摘要
目的研究无托槽隐形矫治器治疗对牙周炎患者龈沟液及血清肿瘤坏死因子-α(TNF-α)、人基质金属蛋白酶-8(MMP-8)、白细胞介素-6(IL-6)水平的影响。方法采用回顾性研究,将2020年1月至2022年1月南京大学医学院附属口腔医院的80例牙周炎患者作为研究对象,根据治疗方式不同分为研究组(n=40)与对照组(n=40)。研究组选取无托槽隐形矫治器治疗,对照组选取直丝弓矫治器治疗。比较两组患者治疗前后龈沟液和血清炎症因子(TNF-α、MMP-8、IL-6)、牙周指标[临床附着丧失(CAL)、牙周袋探诊深度(PD)、牙龈指数(GI)、龈沟出血指数(SBI)、菌斑指数(PLI)]水平、治疗后视觉模拟评分法(VAS)评分及总有效率。结果治疗后,研究组患者龈沟液炎症因子、血清炎症因子水平及PD、PLI均较治疗前明显升高,差异均有统计学意义(P<0.05);对照组患者治疗后龈沟液炎症因子、血清炎症因子水平及CAL、PD、GI、SBI、PLI均较治疗前明显升高,差异均有统计学意义(P<0.05)。研究组患者龈沟液TNF-α、MMP-8、IL-6水平分别为(2.18±0.36)pg/mL、(2015.74±324.76)pg/mL、(6.14±2.05)ng/L,明显高于对照组[(2.83±0.32)pg/mL、(2441.25±351.97)pg/mL、(8.07±2.21)ng/L],差异均有统计学意义(P<0.05)。研究组患者血清TNF-α、MMP-8、IL-6水平分别为(6.17±1.29)pg/mL、(344.48±42.03)pg/mL、(12.48±2.51)ng/L,明显高于对照组[(7.92±1.53)pg/mL、(410.31±51.58)pg/mL、(17.37±3.02)ng/L],差异均有统计学意义(P<0.05)。研究组治疗后CAL、PD、GI、SBI、PLI分别为(3.28±0.26)mm、(2.59±0.27)mm、0.82±0.27、1.52±0.24、3.01±0.35,均明显低于对照组[(4.25±0.51)mm、(3.01±0.26)mm、1.65±0.37、2.91±0.45、3.87±0.64],差异均有统计学意义(P<0.05)。治疗后1、3、7 d,研究组患者VAS评分分别为(0.34±0.09)、(3.09±1.04)、(0.14±0.03)分,均明显低于对照组[(2.37±0.61)、(5.81±1.12)、(0.61±0.08)分],差异均有统计学意义(P<0.05)。研究组患者总有效率为97.50%,明显高于对照组(80.00%),差异有统计学意义(P<0.05)。结论无托槽隐形矫治器治疗牙周炎的临床效果显著,可进一步控制患者龈沟液及血清炎症因子水平与牙周疼痛程度,还可有效改善牙周状态。
Objective To investigate the effects of unsupported invisible appliance on gingival crevicular fluid and serum levels of tumor necrosis factor-α(TNF-α),human matrix metalloproteinase-8(MMP-8)and interleukin-6(IL-6)in the treatment of periodontitis.Methods In retrospective analysis,80 patients with periodontitis from the Stomatology Hospital Affiliated to the School of Medicine of Nanjing University from January 2020 to January 2022 were selected as research objects.According to the treatment methods,they were divided into the study group(n=40)and the control group(n=40).The study group was treated with non-bracket invisible appliance,while the control group was treated with straight wire arch appliance.The inflammatory factors(TNF-α,MMP-8,IL-6)in gingival creval fluid and serum,periodontal indicators[clinical attachment loss(CAL),periodontal pocket probing depth(PD),gingival index(GI),gingival crevicular bleeding index(SBI),plaque index(PLI)],visual alogue scale(VAS)score after treatment and total effective rate of the two groups before and after treatment were compared.Results After treatment,the levels of inflammatory factors in gingival crevicular fluid,serum inflammatory factors,PD and PLI in the study group were significantly higher than those before treatment(P<0.05);after treatment,the levels of inflammatory factors in gingival crevicular fluid,serum inflammatory factors and CAL,PD,GI,SBI,PLI in the control group were significantly higher than those before treatment(P<0.05).The levels of TNF-α,MMP-8 and IL-6 in gingival crevicular fluid of patients in the study group were(2.18±0.36)pg/mL,(2015.74±324.76)pg/mL,(6.14±2.05)ng/L,respectively,which were significantly higher than those in the control group[(2.83±0.32)pg/mL,(2441.25±351.97)pg/mL,(8.07±2.21)ng/L],and the differences were statistically significant(P<0.05).The levels of serum TNF-α,MMP-8 and IL-6 in the study group were(6.17±1.29)pg/mL,(344.48±42.03)pg/mL,(12.48±2.51)ng/L,respectively,which were significantly higher than those in the control group[(7.92±1.53)pg/mL,(410.31±51.58)pg/mL,(17.37±3.02)ng/L],and the differences were statistically significant(P<0.05).After treatment,the CAL,PD,GI,SBI and PLI of the study group were(3.28±0.26)mm,(2.59±0.27)mm,0.82±0.27,1.52±0.24,3.01±0.35,respectively,which were significantly lower than those of the control group[(4.25±0.51)mm,3.01±0.26)mm,(1.65±0.37,2.91±0.45,3.87±0.64],and the differences were statistically significant(P<0.05).The VAS scores at 1,3 and 7 days after treatment were(0.34±0.09),(3.09±1.04)and(0.14±0.03)points,respectively,which were significantly lower than those in the control group[(2.37±0.61),(5.81±1.12)and(0.61±0.08)points],and the differences were statistically significant(P<0.05).The total effective rate was 97.50%,which was significantly higher than that in the control group(80.00%),and the difference was statistically significant(P<0.05).Conclusion In the treatment of periodontitis,the application effect of invisible appliance without brackets is significant,which can further control the level of gingival crevicular fluid and serum inflammatory factors and the degree of periodontal pain,and can also effectively improve the periodontal state.
作者
谢丽
孙伯阳
张杨珩
张鹏
XIE Li;SUN Bo-yang;ZHANG Yang-heng(Department of Pediatric Dentistry,Stomatology Hospital Affiliated to School of Medicine of Nanjing University,Nanjing Jiangsu 210008,China;Department of Comprehensive Section,Stomatology Hospital Affiliated to School of Medicine of Nanjing University,Nanjing Jiangsu 210008,China;Department of Periodontics,Stomatology Hospital Affiliated to School of Medicine of Nanjing University,Nanjing Jiangsu 210008,China)
出处
《临床和实验医学杂志》
2023年第7期742-746,共5页
Journal of Clinical and Experimental Medicine
基金
江苏省自然科学基金(编号:BK20200148)。
关键词
牙周炎
无托槽隐形矫治器
直丝弓矫治器
龈沟液
炎症因子
Periodontitis
Invisible appliance without bracket
Straight wire bow appliance
Gingival crevicular fluid
Inflammatory factor
