Evaluation of Alveolar Bone Changes in Chronic Periodontitis Before and After Sequence of Periodontal Treatment by CBCT
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摘要: 目的：应用锥形束CT（CBCT）评价重度慢性牙周炎基础治疗对比基础治疗合并翻瓣手术治疗的疗效。方法：选取近3年初诊的重度慢性牙周炎患者，纳入仅进行牙周基础治疗的20例和进行基础治疗合并翻瓣手术治疗20例为研究对象，对治疗前后上颌前磨牙进行牙周探诊深度（PD）、附着丧失水平（CAL）的临床效果观察，并拍摄CBCT，利用CBCT随机软件测量牙槽骨骨密度（ABD）。对两组间治疗前后疗效指标的变化值进行协方差分析。结果：共40名研究对象合计治疗评估145颗患牙，其中基础治疗组72颗，基础治疗合并翻瓣手术组73颗。基础治疗合并翻瓣手术治疗组治疗前后PD（-1.25 vs.-2.00，P<0.001）的降低，牙槽骨密度ABD（0.027vs.0.059，P<0.001）的增高较单纯基础治疗组更加明显，两组在CAL变化差值表现不明显。结论：基础治疗合并翻瓣手术治疗比单纯基础治疗在临床指数PD以及牙槽骨密度等方面疗效变化更好。Abstract: Objective: To compare change in PD(periodontal probing), CAL(clinical attachment loss) and ABD(alveolar bone density) between the initial therapy and initial therapy flap surgery groups from baseline to end of follow-up(6 months). Methods: Patients with severe chronic periodontitis were observed in the initial therapy group(20) and the initial therapy flap surgery group(20). Totally 40 patients were followed up for 6 months after both treatment.Outcomes for PD, CAL and ABD for each tooth were collected at two time points(baseline and 6 months after treatment). Descriptive analysis was used to summarize the demographic characteristics. A mixed-model ANCOVA will be conducted, controlling for covariates of baseline outcome value, age, sex and alcohol intake, to evaluate the treatment difference between the initial therapy group and initial therapy flap surgery group in change from baseline of the outcomes. Results: A total of 145 teeth(72 in the initial therapy group, and 73 in the initial therapy flap & surgery group) were evaluated. Teeth that received the initial therapy flap surgery group performed better in change from baseline of PD than teeth that received the initial therapy group(-1.25 vs.-2.00, P<0.001). There is no statistical significance treatment difference in change from baseline of CAL between two groups. Teeth that received the initial therapy flap surgery group performed better in change from baseline of BMD than teeth that received the initial therapy group(0.027 vs. 0.059, P<0.001). Conclusion: There may be substantial benefits for patients who received the initial therapy flap surgery group than the initial therapy group only. CBCT could be used in evaluation of alveolar bone changes in the Sequence of periodontal treatment of chronic periodontitis
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期刊类型引用(6)
1. 张丽. 牙周炎患者牙周序列治疗后正畸的临床价值. 深圳中西医结合杂志. 2021(16): 166-167 . 
百度学术
2. 韩阳平，黄文霞，左起亮，袁海波，李飞来，刘朕哲. 牙周病治疗前后的上颌牙槽骨骨密度的CBCT测量分析. 中外医学研究. 2020(26): 67-69 . 百度学术
3. 李禹洲，刘晓庆. 锥形束CT在慢性牙周炎患者牙周基础治疗后评估牙槽骨变化中的应用价值体会. 全科口腔医学电子杂志. 2019(06): 65+68 . 百度学术
4. 赵莉，殷旭鹤，杨磊. 锥形束CT研究牙周基础治疗前后牙槽骨高度的改变分析. 中国医疗器械信息. 2019(08): 169-170 . 百度学术
5. 钟奇帜，孔令佳，周振邦. 口腔颌面锥形束CT评估非手术治疗慢性牙周炎上颌窦的黏膜变化. 中华口腔医学研究杂志(电子版). 2019(04): 235-241 . 百度学术
6. 熊艳芳. 锥形束CT在慢性牙周炎患者牙周基础治疗后评估牙槽骨变化中的应用价值分析. 当代医学. 2018(28): 40-42 . 百度学术
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