Email Alert | RSS

Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (5): 919-924. doi: 10.19723/j.issn.1671-167X.2019.05.021

Previous Articles     Next Articles

Occlusal changes before and after orthodontic treatment in patients with aggressive periodontitis

Ren-jie DU1,Jian JIAO2,Yan-heng ZHOU1,Jie SHI1,△()   

  1. 1. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2018-10-08 Online:2019-10-18 Published:2019-10-23
  • Contact: Jie SHI E-mail:sjlily@yeah.net
  • Supported by:
    Supported by the New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-16A03);Supported by the New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(YS010118)

RICH HTML

 29   

PDF (PC)

455

Abstract:

Objective: To evaluate the efficacy of occlusal improvement in the labial fixed orthodontic treatment in aggressive periodontitis patients and to explore the relationship between occlusal improvement and inflammation control. Methods: Twenty-two aggressive periodontitis patients who underwent combined periodontal-orthodontic treatment were included in this study. The patient’s photos were matched to the dental models and digital three dimentional models were acquired using 3Shape R700 laser scanner. The occlusal force distribution maps were generated in the OrthoAnalyzer software. The newly established occlusal force distribution score (OFDS) and proximal contact score (PCS) were used to evaluate the occlusal distribution changes before and after labial fixed orthodontic treatment for assessing the effectiveness of orthodontic treatment. The multi-level linear regression analysis was used to explore the relationship between the probing depth changes and OFDS or PCS changes to screen out the favorable orthodontic strategy for inflammation control, which would provide clinical strategy for combined periodontal-orthodontic treatment in aggressive periodontitis patients. Results: At the patient level, OFDS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment(84.5±20.9 vs.105.3±22.6, P <0.001) and PCS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment(68.9±9.1 vs. 83.7±6.3, P <0.001).At the tooth level, the OFDS was significantly increased in the maxillary anterior teeth (P <0.001) while the PCS of the anterior teeth in both maxillary and mandible arches were significantly increased significantly (P <0.01). No significant changes were found in other tooth positions. The multi-level linear regression model showed that no significant correlation was found between age and gender and probing depth decrease (P >0.05). The baseline probing depth,OFDS improvements and PCS improvements (P <0.001) were positively correlated with probing depth decrease. Conclusion: This study showed that the distribution of occlusal force was more reasonable and the proximal contacts were more ideal in aggressive periodontitis patients. Orthodontic treatment was effective in improving occlusal force distribution by the above two ways. Especially, the OFDS and PCS improvements were both positively correlated with probing depth decrease, indicating that in the combined periodontal-orthodontic treatment for aggressive periodontitis patients, occlusal force distribution and proximal contact should be improved in order to facilitate periodontal improvement.

Key words: Aggressive periodontitis, Malocclusion, Probing depth, Occlusal force distribution

CLC Number: 

  • R783.5

Figure 1

Accumulated points rules for occlusal force distribution score A, example of effective occlusion area; B, compact occlusion contacts on non-supporting cusps of non-functional side (arrow); C, lingual surfaces trisected from incisal edge to gingival margin; D, when the occlusal distribution color is only blue, points will be halved; E, compact occlusion area located on the middle gingiva of two teeth (arrow)."

Table 1

Clinical features of 22 aggressive periodontitis patients"

Variebles n(%)
Gender
Male 6(27.3)
Female 16(72.7)
Angle classification
Ⅰ 4(18.2)
Ⅱ 16(72.7)
Ⅲ 2(9.1)
Classification of periodontitis
Local 1(4.5)
Generalized 21(95.5)
Extraction or not
Extraction 6(27.3)
Non-extraction 16(72.7)
Total 22(100)

Table 2

Paired t test on changes of OFDS and PCS at patient level"

Items Pre-treatment Post-treatment t P
OFDS 84.5±20.9 105.3±22.6 -9.028 <0.001
PCS 68.9±9.1 83.7±6.3 -8.671 <0.001

Table 3

Paired t test on changes of OFDS at tooth level"

OFDS of different tooth position Pre-treatment Post-treatment t P
Maxillary
Left
Central incisor 2.2±1.8 5.2±1.9 -6.890 <0.001
Lateral incisor 2.4±2.0 5.2±1.8 -7.738 <0.001
Canine 3.0±1.7 5.6±1.2 -6.411 <0.001
Second premolar 2.9±1.6 3.2±1.6 -0.646 0.525
First molar 3.6±3.3 4.0±2.5 -0.509 0.616
Second molar 2.3±2.0 2.8±1.6 -1.779 0.090
Right
Central incisor 1.9±1.3 5.5±1.4 -9.279 <0.001
Lateral incisor 2.7±1.5 5.4±1.5 -7.286 <0.001
Canine 3.1±1.6 5.5±0.9 -5.786 <0.001
Second premolar 2.9±1.7 3.5±1.6 -1.204 0.242
First molar 4.0±3.0 4.9±2.4 -1.870 0.076
Second molar 2.6±1.8 3.1±2.1 -0.917 0.369
Mandible
Left
Central incisor 4.8±2.4 5.7±1.3 -2.084 0.050
Lateral incisor 5.0±2.1 5.0±2.1 <0.001 1.000
Canine 5.7±1.3 5.7±1.3 <0.001 1.000
Second premolar 3.5±1.2 3.3±1.5 0.576 0.571
First molar 4.7±2.5 4.8±2.8 -0.234 0.817
Second molar 2.0±1.8 2.1±1.5 -0.568 0.576
Right
Central incisor 4.9±2.4 5.4±1.8 -1.451 0.162
Lateral incisor 5.5±1.8 5.3±1.8 1.000 0.329
Canine 5.6±1.4 5.7±1.3 -1.000 0.329
Second premolar 2.8±1.7 3.1±1.8 -0.819 0.422
First molar 5.0±2.6 3.9±3.2 1.827 0.082
Second molar 2.0±1.5 2.1±1.7 -0.311 0.759

