侵袭性牙周炎的牙周正畸联合治疗
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摘要
侵袭性牙周炎是一类在青年人中常见的牙周炎,发病早、进展快、牙周组织破坏严重,牙齿发生病理性移位,严重影响美观、口腔健康和功能。这类患者在牙周治疗基础上应及时进行正畸治疗,恢复正常的生理性牙位及咬合接触关系,消除咬合创伤。恰当的正畸治疗,不仅能改善美观,恢复牙齿正常功能,而且有利于控制侵袭性牙周炎的病情,促进已破坏的牙周组织发生良好改建,提高临床疗效的稳定性和远期预后效果。正畸医生对侵袭性牙周炎要充分认识,应与牙周专科医生密切合作,在牙周有效治疗的前提下进行正畸,遵循个性化合理设计、细丝轻力、严格控制菌斑、定期牙周维护、全程谨慎监控的原则。
Aggressive periodontitis(AgP)is a type of periodontitis with early onset and rapid progression, which mostly affects young adults. The most common problems found in AgP patients include severe periodontal destruction and pathologic tooth migration(PTM), which impair function and aesthetics of the stomatognathic system. Effective orthodontic treatment not only provides an acceptable functional and aesthetic occlusion, and corrects traumatic occlusion, but also stimulates rebuilding of the original periodontal architecture and achieves long-term stability. Hence, it is of utmost importance for an orthodontist to have knowledge and ability to manage the case of aggressive periodontitis with multidisciplinary approach, create harmonious cooperation with the periodontist,initiate the orthodontic treatment after the achievement of proper plaque control, and stick to the strategy of proper design of active treatment, placement with light force, strict control of oral hygiene, regular periodontal maintenance and careful monitoring of the whole course.
Aggressive periodontitis(AgP)is a type of periodontitis with early onset and rapid progression, which mostly affects young adults. The most common problems found in AgP patients include severe periodontal destruction and pathologic tooth migration(PTM), which impair function and aesthetics of the stomatognathic system. Effective orthodontic treatment not only provides an acceptable functional and aesthetic occlusion, and corrects traumatic occlusion, but also stimulates rebuilding of the original periodontal architecture and achieves long-term stability. Hence, it is of utmost importance for an orthodontist to have knowledge and ability to manage the case of aggressive periodontitis with multidisciplinary approach, create harmonious cooperation with the periodontist,initiate the orthodontic treatment after the achievement of proper plaque control, and stick to the strategy of proper design of active treatment, placement with light force, strict control of oral hygiene, regular periodontal maintenance and careful monitoring of the whole course.
引文
[1]Meng H,Xu L,Li Q,et al.Determinants of host susceptibility in aggressive periodontitis[J].Periodontol 2000,2007,43:133-159.
[2]Armitage GC,Cullinan MP.Comparison of the clinical features of chronic and aggresive periodontitis[J].Periodontol 2000,2010,53:12-27.
[3]Buchmann R,Nunn ME,Van Dyke TE,et al.Aggressive periodontitis:5-year follow-up of treatment[J].J Periodontol,2002,73(6):675-683.
[4]Thilander B.Infrabony pockets and reduced alveolar bone height in relation to orthodontic therapy[J].Semin Orthod,1996,2(1):55-61.
[5]Yamaguchi T,Suzuki K,Maki M,et al.Interdisciplinary treatment of aggressive periodontitis:three-dimensional cone-beam X-ray computed tomography evaluation[M]//Buduneli N,Kakudate N,Morita M.Pathogenesis and treatment of periodontitis.Japan:InTech Open Access,2012.
[6]Artun J,Urbye KS.The effect of orthodontic treatment on periodontal bone support in patients with advanced loss of marginal periodontium[J].Am J Orthod Dentofacial Orthop,1988,93(2):143-148.
[7]Stelzel MJ,Flores-de-Jacoby L.Guided tissue regeneration in a combined periodontal and orthodontic treatment:a case report[J].Int J Period Rest Dent,1998,18(2):189-195.
[8]Mathews DP,Kokich VG.Managing treatment for the orthodontic patient with periodontal problems[J].Semin Orthod,1997,3(1):21-38.
[9]Maki K,Inou N,Takanishi A,et al.Computer-assisted simulations in orthodontic diagnosis and the application of a new cone beam X-ray computed tomography[J].Orthod Craniofac Res,2003,6 Suppl 1:95-101.
