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《广州医药》编辑部
目的 分析上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙牙根吸收影响因素。方法 选取2017年8月—2021年5月我院正畸科上颌唇侧倒置埋伏中切牙患者1 542例,统计上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙及牙根吸收发生情况,并进行单因素多因素分析。结果 1 542例上颌唇侧倒置埋伏中切牙患者正畸矫治后共出现埋伏牙186例,其中男102例、女84例,出现埋伏牙1颗最多,占比65.05%,年龄以12~18岁居多,单侧埋伏牙157例(84.41%),双侧埋伏牙29例(15.59%),埋伏牙位置为斜位81例(43.55%),倒置47例25.27%,平行42例(22.58%),水平16例(8.60%);186例正畸矫治后出现埋伏牙的患者中,发生牙根吸收患者75例,发生率为40.32%;出现牙根吸收的患者埋伏牙位置为颌骨中间占比高于未发生牙根吸收患者,近远中分区0~1区占比、年龄均小于未发生牙根吸收患者(P<0.05);埋伏牙位置(颌骨中间)、近远中分区(0~1区)、年龄(低)是上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙牙根吸收的独立危险因素(P<0.05)。结论 上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙发生情况不容乐观,主要为12~18岁的患者为主,且多为单发,牙根吸收发生率较高,主要影响因素包括埋伏牙位置、近远中分区、年龄,临床应根据患者实际情况合理选择治疗方案。
目的 评估无托槽隐形矫治应用在正畸拔牙患者中的效果及对牙根吸收、可溶性细胞间黏附分子-1(sICAM-1)的影响。方法 纳入2022年1月—2024年8月的70例正畸拔牙患者,按照治疗方法分组,即对照组(35例,给予固定矫治)、观察组(35例,给予无托槽隐形矫治),评价组间牙根吸收情况、牙周指标、炎症因子、矫治时间。结果 治疗结束时,两组均出现牙根吸收情况,但是观察组无牙根吸收>3 mm病例,而对照组存在牙根吸收>3 mm、>4 mm病例,P<0.05。治疗前,两组牙周指标[龈沟出血指数(SBI)、牙龈指数(GI)、菌斑指数(PLI)]、炎症因子[白介素-1β(IL-1β)、sICAM-1]比较差异无统计学意义(P>0.05)。治疗后,两组SBI、GI、PLI、IL-1β、sICAM-1升高,且观察组SBI、GI、PLI、IL-1β、sICAM-1低于对照组(P<0.05)。与对照组比较,观察组矫治时间更长(P<0.05)。结论 对正畸拔牙患者进行无托槽隐形矫治,虽然治疗时间长,但是可以抑制牙根吸收,减轻炎症反应,提高牙周健康水平。
Objective To evaluate the effect of clear aligner treatment on orthodontic tooth extraction patients and its impact on root resorption and soluble intercellular adhesion molecule-1(sICAM-1).Methods Seventy orthodontic extraction patients from January 2022 to August 2024 were included and divided into two groups according to treatment methods:a control group(35 cases,receiving fixed orthodontic treatment)and an observation group(35 cases,receiving clear aligner treatment).The root resorption,periodontal indicators,inflammatory factors,and orthodontic treatment time between groups were evaluated.Results At the end of treatment,both groups showed root resorption,but there were no cases of root resorption>3 mm in the observation group,while there were cases of root resorption>3 mm and>4 mm in the control group,P<0.05.Before treatment,there was no difference in periodontal indicators(gingival bleeding index[SBI],gingival index[GI],plaque index[PLI]),inflammatory factors(interleukin-1 β[IL-1 β],sICAM-1) between the groups,P>0.05.After treatment,SBI,GI,PLI,IL-1 β,sICAM-1 increased in both groups,but SBI,GI,PLI,IL-1 β,sICAM-1 were lower in the observation group,P<0.05.Compared with the control group,the observation group had a longer orthodontic treatment time,P<0.05.Conclusions Although the clear aligner treatment time for orthodontic extraction patients is longer,it can inhibit root resorption,reduce inflammatory reactions,and improve periodontal health.