【作者】 杨丽；

【导师】 范存晖；

【作者基本信息】 青岛大学 ， 口腔临床医学， 2012， 硕士

【摘要】 目的：通过检测实施不同洁治周期的固定正正畸患者在矫治前、矫治1、3、6个月时龈沟液量、龈沟液中IL-17的含量以及牙周临床指数的变化,来评价不同周期的预防性洁治对固定正畸患者牙周健康状况的影响,以探讨固定正畸患者合适的洁治周期。方法：选取直丝弓矫治患者41名,随机分成三组,A组为一月一次的牙周洁治组,B组为三月一次的牙周洁治组,C组为六月一次的牙周洁治组(对照组)。以右上颌第一磨牙(16)、左上颌中切牙(21)、左下颌第一前磨牙或第二前磨牙(34／35)、右下颌中切牙(41)为检测牙位,分别于矫治前、矫治1、36个月时采集龈沟液并记录菌斑指数、牙龈指数、探诊深度的变化。采用ELISA法检测所采集的龈沟液中IL-17的含量。结果：1.牙周临床指标： A组在1个月时菌斑指数、牙龈指数较矫治前升高(P<0.05)；B组在1、3个月时菌斑指数较矫治前升高(P<0.05),在1、3、6个月时牙龈指数较矫治前升高(P<0.05),C组在1、3、6个月时菌斑指数、牙龈指数均较矫治前升高(P<0.05),在6个月时探诊深度较矫治前升高(P<0.05)。矫治3个月时A组的菌斑指数、牙龈指数显著低于B、C组(P<0.05),后两组比较无显著差异(P>0.05)；6个月时,三组之间均存在显著差别(P<0.05)。探诊深度在矫治前、矫治1、3、6个月时三组之间均无显著差别(P>0.05)。2.龈沟液量： A、B、C三组的GCF量在矫治1、3、6个月时均较矫治前显著增多(P<0.05)。3个月时A组显著低于B、C组(P<0.05),后两组比较无显著差异(P>0.05)；6个月时,三组之间均存在显著差别(P<0.05)。3. IL-17的含量：A组在矫治1个月时IL-17含量较矫治前升高(P<0.05)；B、C组在矫治1、3、6个月时均较矫治前升高(P<0.05)。3个月时A组显著低于B、C组(P<0.05),后两组比较无显著差异(P>0.05)；6个月时,三组之间均存在显著差别(P<0.05)。结论：1.牙周洁治对固定正畸患者的牙周健康具有维护作用,并且洁治周期越短,其维护效果越好。2.一月一次的牙周洁治对固定正畸患者的牙周维护作用效果最好,但丁正畸医生应根据患者不同的口腔卫生状况适当的选择合适的洁治周期。3.龈沟液量、龈沟液中IL-17的含量与菌斑指数、牙龈指数、探诊深度呈现明显的正正相关关系,可以作为评价正畸患者牙周健康状况的指标。更多还原

【Abstract】 Objective:Patients with fixed orthodontic appliances were gave prophylaxis in different period. The IL-17level in GCF and periodontal clinical index were observed before and during fixed orthodontic treatment to evaluate the effects of different periodic prophylaxis to the health of the periodontal tissues, and to discuss the best periodic prophylaxis of these patients.Methods:41patients wearing the straight wire appliance were divided into three groups. Group A accepted prophylaxis monthly, Group B accepted prophylaxis trimonthly, Group C accepted prophylaxis every six months(control group). we chosed The right maxillary first molar(16), the left maxillary central incisor (21), the left mandibular first premolar or the second (34/35) and the right mandibular central incisor (41) as index teeth. The GCF volume and plaque index, gingival index and probing depth were examined, and the IL-17level in GCF were detectde by ELISA.Results:1. Periodontal indexes:the plaque index and gingival index were significantly higher than the ones pretreatment in group A (P<0.05) at the1st month; In group B, the plaque index at the1st,3rd month were significant higher than the one at pretreatment (P<0.05), and the gingival index at the1st,3rd,6th months were significant higher than the one at pretreatment (P<0.05); while in group C, the plaque index and gingival index at the1st,3rd,6th months were significantly higher than the ones at pretreatment (P<0.05), the probing depth at6th month were significant higher compared with pretreatment (P<0.05). The plaque index and gingival index of group A were significant lower than group B and group C at3rd month (P<0.05), while there was no significant difference between the latter two groups (P>0.05); there were significant differences among the three groups at6th month (P<0.05). There were no significant differences of probing depth among the three groups during the6month treatment (P>0.05) 2. The GCF volume:the GCF volume of the three groups were significant higher at1st,3rd,6th months than pretreatment (P<0.05). At3rd month the GCF volume of group A were significant lower than group B and group C (P<0.05), while there was no significant difference between the latter two groups (P>0.05); there were significant differences among the three groups at6th month (P<0.05)3. The level of IL-17:In group A the level of IL-17was significantly higher than the ones pretreatment (P<0.05) at1st month; while in group B and group C, the level of IL-17were significant higher at1st,3rd,6th months than pretreatment (P<0.05). At3rd month the level of IL-17of group A were significant lower than group B and group C (P<0.05), While there was no significant difference between the latter two groups (P>0.05); there were significant differences among the three groups (P<0.05) at6th month.Conclusions:1.Prophylaxis can maintain the health of periodontal tissue of the fixed orthodontic patients, and the shorter of the cycle of prophylaxis, the better of the maintenance effect.2.Prophylaxis monthly can well maintain the health of periodontal tissue of the fixed orthodontic patients, but orthodontic doctor should choose the appropriate cycle of prophylaxis according to the different periodontal health condition.3.There were significant positive correlation among the GCF volume, the level of IL-17in GCF and the plaque index, gingival index, probing depth. The GCF volume and the level of IL-17in GCF can be effective index to evaluate the periodontal health condition of fixed orthodontic patients.更多还原