上顎犬歯の抜歯時における抜歯部位近傍の歯周病変化の評価

Evaluation of Periodontal Changes Adjacent to Extraction Sites during Upper Canine Retraction.

抄録

はじめに:

矯正治療と歯の移動に伴う歯周病の変化には密接な関係がある。

INTRODUCTION: There is an intimate relationship between orthodontic therapy and the periodontal changes that occur during tooth movement.

材料と方法:

この前向き臨床試験の目的は、上顎犬歯の退縮に伴う遊離歯肉および付着歯肉の移動、ならびに上顎第1小臼歯の抜歯部位の歯槽骨の移動を調査することである。本研究では、歯列矯正前に第1小臼歯の抜歯が必要な患者17人（女性10人、男性7人）を選び、シリアのハマにあるハマ大学歯学部矯正科で治療を行った。上顎第1小臼歯を抜歯し、その後歯槽骨にインプラントオートタックを装着した。その後、デジタルバーニアキャリパーを用いて、インプラントオートタックの中心とL字型ワイヤーの間の寸法を測定した。抜歯3週間後、遊離歯肉と付着歯肉にタトゥーマークポイントを入れ、同じデジタルバーニアキャリパーで測定した。上顎犬歯の後退にはニッケルチタン製のクローズドコイルスプリングを使用し、150gの力を加えた。

MATERIALS AND METHODS: This prospective clinical trial aims at investigating the movement of both the free and attached gingiva, as well as the movement of the alveolar bone in the extraction site of the upper 1st premolars during the retraction of the upper canines. In this study, 17 patients (10 female, 7 male) requiring 1st premolar extraction before orthodontic tooth movement were selected and treated at the Department of Orthodontics in the Faculty of Dentistry in University of Hama, Hama, Syria. The upper 1st premolars were extracted, and the implant AutoTacs were applied on the alveolar bone afterward. Then, measurements between the center of the implant AutoTacs and the L-shape wire were taken, utilizing digital Vernier caliper. After 3 weeks of extraction, tattooing marked points were placed on the free and the attached gingival, and the measurements were taken using the same digital Vernier caliper. Closed coil springs made of nickel-titanium were used to retract the upper canines, and a force of 150 gm was applied.

結果:

本研究の結果、遊離歯肉および付着歯肉の動きと、対応する上顎犬歯の動きの間に有意差が認められた（p < 0.001）。遊離歯肉の移動量は、上顎犬歯の後退量の約77％を形成していた。上顎犬歯の後退において、インプラントAutoTac X1とL型ワイヤー（W）の間に有意差は認められなかった。一方、上顎犬歯の後退において、オートタックX2とL型ワイヤー（W）の間に有意差が認められた（p < 0.001）。

RESULTS: The results of this study showed significant differences between the movement of both the free and attached gingiva and the movement of the corresponding upper canines (p < 0.001). The movement of the free gingiva had formed about 77% of the amount of the movement of the upper canine retraction. No significant differences were detected between the place of implant AutoTac X1 and the L-shaped wire (W) during the retraction of the upper canine. On the contrary, significant differences were noticed between the place of implant AutoTac X2 and the L-shaped wire (W) during the retraction of the upper canine (p < 0.001).

結論:

小臼歯抜歯および矯正治療中および治療後の硬組織および軟組織の移動は有意である。

CONCLUSION: There is significant movement of hard and soft tissues during and after premolar extraction and orthodontic therapy.

臨床的意義:

犬歯の後退時に歯槽骨とともに歯の支持組織が移動することは、歯列矯正における歯の移動の重要な生物学的特徴である。臨床医は、矯正治療中の支持組織の役割と重要性を理解する必要があり、それを日常臨床評価に組み込む必要がある。

CLINICAL SIGNIFICANCE: The movement of supporting tissues of the teeth along with the alveolar bone during canine retraction is an important biological characteristic of the orthodontic tooth movement. Clinicians need to understand the role and importance of the supporting tissues during orthodontic treatment, which needs to be incorporated into their routine clinical evaluations.