[10]Ishihara Y,Tomikawa K,Deguchi T,et al.Interdisciplinary orthodontic treatment for a patient with generalized aggressive periodontitis:Assessment of IgG antibodies to identify type of periodontitis and correct timing of treatment[J].Am J Orthod Dentofacial Orthop,2015,147(6):766-780.
[11]Miyamoto M,Yamashiro Y,Takano-Yamamoto T.Surgical orthodontic treatment for severe maxillary protrusion with aggressive periodontitis[J].Orthod Waves,2008,67(4):171-178.
[12]Turkkahraman H,Sayin MO,Bozkurt FY,et al.Archwire ligation techniques,microbial colonization,and periodontal status in orthodontically treated patients[J].Angle Orthod,2005,75(2):231-236.
[13]Nakamura Y,Tanaka T,Noda K,et al.Calcification of degenerating tissues in the periodontal ligament during tooth movement[J].J Periodont Res,2003,38(3):343-350.
[14]Polson A,Caton J.Polson AP,et al.Periodontal response after tooth movement into infrabony defects[J].J Periodontol,1984,55:197-202.
[15]Cardaropoli D,Gaveglio L.The influence of orthodontic movement on periodontal tissues level[J].Semin Orthod,2007,13(4):234-245.
[16]Miura F.Mogi M,Okamoto Y.New application of superelastic NiTi rectangular wire[J].J Clin Orthod,1990,24(9):544-548.
[17]Mavreas D.Self-ligation and the periodontally compromised patient:A different perspective[J].Semin Orthod,2008,14(1):36-45.
[18]Fukunaga T,Kuroda S,Kurosaka H,et al.Skeletal anchorage for orthodontic correction of maxillary protrusion with adult periodontitis[J].Angle Orthod,2006,76(1):14-155.
[19]Maeda S,Maeda Y,Ono Y,et al.Interdisciplinary treatment of a patient with severe pathologic tooth migration caused by localized aggressive periodontitis[J].Am J Orthod Dentofacial Orthop,2005,127(3):374-384.
[20]Nevins M,Wise RJ.Use of orthodontic therapy to alter infrabony pockets.PartⅡ[J].Int J Periodontics Restorative Dent,1990,10(3):199-207.
[21]Geraci TF,Nevins M,Crosseti HW,et al.Reattachment of the periodontium after tooth movement into an osseous defect in a monkey.PartⅠ[J].Int J Periodontics Restorative Dent,1990,10(3):185-197.
[22]Polson A,Heij LC.Osseous repair in infrabony periodontal defects[J].J Clin Periodontol,1978,5:13-23.
[23]Re S,Corrente G,Abundo R,et al.Orthodontic treatment inperiodontally compromised patients:12-year report[J].Int J Periodontics Restorative Dent,2000,20(1):31-39.
[24]Harpenau LA,Boyd RL.Long-term follow-up of successful orthodontic-periodontal treatment of localized aggressive periodontitis:a case report[J].Clin Orthod Res,2000,3(4):220-229.
[25]Hom BM,Turley PK.The effects of space closure of the mandibular first molar area in adults[J].Am J Orthod,1984,85(6):457-469.
[26]McLain JB,Proffit WR,Davenport RH.Adjunctive orthodontic therapy in the treatment of juvenile periodontitis:report of a case and review of the literature[J].Am J Orthod,1983,83(4):290-298.
[27]van Venrooy J,Yukna R.Orthodontic extrusion of single-rooted teeth affected with advanced periodontal disease[J].Am J Orthod,1985,87(1):67-74.
[28]Iino S,Taira K,Machigashira M,et al.Isolated vertical infrabony defects treated by orthodontic tooth extrusion[J].Angle Orthod,2008,78(4):728-736.
[29]Melsen B.Tissue reaction following application of extrusive and intrusive forces to teeth in adult monkeys[J].Am J Orthod,1986,89(6):469-475.
[30]Pikdoken L,Erkan M,Usumez S.Gingival response to mandibular incisor extrusion[J].Am J Orthod Dentofacial Orthop,2009,135(4):432,e1-e6.
[31]Kozlovsky A,Tal H,Lieberman M.Forced eruption combined with gingival fiberotomy.A technique for clinical crown lengthening[J].J Clin Periodontol,1988,15(9):534-538.
[32]Mirmarashi B,Torbati A.Aalam A,et al.Orthodontically assisted vertical augmentation in the esthetic zone[J].J Prosthodont,2010.19(3):235-239.
[33]Brown IS.The effect of orthodontic therapy on certain types of periodontal defects.Ⅰ.Clinical findings[J].J Periodontol,1973,44(12):742-756.
