槽骨再生正畸治疗成人中重度牙周炎错畸形远期疗效评价

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (3): 234-238.

槽骨再生正畸治疗成人中重度牙周炎错畸形远期疗效评价

王博^{1*, *}, 于洪波^{1*, *}, 孙良龑¹, 沈国芳¹, 王旭东¹, 房兵, 郭秋曼

1.上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科;
2.牙周病科,上海市口腔医学重点实验室,上海 200011

收稿日期:2015-06-05 出版日期:2016-06-20 发布日期:2016-07-04
通讯作者: 房兵,E-mail：braces_dr@hotmail.com;郭秋曼,E-mail：sukeseki@126.com。^#共同通信作者
作者简介:王博（1985-）,男,硕士,主治医师,E-mail：wb228@126.com;于洪波（1976-）,男,博士,副主任医师,E-mail：yuhb@sdu.edu.cn。*并列第一作者
基金资助:
上海市卫生和计划生育委员会青年项目（20144Y0125）; 上海交通大学医学院科技基金项目（12XJ10055）

Long-term effect of augmented corticotomy assisted orthodontic treatment for adult patients with moderate to severe periodontitis

WANG Bo¹, YU Hong-bo¹, SUN Liang-yan¹, SHEN Guo-fang¹, WANG Xu-dong¹, FANG Bing¹, GUO Qiu-man²

1.Department of Oral and Craniomaxillofacial Science, 2. Department of Periodontology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China)

Received:2015-06-05 Online:2016-06-20 Published:2016-07-04

摘要/Abstract

摘要： 目的评价牙槽骨再生正畸治疗成人中重度牙周炎错畸形的远期疗效。方法成人中重度牙周炎错畸形3例,伴不同程度上或下前牙区牙槽骨吸收,平均年龄31岁。经正颌-正畸联合会诊,制订综合治疗计划。系统性牙周治疗后,行牙槽骨再生正畸治疗结合定期牙周检查与维护,矫治结束后随访2~3 a。结果3例患者均顺利完成治疗,面型及咬合关系获良好改善,牙槽骨吸收区域骨量增加明显且远期效果稳定,术区正畸牙移动到位且未见医源性牙周并发症。结论针对成人中重度牙周炎错畸形患者,牙槽骨再生正畸是一种较为理想的技术。

关键词: 牙槽骨再生正畸, 成人, 牙周炎, 锥形束CT, 远期疗效

Abstract: PURPOSE: To investigate the long-term effect of augmented corticotomy assisted orthodontic treatment for adult patients with moderate to severe periodontitis. METHODS: A joint orthodontic and orthognathic consultation was performed on 3 adult patients diagnosed as moderate to severe periodontitis with an average age of 31 years old. Augmented corticotomy assisted orthodontic treatment and combined periodontal therapy were carried out with long-term follow-up of 2-3 years. RESULTS: Augmented corticotomy assisted orthodontic treatment resulted in normal facial appearances and occlusal relationships without the occurrences of periodontal iatrogenic sequelae. The long-term effect of alveolar augmentation were maintained at the surgical sites. CONCLUSIONS: Augmented corticotomy assisted orthodontic treatment is a promising technique for treatment of adult patients with moderate to severe periodontitis.

Key words: Augmented corticotomy assisted orthodontic treatment, Adult, Periodontitis, Cone-beam CT, Long-term effect

中图分类号:

R783.5

王博, 于洪波, 孙良龑, 沈国芳, 王旭东, 房兵, 郭秋曼. 槽骨再生正畸治疗成人中重度牙周炎错畸形远期疗效评价[J]. 中国口腔颌面外科杂志, 2016, 14(3): 234-238.

WANG Bo, YU Hong-bo, SUN Liang-yan, SHEN Guo-fang, WANG Xu-dong, FANG Bing, GUO Qiu-man. Long-term effect of augmented corticotomy assisted orthodontic treatment for adult patients with moderate to severe periodontitis[J]. China J Oral Maxillofac Surg, 2016, 14(3): 234-238.

