Ⅳ期牙周炎患者的正畸考量和时机选择

doi:10.13591/j.cnki.kqyx.2025.01.005

口腔医学 ›› 2025, Vol. 45 ›› Issue (1): 25-36.doi: 10.13591/j.cnki.kqyx.2025.01.005

Ⅳ期牙周炎患者的正畸考量和时机选择

彭焱, 张驰, 高雳, 李希庭, 赵川江()

中山大学附属口腔医院、光华口腔医学院牙周病科,广东省口腔疾病临床医学研究中心,广东广州(510055)

收稿日期:2024-10-25 出版日期:2025-01-28 发布日期:2025-01-16
通讯作者: 赵川江 E-mail:zhaochj@mail.sysu.edu.cn
作者简介:赵川江,口腔医学博士,主任医师、博士生导师。中山大学光华口腔医学院·附属口腔医院牙周病科主任、牙周病学教研室主任,国家临床重点专科学科带头人。美国加州大学旧金山分校访问学者。现任中华口腔医学会牙周病学专业委员会副主任委员,广东省口腔医学会牙周病学专业委员会副主任委员(主持工作);中华口腔医学会口腔医疗服务分会委员,中国医院协会口腔医院分会常委,国家口腔质控委员会牙周病专业专家组成员。全国高等院校“十四五”规划教材《牙周病学》《口腔科学》编委;《中华口腔医学研究杂志(电子版)》《牙体牙髓牙周病学杂志》编委。主要研究方向为牙周病病因及防治,主持国家自然科学基金项目3项,已在国内外重要学术刊物上发表论著50余篇。长期从事牙周疾病的诊疗工作,对临床疑难牙周病病例的诊治具有丰富的经验。
基金资助:
国家自然科学基金(81870770);国家自然科学基金(82370958)

Orthodontic considerations and timing selection for patients with stage Ⅳ periodontitis

PENG Yan, ZHANG Chi, GAO Li, LI Xiting, ZHAO Chuanjiang()

Department of Periodontology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University & Guangdong Provincial Clinical Research Center of Oral Diseases, Guangzhou 510055, China

Received:2024-10-25 Online:2025-01-28 Published:2025-01-16

摘要/Abstract

摘要：

Ⅳ期牙周炎患者的牙槽骨破坏严重,失牙较多,通常伴有咀嚼功能障碍和咬合紊乱、牙齿移位或扭转等问题,仅通过牙周治疗不足以稳定病情、解决咀嚼功能障碍并改善患者的生活质量,因此常需进行复杂的咬合重建和跨学科治疗,其中就包括正畸治疗。正畸治疗有利于改善患者的咀嚼功能和美观,促进牙周健康,但Ⅳ期牙周炎患者的牙周支持组织不足,正畸治疗风险较大,是临床上的难点。本文就Ⅳ期牙周炎患者的正畸考量和时机选择作一综述,并附典型病例——牙周炎(Ⅳ期,C级)的牙周正畸正颌联合治疗1例,以期为广大牙周与正畸医生提供参考。

关键词: Ⅳ期牙周炎, 牙周正畸联合治疗, 正畸考量及时机选择

Abstract:

Patients suffering from stage Ⅳ periodontitis manifest substantial alveolar bone destruction and pronounced tooth loss, frequently accompanied by masticatory dysfunction, occlusal disorder and tooth displacement or torsion. Standard periodontal interventions alone are insufficient to stabilize the condition, address masticatory dysfunction, and enhance patients’ quality of life. Hence, intricate reconstructive and interdisciplinary regimens, encompassing orthodontic treatment, are often indispensable. Orthodontic therapy can optimize the masticatory function and esthetic appearance of patients, and promote periodontal well-being. However, individuals with stage Ⅳ periodontitis present with inadequate periodontal support tissue and a heightened risk profile, rendering their orthodontic management a considerable clinical challenge. This article reviews the orthodontic considerations and optimal timing for intervention in patients with stage Ⅳ periodontitis and presents a representative case of combined periodontal-orthodontic-orthognathic treatment for periodontitis(stage Ⅳ, grade C), in order to provide reference for periodontists and orthodontists.

Key words: stage Ⅳ periodontitis, combined periodontal and orthodontic therapy, orthodontic considerations and timing selection

中图分类号:

R781.4

彭焱, 张驰, 高雳, 李希庭, 赵川江. Ⅳ期牙周炎患者的正畸考量和时机选择[J]. 口腔医学, 2025, 45(1): 25-36.

PENG Yan, ZHANG Chi, GAO Li, LI Xiting, ZHAO Chuanjiang. Orthodontic considerations and timing selection for patients with stage Ⅳ periodontitis[J]. Stomatology, 2025, 45(1): 25-36.

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Ⅳ期牙周炎患者的正畸考量和时机选择

Orthodontic considerations and timing selection for patients with stage Ⅳ periodontitis

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