| [Objective]In this study, measure and compare several sets of data from the combined orthodontic and periodontal treatment for the periodontitis to evaluate the efficacy. The probing depth(PD), distance between CEJ and alveolar crest (CEJAC), tooth mobility(TM), bleeding on probing(BOP), clinical attachment loss(CAL) and Clinical tooth length(CTL) are recorded in three treatment periods, before treatment of periodontal (To), before (T1) and after treatment of periodontal and combined orthodontic treatment of periodontal (T2). At the same time, CBCT is used to measure tooth length(TL), alveolar bone density (ABD) and the distance between CEJ and alveolar crest(CEJAC) before and after the orthodontic treatment. According these datas, we can evaluate the efficacy and influencing factors and provide moreevidence for the security of this treatment.[Methods]20patients with periodontal disease were selected in this study. Before the periodontal treatment(To), measure the following indicators:PD, TM, BOP, CAL and CTL. After3month periodontal treatment, measure them again. The combined orthodontic-periodontal treatment was practiced after the periodontitis controlled. The same indicators were measured after10months. Then CBCT was used to measure tooth length(TL), alveolar bone density (ABD) and the distance between CEJ and alveolar crest(CEJAC) before (Ti) and after the orthodontic treatment (T2).[Result]1. Bleeding on probing(BOP):The changes of bleeding on probing had statistical significance before and afterperiodontal treatment (p<0.05). BOP was decreased from55.9%±9.7%to45.0%±10.7%. After the combined orthodontic-periodontal treatment, BOP decreased to43.4%±11.4%.2. Tooth mobility(TM):The changes of tooth mobility had statistical significance before and after periodontal treatment (p<0.05).TM was decreased from0.87±0.65to0.31±0.47. After the combined orthodontic-periodontal treatment, PD increased to0.63+0.61.3. Probing depth(PD):Probing depth decreased significantly before and after periodontal treatment (p<0.05). PD was decreased from3.71±0.78mm to2.59±0.55mm. After the combined orthodontic-periodontal treatment, PD decreased to2.23±0.55mm.4. Clinical attachment loss(CAL):CAL decreased significantly before and after periodontal treatment (p<0.05). It was decreased from2.69±0.68mm to1.89±0.81mm. CAL had no significant differenceafter the combined orthodontic-periodontal treatment (p>0.05).5. Clinical tooth length(CTL):The changes of CTL had statistical significance before and after periodontal treatment (p<0.05).CTL increased by8.48±1.81mm to7.89±1.95mm. After the combined orthodontic-periodontal treatment, CTL was increased from7.43±1.98mm.6. Tooth length(TL):TL had no significant difference before and after the combined orthodontic-periodontal treatment(p>0.05).There was no obvious sign of root absorption checked by CBCT.7. The distance between CEJ and alveolar crest(CEJAC):CEJAC had no significant difference before and after the combined orthodontic-periodontal treatment (p>0.05). It shows that this treatment doesn’t cause the alveolar bone absorption.8. Alveolar bone density (ABD):ABD decreased significantly before and after the combined orthodontic-periodontal treatment (p<0.05). It was decreased from345.52+53.23to18.64±62.26.The alveolar bone density of moderate periodontal was more seriously decreased than the mild. The mandibular density reduced more seriously than the maxillary. 9. Thin gums group and thick gums gums group changes of periodontal parameters before and after the combined orthodontic-periodontal treatment:the PD of the thin gums group was decreased0.28+0.28mm, the thick gums group was decreased0.27±0.27mm. Thick gums clinical attachment loss changes before and after the treatment was not statistically significant, and thin gums type was increased0.23±0.34mm. The BOP of the thin gums group was decreased3.72±8.0%, and the thick gums group was decreased1.68±6.2%. The TL of the thin gums group was decreased0.31±0.31, and the thick gums group was decreased0.45±0.53. The TL of the thin gums group was increased0.31±0.49, and the thick gums group was increased0.45±0.53. The CCL of the Thin gums group was increased0.31±0.31, and the thick gums group was increased0.45±0.53. The Alveolar bone height of thick gums group change was not statistically significant, thin gums type was increased by3.1±0.71mm. The ABD of the thin gums group was decreased49.37±50.25, and the thick gums group was decreased50.97±61.12.[Conclusion]1. After the periodontal treatment, periodontal disease will be prevented deteriorating and develop into stable. Then the periodontal treatment combined with orthodontic treatment can r improve periodontal health of patients, occlusion function and esthetics. This treatment does not cause root and alveolar bone absorption.2. The combined orthodontic-periodontal treatment will increase the length of clinical crowns and cause gum atrophy. Thin gums are more likely to cause gum atrophy than thick gums.3. After the combined orthodontic-periodontal treatment, alveolar bone density is reduced, which depend on maxillary or mandibular and the severity of the periodontal disease. The alveolar bone density of moderate periodontal disease was decreased seriously more than the mild, the mandibular density decreased more than the maxillary. |
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