参考文献

[1] Consolaro A. In adults: 47.2% have periodontitis! How about in orthodontic patients [J]. Dental Press J Orthod, 2013, 18(1): 3-5.
[2] Ma ZG, Yang C, Fang B, et al. Three-D imaging of dental alveolar bone change after fixed orthodontic treatment in patients with periodontitis [J]. Int J Clin Exp Med, 2015, 8(2): 2385-2391.
[3] Handelman CS. The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae [J]. Angle Orthod, 1996, 66(2): 95-109.
[4] 王博, 房兵, 樊林峰, 等. 成人骨性Ⅲ类错下前牙区牙槽厚度的测量分析[J]. 上海口腔医学, 2012, 21(4): 422-426.
[5] Wehrbein H, Bauer W, Diedrich P. Mandibular incisors, alveolar bone, and symphysis after orthodontic treatment. A retrospective study[J]. Am J Orthod Dentofacial Orthop, 1996, 110(3): 239-246.
[6] Ten Hoeve A, Mulie RM. The effect of antero-postero incisor repositioning on the palatal cortex as studied with laminagraphy [J]. J Clin Orthod, 1976, 10(11): 804-822.
[7] Mulie RM, Hoeve AT. The limitations of tooth movement within the symphysis, studied with laminagraphy and standardized occlusal films [J]. J Clin Orthod, 1976, 10(12): 882-893.
[8] Vardimon AD, Oren E, Ben-Bassat Y. Cortical bone remodeling/tooth movement ratio during maxillary incisor retraction with tip versus torque movements [J]. Am J Orthod Dentofacial Orthop, 1998, 114(5): 520-529.
[9] Wilcko MT, Wilcko WM, Pulver JJ, et al. Accelerated osteogenic orthodontics technique: a 1-stage surgically facilitated rapid orthodontic technique with alveolar augmentation[J]. J Oral Maxillofac Surg, 2009, 67(10): 2149-2159.
[10] Wilcko WM, Wilcko T, Bouquot JE, et al. Rapid orthodontics with alveolar reshaping: two case reports of decrowding [J]. Int J Periodontics Restorative Dent, 2001, 21(1): 9-19.
[11] 王博, 沈国芳, 房兵, 等. 牙槽骨再生正畸治疗下前牙区牙槽骨发育不良的成人骨性Ⅲ类错畸形 [J].中国口腔颌面外科杂志, 2014, 12(3): 223-227.
[12] 王博, 沈国芳, 房兵, 等. 微手术正畸治疗骨性Ⅲ类错伴下前牙区牙槽骨发育不良的效果评价[J]. 上海口腔医学,2012,21(5): 535-540.
[13] Wang B, Shen G, Fang B, et al. Augmented corticotomy-assisted surgical orthodontics decompensates lower incisors in Class Ⅲ malocclusion patients [J]. J Oral Maxillofac Surg, 2014, 72(3): 596-602.
[14] Wang B, Shen G, Fang B, et al. Augmented corticotomy-assisted presurgical orthodontics of Class Ⅲ malocclusions: a cephalometric and cone-beam computed tomography study [J]. J Craniofac Surg, 2013, 24(6): 1886-1890.
[15] Wang B, Yu H, Shen G, et al. Augmented corticotomy assisted orthodontics of an adult patient with alveolar defect [J]. J Craniofac Surg, 2015, 26(2): 600-101.
[16] 王博, 房兵, 张莉. 成人骨性Ⅲ类错下前牙冠根形态的锥形束CT分析[J]. 中国口腔颌面外科杂志, 2011, 9(6): 472-476.
[17] Adams GL, Gansky SA, Miller AJ, et al. Comparison between traditional 2-dimensional cephalometry and a 3-dimensional approach on human dry skulls [J]. Am J Orthod Dentofacial Orthop, 2004, 126(4): 397-409.
[18] Loubele M, Bogaerts R, Van Dijck E, et al. Comparison between effective radiation dose of CBCT and MSCT scanners for dentomaxillofacial applications[J]. Eur J Radiol,2009,71(3):461-468.
[19] 孙良龚, 王博, 房兵. 错畸形伴牙槽骨缺损及其治疗方式[J]. 北京口腔医学, 2013, 21(3): 176-177.
[20] Sebaoun JD, Kantarci A, Turner JW, et al. Modeling of trabecular bone and lamina dura following selective alveolar decortication in rats [J]. J Periodontol, 2008, 79(9): 1679-1688.
[21] Iino S, Sakoda S, Ito G, et al. Acceleration of orthodontic tooth movement by alveolar corticotomy in the dog[J]. Am J Orthod Dentofacial Orthop, 2007, 131(4): 448. e1-8.
[22] 施捷, 付民魁. 牙周病正畸治疗中的误区[J]. 口腔正畸学, 2005, 12(3):140-142.