[34]Vanarsdall R,Marks MH,Levitt HL.Uprighting mesially inclined tipped molars[M]//Marks MH,Com H.Atlas of adult orthodontics.Philadelphia:Lea&Febiger,1989:391-412.
[35]Melsen B.Tissue reaction to orthodontic tooth movement--a new paradigm[J].Eur J Orthod,2001,23(6):671-681.
[36]Roberts WE,Chase DC.Kinetics of cell proliferation and migration associated with orthodontically induced osteogenesis[J].J Dent Res,1981,60(2):174-181.
[37]Corrente G,Abundo R,Re S,et al.Orthodontic movement into infrabony defects in patients with advanced periodontal disease:A clinical and radiological study[J].J Periodontol,2003,74(8):1104-1109.
[38]Re S,Cardaropoli D,Abundo R,et al.Reduction of gingival recession following orthodontic intrusion in periodontally compro-mised patients[J].Orthod Craniofac Res,2004,7(1):35-39.
[39]Cardaropili D,Re S,Manuzzi W,et al.Bio-Oss collagen and orthodontic movement for the treatment of infrabony defects in the esthetic zone[J].Int J Periodontics Restorative Dent,2006,26(6):553-539.
[40]Re S,Corrente G,Abundo R,et al.The use of orthodontic intrusive movement to reduce infrabony pockets in adult periodontal patients:A case report[J].Int J Periodontics Restorative Dent,2002,22(4):365-371.
[41]Ghezzi C,Masiero S,Silvestri M,et al.Orthodontic treatment of periodontally involved teeth after tissue regeneration[J].Int J Periodontics Restorative Dent,2008,28(6):559-567.
[42]Vandevska-Radunovic V,Kristiansen AB,Heyeraas KJ,et al.Changes in blood circulation in teeth and supporting tissues incident to experimental tooth movement[J].Eur J Orthod,1994,16(5):361-369.
[43]Cao T,Xu L,Shi J,et al.Combined orthodontic-periodontal treatment in periodontal patients with anteriorly displaced incisors[J].Am J Orthod Dentofacial Orthop.2015,148(5):805-813.
[44]施捷,周彦恒,傅民魁.牙周炎致错位前牙正畸牙周联合治疗的CT研究[J].北京大学学报(医学版),2003,35(6):659-662.
[45]Passanezi E,Janson M,Janson G,et al.Interdisciplinary treatment of localized juvenile periodontitis:a new perspective to an old problem[J].Am J Orthod Dentofacial Orthop,2007,131(2):268-276.
[46]刘晓峰,潘晓岗,束蓉.嵴上纤维环切联合正畸治疗牙周炎致切牙扇形移位的初步研究[J].上海口腔医学,2008,17(3):264-266.
[47]Tarnow DP,Magmer AW,Fletcher P.The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla[J].J Periodontol,1992,63(12):995-996.
[48]Papalexiou V,Novaes AB Jr,Macedo GO,et al.Preprosthetic periodontal surgery in the proximal area with modification of the col area:Results following the reestablishment of the contact point[J].J Periodontol,2006,77(11):1856-1862.
[49]Martegani P,Silvestri M,Mascarello F,et al.Morphometric study of the interproximal unit in the esthetic region to correlate anatomic variables affecting the aspect of soft tissue embrasure space[J].J Periodontol,2007,78(12):2260-2265.
[50]Cardaropoli D,Re S.Interdental papilla augmentation procedure following orthodontic treatment in a periodontal patient[J].J Periodontol,2005,76(4):655-661.
[2]Armitage GC,Cullinan MP.Comparison of the clinical features of chronic and aggresive periodontitis[J].Periodontol 2000,2010,53:12-27.
[3]Buchmann R,Nunn ME,Van Dyke TE,et al.Aggressive periodontitis:5-year follow-up of treatment[J].J Periodontol,2002,73(6):675-683.
[4]Thilander B.Infrabony pockets and reduced alveolar bone height in relation to orthodontic therapy[J].Semin Orthod,1996,2(1):55-61.
[5]Yamaguchi T,Suzuki K,Maki M,et al.Interdisciplinary treatment of aggressive periodontitis:three-dimensional cone-beam X-ray computed tomography evaluation[M]//Buduneli N,Kakudate N,Morita M.Pathogenesis and treatment of periodontitis.Japan:InTech Open Access,2012.