Table 4

Comparison on changes of PCS at tooth level"

PCS of different tooth position Pre-treatment Post-treatment P
Maxillary
Left
Central incisor 2.1±1.5 4.0(4.0, 4.0) <0.001
Lateral incisor 2.6±1.4 3.9±0.4 <0.001
Canine 3.2±1.0 4.0(4.0, 4.0) 0.001
Second premolar 3.8±0.6 3.7±0.7 0.665
First molar 3.8±0.6 3.9±0.5 0.331
Second molar 1.7±0.9 1.9±0.8 0.481
Right
Central incisor 1.7±0.8 3.9±0.4 <0.001
Lateral incisor 2.0±1.6 4.0(4.0, 4.0) <0.001
Canine 2.5±1.6 4.0(4.0, 4.0) <0.001
Second premolar 3.8±0.5 3.9±0.4 0.162
First molar 4.0(4.0, 4.0) 4.0±0.2 0.329
Second molar 1.9±0.4 2.0(2.0, 2.0) 0.329
Mandible
Left
Central incisor 2.8±1.2 3.9±0.4 <0.001
Lateral incisor 2.9±1.2 3.8±0.9 0.001
Canine 3.5±0.7 4.0(4.0, 4.0) 0.009
Second premolar 3.7±0.5 3.9±0.4 0.083
First molar 3.9±0.4 3.9±0.4 1.000
Second molar 1.9±0.4 1.9±0.4 1.000
Right
Central incisor 2.7±1.2 3.9±0.4 <0.001
Lateral incisor 2.9±1.2 3.8±0.9 0.001
Canine 3.3±0.7 4.0(4.0, 4.0) <0.001
Second premolar 4.0±0.2 3.9±0.6 0.540
First molar 4.0±0.2 4.0(4.0, 4.0) 0.329
Second molar 2.0±0.2 2.0(2.0, 2.0) 0.329

Table 5

Multi-level linear regression analysis of probing depth decrease and various level factors"

