Clinical Investigation To The Changes Of Clinical Periodontal Indexes And Gingival Crevicular Fluid In Adults And Adolescents With Fixed Orthodontic Appliances

Objective: Fixed orthodontic treatment is one of the most widely used orthodontic treatments. It improves the profile and the Mastication effici- ency. As confirmed, such as gingival swelling, bleeding and hypertrophy, are often observed during therapy. And another phenomenon is adults and adolescents have different symptoms. However, it is not certain that the influence of the fixed orthodontic treatment to the periodontium is expe- dient or not. Therefore, large-scale clinical investigation would provide the- oretical basis to the prevention and therapy of periodontal diseases who with the fixed orthodontic treatment. The dynamic variation of Gingival Crevicular Fluid volume and clinical examinations for periodontal tissue were taken in this study to interpret the basic characters of periodontal tissue of malocclusion patients and the difference between adults and adolescents.Method: 120 malocclusion patients were selected randomly, and divi- ded into four groups: treatment group of adults; treatment group of adolesc- ents; treatment-ended group of adults and treatment-ended group of adoles- cents. respectively contains 30 patients. All the patients were treated by straight wire appliance.14(or15),13,11,21,33,31,41,44(or45) were the observed teeth. Plaque index(PLI), gingival index(GI), sulcus ble- eding index(SBI),probing depth(PD) and attachment loss(AL) of observed teeth were examined before orthodontic treatment, one month after treat- ment , three months after treatment and six months after treatment .And the same experiment was taken before orthodontic treatment ended, one month after treatment ended, three months after treatment ended and six months after treatment ended. The treatment group and the treatment- ended group were analysed by Repeated Measures of General Linear Model. The correlated index between treatment group and treatment-ended group was analysed by Independent Sample T test. Gingival Crevicular Fluid volume was analysed by One-Way ANOVA analysis. Results:1.Periondontal indexes:AL were not check-out during the whole groups. Treatment Group: the PLI index of adolescents increased, the PLI index of adults increased first and then descended, and there was no statistics'difference between adults and adolescents. The SBI index were both upward trend, and there was no statistics'difference between adults and adolescents. The PLI index of adolescents was increased, but the PLI index of adults was descended, as analysed, the two groups were at different level.Treatment-ended Group: The trend of all the clinical periodontal indexes was downward. When the appliance was removed, the periodontal indexes descended most apparently during the first month, but there was no statistics'difference between adults and adolescents.The comparison of Treatment Group and Treatment-ended Group: Before the appliance removing, all of the periodontal indexes for the whole patients were bigger than the indexes of the sixth month after beginning, but only the SBI and DP indexes had statistics'difference. Contrast the periodontal indexes of the sixth month after removing appliance to the indexes before fixing the appliance, the PLI indexes were smaller, and the SBI and DP indexes were bigger. But there was no statistics'difference between them.2. The changes of GCF-volume: there was no statistics'difference bet- ween adults and adolescents. The trend of DP indexes of adolescents were upward, but the trend of DP indexes of adults were upward first and then downward.Conclusions: Fixed orthodontic appliances promoted the accumulation of plaque. The number of plaque increased before three months of therapy in adults and adolescents; during the following three months the number of plaque in adults descended; in adolescents, the fixed orthodontic appliances caused the mild gingivitis and the increasing of sulcus bleeding index during the initial stage of therapy and gingiva had the trend of hyperplasting while in adults, the gingiva had atrophy's trend, which could not lead to the periodontal attachment loss that was in the normal field. The mouth's health of patients was improved and gingivitis were recovered fastly after the therapy . The experiment showed that the effect of fixed orthodontic appliances was more significant in the periodontal tissues of adolescents .The conditions of the periodontal tissues were indeed influenced by the fixed orthodontic appliances, but they were relatively healthy in this study. The effect of fixed orthodontic appliances in the long run still need further research.