[6]Artun J,Urbye KS.The effect of orthodontic treatment on periodontal bone support in patients with advanced loss of marginal periodontium[J].Am J Orthod Dentofacial Orthop,1988,93(2):143-148.
[7]Stelzel MJ,Flores-de-Jacoby L.Guided tissue regeneration in a combined periodontal and orthodontic treatment:a case report[J].Int J Period Rest Dent,1998,18(2):189-195.
[8]Mathews DP,Kokich VG.Managing treatment for the orthodontic patient with periodontal problems[J].Semin Orthod,1997,3(1):21-38.
[9]Maki K,Inou N,Takanishi A,et al.Computer-assisted simulations in orthodontic diagnosis and the application of a new cone beam X-ray computed tomography[J].Orthod Craniofac Res,2003,6 Suppl 1:95-101.
[10]Ishihara Y,Tomikawa K,Deguchi T,et al.Interdisciplinary orthodontic treatment for a patient with generalized aggressive periodontitis:Assessment of IgG antibodies to identify type of periodontitis and correct timing of treatment[J].Am J Orthod Dentofacial Orthop,2015,147(6):766-780.
[11]Miyamoto M,Yamashiro Y,Takano-Yamamoto T.Surgical orthodontic treatment for severe maxillary protrusion with aggressive periodontitis[J].Orthod Waves,2008,67(4):171-178.
[12]Turkkahraman H,Sayin MO,Bozkurt FY,et al.Archwire ligation techniques,microbial colonization,and periodontal status in orthodontically treated patients[J].Angle Orthod,2005,75(2):231-236.
[13]Nakamura Y,Tanaka T,Noda K,et al.Calcification of degenerating tissues in the periodontal ligament during tooth movement[J].J Periodont Res,2003,38(3):343-350.
[14]Polson A,Caton J.Polson AP,et al.Periodontal response after tooth movement into infrabony defects[J].J Periodontol,1984,55:197-202.
[15]Cardaropoli D,Gaveglio L.The influence of orthodontic movement on periodontal tissues level[J].Semin Orthod,2007,13(4):234-245.
[16]Miura F.Mogi M,Okamoto Y.New application of superelastic NiTi rectangular wire[J].J Clin Orthod,1990,24(9):544-548.
[17]Mavreas D.Self-ligation and the periodontally compromised patient:A different perspective[J].Semin Orthod,2008,14(1):36-45.
[18]Fukunaga T,Kuroda S,Kurosaka H,et al.Skeletal anchorage for orthodontic correction of maxillary protrusion with adult periodontitis[J].Angle Orthod,2006,76(1):14-155.
[19]Maeda S,Maeda Y,Ono Y,et al.Interdisciplinary treatment of a patient with severe pathologic tooth migration caused by localized aggressive periodontitis[J].Am J Orthod Dentofacial Orthop,2005,127(3):374-384.
[20]Nevins M,Wise RJ.Use of orthodontic therapy to alter infrabony pockets.PartⅡ[J].Int J Periodontics Restorative Dent,1990,10(3):199-207.
[21]Geraci TF,Nevins M,Crosseti HW,et al.Reattachment of the periodontium after tooth movement into an osseous defect in a monkey.PartⅠ[J].Int J Periodontics Restorative Dent,1990,10(3):185-197.
[22]Polson A,Heij LC.Osseous repair in infrabony periodontal defects[J].J Clin Periodontol,1978,5:13-23.
[23]Re S,Corrente G,Abundo R,et al.Orthodontic treatment inperiodontally compromised patients:12-year report[J].Int J Periodontics Restorative Dent,2000,20(1):31-39.
[24]Harpenau LA,Boyd RL.Long-term follow-up of successful orthodontic-periodontal treatment of localized aggressive periodontitis:a case report[J].Clin Orthod Res,2000,3(4):220-229.
[25]Hom BM,Turley PK.The effects of space closure of the mandibular first molar area in adults[J].Am J Orthod,1984,85(6):457-469.
[26]McLain JB,Proffit WR,Davenport RH.Adjunctive orthodontic therapy in the treatment of juvenile periodontitis:report of a case and review of the literature[J].Am J Orthod,1983,83(4):290-298.
[27]van Venrooy J,Yukna R.Orthodontic extrusion of single-rooted teeth affected with advanced periodontal disease[J].Am J Orthod,1985,87(1):67-74.
[28]Iino S,Taira K,Machigashira M,et al.Isolated vertical infrabony defects treated by orthodontic tooth extrusion[J].Angle Orthod,2008,78(4):728-736.
