| [Background]Periodontitis, which causing pocket formation, periodontal destruction and attachlossing, alveolar bone resorption, and eventually teeth exfoliation, is one of the mostcommon chronic diseases in adults. Occlusal truma is frequent complication ofperiodontitis. As a multifactorial disease, periodontal destruction is not only caused bydental plaque biofilm or huaman immune response, but by abnormal occlusal force,premature contact.Occlusal therapy is an integral part of periodontal therapy. Failure to treat withocclusal trauma may result in progressive bone losing and an adverse changingin patients with chronic periodontitis. Given this information, patients should then be ableto make informed decisions regarding their periodontal therapy.Previous studies demonstrated that after SRP the clinical parameters were improved and the levels of mediators of inflammtion in gingival crevicular fluid weredown-regulated. However, the effect of occlusal therapy on teeth with chronicperiodontitis and secondary occlusal trauma in occlusal parameters and the levels ofmediators of inflammation in gingival crevicular fluid are still unknow.[Aims]To evaluate the effect of SRP and occlusal adjustment therapy on clinical andocclusal parameters and the levels of mediators of inflammtion in gingival crevicular fluidin teeth with chronic periodontitis and secondary occlusal traum[Methods]Eighteen patients with moderate-severe chronic periodontitis and secondary occlusaltrauma were included and randomly divided into group A and group B. On day0, group Awas treated by full-mouth subgingival scaling and root planning; group B was treated byocclusal adjustment therapy in occlusal trauma site. On day28, group A was treated byocclusal adjustment in occlusal trauma site; group B was treated by full-mouth SRP.Probing depth(PD)，attachment loss(AL), bleeding index(BI) were evaluated on0,28and56d; the occlusal time(OT) and the percentage of occlusal force were evaluated on0,28and56d in occlusal trauma site．The gingival crevicular fluid were collected on0,28and56d in occlusal trauma site.The level of IL-1β、RANKL、OPG in GCF from18patientswere determined by ELISA. Data was statistically analyzed by SPSS.18software forStudent’s t test and analysis of covariance.[Results]In baseline, the PD(4.42±1.41mm VS4.36±1.38mm),AL(2.75±1.32mm VS2.63±1.37mm), BI(2.20±0.81VS2.24±0.89) of the full-mouth showed no significantdifference between two groups（P＞0.05）; There was no significant difference inPD(5.21±1.21mm VS5.08±1.12mm),AL(4.94±1.47mm VS4.89±1.32mm), BI(2.61±0.92VS2.50±0.79),OT(1.29±0.39s VS1.34±0.35s) and the percentage of occlusalforce(6.8±2.1%VS7.4±1.7%) in occlusal trauma site between two groups（P＞0.05）.After SRP therapy, the PD,AL,BI,OT were significantly decreased （P＜0.05）. The clinical parameters exhibited no significant difference after only occlusal adjustment （P＞0.05）. On56d, the reduction in clinical parameters was not significantly differentbetween two groups（P＞0.05）, however the reduction of OT and the change of thepercentage of occlusal force of group A （0.85±0.41s;2.2±2.2%）were more significantthan those in group B(0.70±0.38s;1.5±1.6%（)P＜0.05）. After occlusal adjustment, theincrease of OT in group A（0.21±0.11s） was lower than that in group B （0.67±0.37s）through the28-day observation period（P＜0.05）. After SRP therapy, levels of IL-1β inGCF were significantly decreased（P＜0.05）,however levels of RANKL、 OPG wereincreased（P＜0.05）. After occlusal adjustment therapy, levels of IL-1β、RANKL/OPGin GCF were significantly decreased（P＜0.05）。[Conclusions]1) Occlusal adjustment only is inadequate for control and management of periodontitis.2) SRP can both eliminate the inflammation and decrease the OT of tooth with occlusaltrauma.3) The combination of SRP and occlusal adjustment may achieve more stable results.4) Levels of IL-1β、RANKL/OPG in GCF were decreased after occlusal adjustmenttherapy, it indicates that occlusal adjustment therapy may help to inhibit periodontalbone destruction. |
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