성견 치주질환 이환치아의 수평이동이 치주조직에 미치는 영향

Abstract

Most adults, unlike growing children, have some periodontal problems which can influence the outcome of the orthodontic treatment. In cases where periodontal disease progression resulted in marked reduction of periodontium, orthodontic treatment could result in the worsening of the periodontal conditions, and therefore orthodontic treatment planning in such adult patients requires special considerations for the periodontal problems. This study investigates the effects of horizontal orthodontic tooth movement on the changes in the mesial, distal and furcation areas of the disease affected periodontium of adult dogs with advanced bone loss. Six adult dogs with healthy penodontium were selected, and mandibular 2nd premolars were extracted. In the mandib≫h r 3rd premolars, angular bony defects in the mesial and distal sides, and horizontal bony defects in the furcation areas were created Those that received the flap operation and plaque control were designated as the control, those that had horizontal tooth movement without plaque control after the flap operation as Experimental group I, those that had horizontal tooth movement under plaque control without the´ flap operation as `Experimental group II, and those that had horizontal tooth movement under plaque control after the flap operation as Experimental group III. The control group was sacrificed 2 months postoperatively, and the experimental groups were sacrificed 5 months´ after the initiation of tooth movement. Specimens were histologically analyzed under light microscope. The results were as follows;

1. After the horizontal tooth movements, Experimental group I and Ii showed angular bony defects in the mesial sides of the roots and the distal side of the formation areas, which correspond to the pressure sides. 2. After the horizontal tooth movements, Experimental group I and H showed decreased level of alveolar bone crest in the distal sides of the roots, which correspond to the tension sides. 3. Long junctional epithelium in the control group has not been replaced by periodontal connective tissue after the horizontal tooth movements. 4. Limited formation of new bone was observed in the angular bony defects in the mesial and distal aspects of the roots in the control group 5. Inflammatory cell infiltration in the connective tissue was most severe in the Experimental group I, followed by Experimental group II, aII, and the control group in that order.

These results seem to indicate that plaque control was the most influencing factor in the alteration of the periodontal tissue after the horizontal tooth movements in the periodontal tissue with alveolar bone defects.