正畸, 微型种植体支抗, 龈沟液趋化因子, 龈下菌群