," /> ,"/> 隐形矫治重度牙周炎患者前牙区病理性移位患牙的临床疗效
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北京大学学报（医学版） ›› 2025, Vol. 57 ›› Issue (1): 51-56. doi: 10.19723/j.issn.1671-167X.2025.01.008

• 论著 • 上一篇    下一篇

隐形矫治重度牙周炎患者前牙区病理性移位患牙的临床疗效

李敬谦1, 朱子璐1, 焦剑2, 施捷1,*()   

  1. 1. 北京大学口腔医学院·口腔医院正畸科，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，北京 100081
    2. 北京大学口腔医学院·口腔医院门诊部，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，北京 100081
  • 收稿日期:2024-10-09 出版日期:2025-02-18 发布日期:2025-01-25
  • 通讯作者: 施捷 E-mail:sjlily@yeah.net
  • 基金资助:
    北京市自然科学基金-海淀原始创新基金联合基金(L232107)

Clinical efficacy of clear aligner treatment for pathologically migrated teeth in the anterior region of patients with severe periodontitis

Jingqian LI1, Zilu ZHU1, Jian JIAO2, Jie SHI1,*()   

  1. 1. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
    2. First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2024-10-09 Online:2025-02-18 Published:2025-01-25
  • Contact: Jie SHI E-mail:sjlily@yeah.net
  • Supported by:
    the Beijing Natural Science Foundation-Combined Fund of Haidian Original Innovation Fund(L232107)

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摘要：

目的: 评估隐形矫治在重度牙周炎伴前牙区病理性移位患者中的临床疗效。方法: 回顾性分析2019—2022年在北京大学口腔医院牙周科和正畸科同时就诊的重度牙周炎伴前牙区病理性移位的患者共26例，患者定期进行牙周基础治疗并维护，均采用隐形矫治器进行正畸治疗，利用软件测量口腔扫描数据，比较正畸前后病理性移位患牙的咬合分布和邻面接触评分，同时评价牙周治疗前和正畸治疗前后牙周临床指标的变化。结果: 26例患者病理性移位的前牙共217颗，其中105颗在牙周治疗前存在探诊深度(probing depth, PD)≥ 5 mm的牙周袋。隐形矫治后，咬合评分由10.35±8.61提高至23.62± 9.73(P < 0.001)，邻面接触评分由13.62±4.73提升至31.62± 10.37(P < 0.001)。牙周治疗前(T0)，患牙的平均PD中位数为3.33 mm [四分位距(interquartile range, IQR)=0.92]；正畸治疗前(T1)，PD降至2.50 mm (IQR=0.67，P < 0.001)；隐形矫治后(T2)，PD仍维持在2.50 mm (IQR=0.50)，与T0相比差异有统计学意义(P < 0.001)，T1与T2之间差异无统计学意义(P=0.948)。结论: 隐形矫治对重度牙周炎伴前牙区病理性移位的患者具有良好的临床疗效，未来需要更多大样本量的前瞻性对照研究进一步验证其长期临床效果。

关键词: 正畸治疗, 牙周炎, 可摘式正畸矫正器, ')">牙

Abstract:

Objective: To evaluate the clinical efficacy of clear aligner therapy in patients with severe periodontitis accompanied by pathological tooth displacement in the anterior region. Methods: This retrospective study analyzed patients diagnosed with severe periodontitis and pathological displacement in the anterior region, who visited both the Periodontics and Orthodontics Departments at Peking University School and Hospital of Stomatology between 2019 and 2022. A total of 26 eligible cases were included in this study. All the patients underwent regular periodontal maintenance throughout the treatment process, and clear aligners were used for orthodontic treatment. Intraoral scans were analyzed by dedicated software to measure and compare occlusal distribution and proximal contact scores before and after orthodontic treatment. Periodontal clinical indicators were assessed at three key time points: before periodontal treatment (T0), before orthodontic treatment (T1), and after orthodontic treatment (T2). All the cases were treated with clear aligner. Results: A total of 217 pathologically displaced anterior teeth from 26 patients were analyzed. Among these, 105 teeth exhibited periodontal pockets [probing depth (PD) ≥5 mm] before periodontal treatment. After clear aligner therapy, the occlusal score improved significantly from 10.35±8.61 to 23.62±9.73 (P < 0.001), and the proximal contact score increased from 13.62±4.73 to 31.62±10.37 (P < 0.001). The median PD decreased significantly from 3.33 mm [interquartile range (IQR)=0.92] at T0 to 2.50 mm (IQR=0.67, P < 0.001) at T1 and remained stable at 2.50 mm (IQR=0.50) after treatment (T2). A significant reduction in PD was observed between T0 and T2 (P < 0.001), but no significant difference was found between T1 and T2 (P=0.948). Conclusion: Clear aligner therapy demonstrates favorable clinical efficacy in patients with severe periodontitis and pathological anterior tooth displacement. It effectively improves occlusal distribution and proximal contact while maintaining periodontal health in these patients. However, further large-scale prospective controlled studies are needed to verify its long-term clinical outcomes.

Key words: Orthodontic treatment, Periodontitis, Removable orthodontic appliances, Dental occlusion

中图分类号: 

  • R783.5

图1

咬合分布评分积分规则"

图2

隐形矫治前后上下颌咬合力分布变化"

图3

隐形矫治前(T1)和矫治后(T2)患者平均咬合力分布评分(A)和邻面接触评分(B)的变化(均数±标准差，配对t检验)"

图4

牙周治疗前(T0)、隐形矫治前(T1)和矫治后(T2)患牙平均PD (A)、最大PD (B)和最大BI (C)的变化情况(Friedman检验及Dunn多重比较检验)"

图5

牙周治疗前(T0)存在PD ≥5 mm位点的患牙在隐形矫治前(T1)和矫治后(T2)平均PD (A)、最大PD (B)和最大BI (C)的变化情况(Friedman检验及Dunn多重比较检验)"

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ISSN 1671-167X
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