歯列矯正と全身的歯周治療の併用効果に関する観察研究

An observational study of the efficacy of combined orthodontic-systemic periodontal treatment.

抄録

本研究は、臨床治療プロトコールの改善を目的として、矯正・全身歯周併用治療後6ヶ月の患者の歯周状態を比較分析したものである。2019年6月から2022年6月までに当院で治療を受けた歯周炎患者80名を被験者とし、無作為に観察群と対照群に分け、各群40名とした。観察群では矯正と全身的歯周治療の併用治療を行い、対照群では全身的歯周治療を行った。全症例を6ヵ月間追跡し，治療後6ヵ月目に歯周臨床検査と歯肉隙間液検査を行い，有効率を2群間で比較した．有効率は観察群（97.50％）が対照群（87.50％）を上回った．治療前と比較して，治療6ヵ月後の臨床的アタッチメントロス，歯肉出血指数，歯周プロービングデプス，プラーク指数，プロービング時出血，歯肉溝液中の腫瘍壊死因子α，インターロイキン-6，インターロイキン-1β濃度は2群で有意に減少し，観察群では対照群より低く，統計学的に有意差が認められた（P<.05）．歯列矯正と全身的歯周治療の併用は，歯周炎患者の治療効果を高め，歯周状態を改善し，抗炎症反応を増強し，回復を促進することができる．

This study comparatively analyzes the periodontal status of patients at 6 months after combined orthodontic-systemic periodontal treatment for improving clinical treatment protocols. Eighty periodontitis patients treated in our hospital from June 2019 to June 2022 were selected as subjects and randomly divided into observation and control groups, with 40 patients in each group. The observation group underwent combined orthodontic-systemic periodontal treatment; the control group underwent systemic periodontal treatment. All subjects had been followed up for 6 months, they underwent periodontal clinical examination and gingival crevicular fluid detection at 6 months after treatment; the effective rate was compared between 2 groups. The total effective rate was higher in the observation group (97.50%) than in the control group (87.50%). Compared with before treatment, the clinical attachment loss, gingival bleeding index, periodontal probing depth, plaque index, bleeding on probing, tumor necrosis factor-α, interleukin-6, and interleukin-1β levels in gingival sulcus fluid were significantly decreased in 2 groups at 6 months after treatment, which were lower in the observation group than in the control group, with statistically significant differences (P < .05). Combined orthodontic-systemic periodontal treatment can increase the therapeutic effect, improve periodontal status and enhance anti-inflammatory response in periodontitis patients, thus promoting their recovery.