歯周治療における矯正的圧下の影響

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  • Periodontal Tissue Changes Caused by Orthodontic Intrusion Associated with Normal Gingiva, Experimental Periodontitis and Healthy Gingiva Treated Periodontitis

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Periodontal treatment combined with orthodontic treatment is on the increase. However, there has been little research about whether orthodontic treatment influences the condition of periodontal disease. In the present study, the nine lower second premolars of six mongrel dogs were intruded by means of expansion screw approach for four weeks. The teeth were divided into three groups, according to periodontal condition : Normal group=no attachment loss and normal periodontal condition (=normal gingiva), oral hygiene program once per three days ; Periodontitis group=attachment loss and experimental periodontitis, no oral hygiene program ; FO group=attachment loss and normal periodontal condition, with oral hygiene program. The following effects were examined : (A) change of gingival crevicular fluid by Periotron (PT) ; (B) change of probing pocket depth (PPD) ; (C) gain of probing attachment level (PAL) ; (D) histomorphometry with the use of microcomputer-based system ; (E) microscope effect (histological observation) on the alveolar tissue. The results were as follows : (A) The values of PT were markedly higher in the Periodontitis group than in the other groups. (B) The values of PPD showed that the FO group was greater than the Normal group, and the Normal group was greater than the Periodontitis group in the 4-week experiment. (C) The Normal group and the FO group showed a gain of PAL, and there was no gain or loss of PAL in the Periodontitis group in the 4-week experiment. (D) The length of the three groups (from base of epithelium to bone crest) following from high to low was : Periodontitis group>FO group>Normal group. The base of scaling was located beneath the level of the bone crest. On the average, the distance between the bone crest and the base of scaling in the FO group was 0.77 mm. (E) A slight infiltration of inflammatory cells appeared in the gingiva, epithelial attachment reached the cemento-enamel junction, and bone resorption in the alveolar crest was seldom observed in the Normal group. In the Periodontitis group, there were distension of epithelial cells and dissolution of supraalveolar fiber because of the severe infiltration of chronic inflammatory cells. Many osteoclasts and bone resorption in the alveolar crest were observed. In the FO group, a few inflammatory cells, long junctional epithelium and bone formation in the alveolar crest could be detected. The ability to obtain new attachment was suggested, because the base of the epithelium was coronal to the base of scaling.

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