[29]Melsen B.Tissue reaction following application of extrusive and intrusive forces to teeth in adult monkeys[J].Am J Orthod,1986,89(6):469-475.
[30]Pikdoken L,Erkan M,Usumez S.Gingival response to mandibular incisor extrusion[J].Am J Orthod Dentofacial Orthop,2009,135(4):432,e1-e6.
[31]Kozlovsky A,Tal H,Lieberman M.Forced eruption combined with gingival fiberotomy.A technique for clinical crown lengthening[J].J Clin Periodontol,1988,15(9):534-538.
[32]Mirmarashi B,Torbati A.Aalam A,et al.Orthodontically assisted vertical augmentation in the esthetic zone[J].J Prosthodont,2010.19(3):235-239.
[33]Brown IS.The effect of orthodontic therapy on certain types of periodontal defects.Ⅰ.Clinical findings[J].J Periodontol,1973,44(12):742-756.
[34]Vanarsdall R,Marks MH,Levitt HL.Uprighting mesially inclined tipped molars[M]//Marks MH,Com H.Atlas of adult orthodontics.Philadelphia:Lea&Febiger,1989:391-412.
[35]Melsen B.Tissue reaction to orthodontic tooth movement--a new paradigm[J].Eur J Orthod,2001,23(6):671-681.
[36]Roberts WE,Chase DC.Kinetics of cell proliferation and migration associated with orthodontically induced osteogenesis[J].J Dent Res,1981,60(2):174-181.
[37]Corrente G,Abundo R,Re S,et al.Orthodontic movement into infrabony defects in patients with advanced periodontal disease:A clinical and radiological study[J].J Periodontol,2003,74(8):1104-1109.
[38]Re S,Cardaropoli D,Abundo R,et al.Reduction of gingival recession following orthodontic intrusion in periodontally compro-mised patients[J].Orthod Craniofac Res,2004,7(1):35-39.
[39]Cardaropili D,Re S,Manuzzi W,et al.Bio-Oss collagen and orthodontic movement for the treatment of infrabony defects in the esthetic zone[J].Int J Periodontics Restorative Dent,2006,26(6):553-539.
[40]Re S,Corrente G,Abundo R,et al.The use of orthodontic intrusive movement to reduce infrabony pockets in adult periodontal patients:A case report[J].Int J Periodontics Restorative Dent,2002,22(4):365-371.
[41]Ghezzi C,Masiero S,Silvestri M,et al.Orthodontic treatment of periodontally involved teeth after tissue regeneration[J].Int J Periodontics Restorative Dent,2008,28(6):559-567.
[42]Vandevska-Radunovic V,Kristiansen AB,Heyeraas KJ,et al.Changes in blood circulation in teeth and supporting tissues incident to experimental tooth movement[J].Eur J Orthod,1994,16(5):361-369.
[43]Cao T,Xu L,Shi J,et al.Combined orthodontic-periodontal treatment in periodontal patients with anteriorly displaced incisors[J].Am J Orthod Dentofacial Orthop.2015,148(5):805-813.
[44]施捷,周彦恒,傅民魁.牙周炎致错位前牙正畸牙周联合治疗的CT研究[J].北京大学学报(医学版),2003,35(6):659-662.
[45]Passanezi E,Janson M,Janson G,et al.Interdisciplinary treatment of localized juvenile periodontitis:a new perspective to an old problem[J].Am J Orthod Dentofacial Orthop,2007,131(2):268-276.
[46]刘晓峰,潘晓岗,束蓉.嵴上纤维环切联合正畸治疗牙周炎致切牙扇形移位的初步研究[J].上海口腔医学,2008,17(3):264-266.
[47]Tarnow DP,Magmer AW,Fletcher P.The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla[J].J Periodontol,1992,63(12):995-996.
[48]Papalexiou V,Novaes AB Jr,Macedo GO,et al.Preprosthetic periodontal surgery in the proximal area with modification of the col area:Results following the reestablishment of the contact point[J].J Periodontol,2006,77(11):1856-1862.
[49]Martegani P,Silvestri M,Mascarello F,et al.Morphometric study of the interproximal unit in the esthetic region to correlate anatomic variables affecting the aspect of soft tissue embrasure space[J].J Periodontol,2007,78(12):2260-2265.
[50]Cardaropoli D,Re S.Interdental papilla augmentation procedure following orthodontic treatment in a periodontal patient[J].J Periodontol,2005,76(4):655-661.
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