分析与正畸治疗相关的牙弓横向尺寸稳定性和牙龈凹陷风险

L. N. Soldatova, A. V. Shefova
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摘要

相关性。正畸治疗可能会对牙周健康产生不利影响。因此,由牙周病医生进行全面诊断和制定治疗计划至关重要。牙槽骨扩张是为错颌畸形矫正提供空间的方法之一。然而,对所获得的横向尺寸的稳定性研究仍然不足,需要进行更多的研究。对比研究包括临床阶段和准临床阶段。纳入和排除标准决定了研究样本的形成。每位患者都按照制造商推荐的标准换弓方案进行了正畸治疗;平均治疗时间为 18 ± 4 个月。所有患者都接受了专门针对牙龈退缩诊断的临床检查。在辅助临床阶段,研究人员调查了医疗记录,并使用庞氏指数(1909 年)和林德-哈特指数(1939 年)测量了研究模型参数。在正畸治疗期间进行了四次测量:治疗前、治疗后、治疗后一年和六年。所有获得的数据均采用显著性标准进行统计处理。在积极治疗阶段对研究模型进行的分析表明,牙列的每个区段都有所扩大。然而,在去除托槽系统后的第一年内,结果很容易复发。口腔临床检查显示,牙龈凹陷出现在正畸治疗的积极阶段。因此,每三个病例中就有一个出现边缘组织移位。通过比较研究组和对照组的初始横向尺寸,发现测量值和参考值之间存在差异,这可能是确定新参数的前提条件。牙周病医生应监测正畸患者,以保护牙周健康。上下前磨牙区域的横向尺寸似乎增加到了极致。然而,取得的效果并不总是稳定的。大多数复发发生在正畸治疗后的第一年;随后,结果保持稳定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of the transverse dental arch dimension stability and risk of gingival recessions associated with orthodontic treatment
Relevance. Orthodontic treatment may adversely affect the periodontal health. Therefore, a comprehensive diagnosis and treatment planning with a periodontist are crucial. Dentoalveolar expansion is one of the ways to provide the space for malocclusion correction. Nevertheless, the stability of the obtained transverse dimensions remains insufficiently studied and requires additional research.Material and methods. The comparative study included the clinical and paraclinical stages. The inclusion and exclusion criteria determined the study sample formation. Each patient had orthodontic treatment with the same standard arch-changing protocol recommended by the manufacturer; the average treatment duration was 18 ± 4 months. All patients underwent a clinical examination specifically focused on the gingival recession diagnosis. During the paraclinical stage, the study investigated medical records and measured study model parameters using Pont’s (1909) and Linder-Hart (1939) indices. Measurements were made four times during orthodontic treatment: before, immediately after, one and six years after treatment. All obtained data were statistically processed using the significance criteria.Results. Study models’ analysis during the active stage of treatment revealed expansion in each segment of the dentition. However, the result is prone to relapse within the first year after the bracket system removal. Clinical examination of the oral cavity revealed gingival recessions, which appeared during the active stage of the orthodontic treatment. Thus, every third case showed marginal tissue displacement. The comparison of the initial transverse dimensions in the study and control groups detected a discrepancy between the measured and reference values, which might be a prerequisite for determining new parameters.Conclusion. A periodontist should monitor orthodontic patients to protect periodontal health. The transverse dimensions appeared to increase to the utmost in the upper and lower premolar regions. However, the achieved result does not always remain stable. Most relapses occur during the first year after the orthodontic treatment; then, the outcome remains stable.
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