Items 95%CI P
Patient level
Age 0.006 (-0.042, 0.030) 0.744
Gender -0.072 (-0.390, 0.533) 0.760
Tooth level
OFDS(T2-T1) 0.050(0.024, 0.077) <0.001
PCS(T2-T1) 0.244(0.182,0.305) <0.001
Baseline PD(T0) 0.363(0.286,0.440) <0.001
[1] 孟焕新 . 临床牙周病学[M]. 北京: 北京大学医学出版社, 2014: 185-195.
[2] Azuma S, Kohzuki M, Saeki S , et al. Beneficial effects of orthodontic treatment on quality of life in patients with malocclusion[J]. Tohoku J Exp Med, 2008,214(1):39-50.
[3] Bernabé E, Tsakos G, Messias d OC, et al. Impacts on daily performances attributed to malocclusions using the condition-specific feature of the oral impacts on daily performances index[J]. Angle Orthod, 2008,78(2):241-247.
[4] 施捷 . 牙周炎患者的正畸减数治疗及其远期疗效观察[J]. 中华口腔正畸学杂志, 2010,17(4):181-187.
[5] Armitage GC . Development of a classification system for periodontal diseases and conditions[J]. Ann Periodontol, 2005,4(1):1-6.
[6] Dawson P . Functional occlusion: from TMJ to smile design[M]. Missouri: Mosby Elsevier, 2008: 404-405.
[7] 徐莉, 孟焕新, 田雨 , 等侵袭性牙周炎患者牙根形态异常的观察[J]. 中华口腔医学杂志, 2009,44(5):266-269.
[8] 乔敏, 徐莉, 孟焕新 , 等. 侵袭性牙周炎核心家系牙槽骨吸收和牙根形态的遗传度分析[J]. 中华口腔医学杂志, 2013,48(10):577-580.
[9] Slot J, Rosling BG . Suppression of the periodontopathic microflora in localized juvenile periodontitis by systemic tetracycline[J]. Journal Clin Periodontol, 1983,10(5):465-486.
[10] Lindhe J, Hamp SE, Loe H . Experimental periodontitis in the beagle dog[J]. J Periodontal Res, 1973,8(1):1-10.
[11] Shi J, Liu Z, Kawai T , et al. Antibiotic administration alleviates the aggravating effect of orthodontic force on ligature-induced experimental periodontitis bone loss in mice[J]. J Periodontal Res, 2017,52(4):725-733.
[1] ZHU Xiao-ling,LI Wen-jing,WANG Xian-e,SONG Wen-li,XU Li,ZHANG Li,FENG Xiang-hui,LU Rui-fang,SHI Dong,MENG Huan-xin. Gene polymorphisms of cytochrome B-245 alpha chain (CYBA) and cholesteryl ester transfer protein (CETP) and susceptibility to generalized aggressive periodontitis [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 18-22.
[2] LIU Jian,WANG Xian-e,LV Da,QIAO Min,ZHANG Li,MENG Huan-xin,XU Li,MAO Ming-xin. Association between root abnormalities and related pathogenic genes in patients with generalized aggressive periodontitis [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 16-23.
[3] Ming-xin MAO,Li XU,Wu-di JING,Xiao XU,Jian-xia HOU,Xiao-tong LI,Xiao-xia WANG. Alveolar crest and relevant analysis of labial side of anterior teeth on skeletal Angle class Ⅲ patients [J]. Journal of Peking University(Health Sciences), 2020, 52(1): 77-82.
[4] Xiu-jing WANG,Yi-mei ZHANG,Yan-heng ZHOU. Orthodontic-orthognathic treatment stability in skeletal class Ⅲ malocclusion patients [J]. Journal of Peking University(Health Sciences), 2019, 51(1): 86-92.
[5] ZHANG You-wen, XIN Tian-yi, JIAO Jian,ZHOU Yan-heng, SHI Jie. Extraction-orthodontic treatment on patients with chronicperiodontitis: a preliminary study [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 308-313.
[6] ZHANG Hai-dong, ZHANG Li, SHI Dong, HAN Jie, YAN Xia, XIE Ye-si, MENG Huan-xin. Clinical study of locking-taper implants in patients treated for periodontitis [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 300-307.
[7] XU Xiao， XU Li, JIANG Jiu-hui, WU Jia-qi, LI Xiao-tong, JING Wu-di. Accuracy analysis of alveolar dehiscence and fenestration of maxillary anterior teeth of Angle class Ⅲ by cone-beam CT [J]. Journal of Peking University(Health Sciences), 2018, 50(1): 104-109.
[8] MA Jing, JIANG Jiu-hui. Morphological analysis of alveolar bone of anterior mandible in high-angle skeletal class Ⅱ and class Ⅲ malocclusions assessed with cone-beam computed tomography [J]. Journal of Peking University(Health Sciences), 2018, 50(1): 98-103.
[9] FAN Shao-qing， ZHOU Yan-heng. Evaluation of the correction of the skeletal class Ⅲ malocclusion by distalization of the whole mandible dentition with micro-implant anchorage [J]. Journal of Peking University(Health Sciences), 2017, 49(3): 531-539.
[10] ZHENG Xu， HU Xing-Xue， MA Ning， CHEN Xiao-Hong. A new method to orthodontically correct dental occlusal plane canting: waveshaped arch [J]. Journal of Peking University(Health Sciences), 2017, 49(1): 176-180.
[11] SHEN Xiao, SHI Jie, XU Li, JIAO Jian, LU Rui-fang, MENG Huan-xin. Clinical evaluation of periodontal-orthodontic treatment in patients with aggressive periodontitis and malocclusion [J]. Journal of Peking University(Health Sciences), 2017, 49(1): 60-066.
[12] ZHANG Jie, LI Xiao-tong. Study of anterior alveolar bone thickness in skeletal class Ⅲ malocclusion patients with orthognathic surgery [J]. Journal of Peking University(Health Sciences), 2016, 48(1): 111-115.
[13] LI Min, WANG Si-wei, ZHAO Yi-jiao, LIU Yi. A cone-beam computed tomography study on crown-root morphology of maxillary anterior teeth in Class Ⅱ, division 2 malocclusion [J]. Journal of Peking University(Health Sciences), 2016, 48(1): 105-110.
[14] SONG Wen-li, TIAN Yu, WANG Xian-e, ZHANG Li, XU Li, SHI Dong, FENG Xiang-hui, LU Rui-fang, CHEN Zhi-bin, MENG Huan-xin. Association between FADS1 rs174537 polymorphism and serum proteins in patients with aggressive periodontitis [J]. Journal of Peking University(Health Sciences), 2016, 48(1): 10-15.
[15] HE Wei, XIE Xiao-yan, WANG Xing, WANG Xiao-xia1, FU Kai-yuan2, LI Zi-li. Effect of segmental Le FortⅠosteotomy and bilateral sagittal split ramus osteotomy on the condyle position in skeletal class Ⅲ malocclusion patients [J]. Journal of Peking University(Health Sciences), 2015, 47(5): 829-833.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Journal of Peking University(Health Sciences), 2009, 41(4): 456 -458 .
[2] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 158 -161 .
[3] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 217 -220 .
[4] . [J]. Journal of Peking University(Health Sciences), 2009, 41(3): 297 -301 .
[5] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 304 -309 .
[6] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 323 -328 .
[7] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 341 .
[8] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 342 .
[9] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 365 -368 .
[10] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 399 -402 .
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd