Objective: To investigate the influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP). Methods: A retrospective analysis was conducted in 25 AgP patients, who have received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology. Changes in the ratio of the residual alveolar bone height (RBH) was measured at three time points: baseline (T0), post orthodontic treatment (T1), and the last re-visit 3 years after orthodontic treatment (T2). Root abnormity was evaluated by observing periapical radiographs, and its relationship with alveolar bone loss after orthodontic treatment was analyzed. A multi-level analysis on factors related to the clinical outcome (alveolar bone height change) was performed. Results: Totally 693 teeth of 25 patients at T0 and T1 and 368 teeth of 14 patients at T2 were investigated. During the periodontal-orthodontic treatment, the RBH was mainly influenced by root abnormity (estimation value -2.392), tooth position (estimation value for upper teeth vs. lower teeth 3.139, and anterior teeth vs. posterior teeth -3.469) and the baseline RBH at T0 (estimation value -0.391) (P<0.05). Teeth with root abnormity, teeth in mandibular and anterior area, and teeth with higher RBH showed less change in T1-T0 RBH values. In the long-term follow-up, RBH was mainly influenced by tooth position (estimation value for upper teeth vs. lower teeth 3.735, and anterior teeth vs. posterior teeth -5.318), the baseline RBH and probing depth (PD) at T0. Teeth in mandibular and anterior area, teeth with higher RBH (estimation value -0.498) and PD (estimation value -1.594) (P<0.05) showed less change in T0-T2 RBH values. Conclusions: During orthodontic treatment, teeth with abnormal root, lower teeth, anterior teeth, and teeth with high RBH were unfavorable factors for bone gain. In the long-term observation, lower teeth, anterior teeth, teeth with high RBH and PD at first visit were unfavorable factors for bone gain.
目的： 分析侵袭性牙周炎（aggressive periodontitis，AgP）患者牙周-正畸联合治疗长期疗效的相关影响因素。 方法： 纳入2002年1月至2010年9月于北京大学口腔医学院·口腔医院牙周科就诊，并完成牙周-正畸治疗的AgP患者25例，收集初诊（T0）、正畸治疗完成后（T1）、正畸结束3年以上末次复查（T2）时的全口根尖X线片，通过根尖X线片评价患者根形态异常情况、正畸前后剩余牙槽骨高度（residual alveolar bone height，RBH）的变化。评价根形态异常对牙周-正畸治疗的影响，并进行多因素分析，评价与正畸后长期牙槽骨高度变化相关的牙和个体水平因素。 结果： T0、T1时统计25例患者的693颗牙，T2期随访14例患者，共观测368颗牙。牙周-正畸治疗前后，牙槽骨高度变化的主要影响因素为根形态异常（估计值为−2.392）、牙位（上颌牙vs.下颌牙估计值为3.139；前牙vs.后牙估计值为−3.469）和T0期的牙槽骨高度变化（估计值为-0.391）（P<0.05）。根形态异常、下颌牙、前牙以及T0时牙槽骨高度高，都是牙槽骨增加的不利因素。正畸后长期观察，牙槽骨高度变化的主要影响因素为牙位（上颌牙vs.下颌牙估计值为3.735；前牙vs.后牙估计值为−5.318）、T0时探诊深度（估计值为-1.594）和T0时牙槽骨高度（估计值为-0.498）（P<0.05）。下颌牙、前牙、T0时牙槽骨高度增加和T0探诊深度增加，都是正畸后长期牙槽骨增加的不利因素。 结论： 多因素分析显示，正畸治疗结束时，牙槽骨高度变化的主要影响因素为根形态异常、牙位和T0时牙槽骨高度；正畸后3年以上复查，牙槽骨高度变化的主要影响因素为牙位、T0时的探诊深度和T0时牙槽骨高度。.
Keywords: Aggressive periodontitis; Alveolar bone lose; Multi-factor analysis; Orthodontics, corrective.