正畸异常患者慢性牙周炎的个性化治疗:临床病例报告

S. L. Blashkova, Y. V. Fazylova, I. M. Shaidullin, I. Z. Urdyakov
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摘要

相关性。慢性牙周炎是一种受多种因素影响的多因素疾病。除了牙周病原体和全身性疾病外,重要的致病因素还包括咬合不正、牙齿错位和牙齿脱落。这些情况会损害组织血流血流动力学,导致咬合创伤,出现功能性超负荷迹象。矫正错颌畸形是有效治疗牙周疾病的关键,需要通过正畸治疗来解决错颌畸形并减轻功能性超负荷的症状。这种治疗的目的是均匀地重新分配咬合力,从而为成功的义齿修复创造有利的环境,并促进最佳的个人口腔卫生。本文概述了一种针对正畸异常患者牙周炎症的个性化治疗方法。患者Z.出生于2002年,被诊断为中度慢性牙周炎(K05.31),两侧臼齿和犬齿关系为I类,牙弓收缩,个别牙齿巨牙症,门牙后退和扭转。对患者牙周状况和整体健康的评估是通过标准的临床、放射和实验室诊断进行的,而正畸评估则包括牙模和头颅侧位X光片的人体测量分析。牙周干预包括非手术基础治疗,如龈上和龈下超声波洁牙、使用 Vector Paro 系统破坏生物膜以及特定药物治疗。正畸治疗的目的是扩大两个牙弓,矫正上下门牙的倾斜,按照治疗计划使用固定正畸器(达蒙 Q 托槽)实现正常的咬合。通过检查干预前后牙龈状况、牙周参数和放射学证据的改善情况来衡量治疗效果。研究表明,将牙周护理和正畸护理结合起来的个性化治疗方案可以大大改善牙颌面复合体的整体健康、咀嚼效率和美观。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Individualized management of chronic periodontitis in patients with orthodontic abnormalities: a clinical case report
Relevance. Chronic periodontitis is a multifactorial disease influenced by a variety of factors. Beyond periodontal pathogens and systemic conditions, important contributing factors include malocclusion, dental misalignment, and tooth loss. These conditions can compromise the tissue blood flow hemodynamics and precipitate occlusal trauma with signs of functional overload. Subsequently, this may intensify the inflammation and degradation of the alveolar bone, often leading to premature tooth loss.Correction of malocclusion is paramount in the effective management of periodontal diseases, requiring orthodontic treatment to resolve malocclusion and mitigate signs of functional overload. This treatment aims to redistribute occlusal forces uniformly, thus creating a conducive environment for successful prosthodontic rehabilitation and promoting optimal personal oral hygiene.Clinical case description. This article outlines a personalized approach to managing periodontal inflammation in individuals with orthodontic anomalies. Patient Z., born in 2002, was diagnosed with moderate severity chronic periodontitis (K05.31), presenting with a Class I molar and canine relationship on both sides, constricted dental arches, individual tooth macrodontia, and retrusion and torsiversion of the incisors. The assessment of the patient's periodontal status and overall health was conducted using standard clinical, radiographic, and laboratory diagnostics, whereas the orthodontic assessment involved anthropometric analysis of dental casts and lateral cephalometric radiographs. The periodontal intervention included foundational non-surgical treatments such as ultrasonic scaling both supra- and subgingivally, biofilm disruption using the Vector Paro system, and specific pharmacotherapy. The orthodontic treatment aimed to widen both dental arches and correct the inclination of the upper and lower incisors, achieving a normal occlusion with fixed orthodontic appliances (Damon Q brackets) in accordance with the treatment plan. The effectiveness of the treatment was measured by examining the improvement in gingival conditions, periodontal parameters, and radiographic evidence before and after the intervention.Conclusion. The research demonstrated that an individualized treatment protocol integrating periodontal and orthodontic care can substantially improve the overall health of the dentofacial complex, masticatory efficiency, and aesthetic aspects.
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