교합면 삭제(occlusal reduction)를 이용한 수동적 정출 (passive eruption)이 치주조직에 미치는 영향
Clinical Evaluation of Passive Eruption Using Occlusal Reduction on Periodontium
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초록
치주치료에 있어 교합치료의 타당성은 오래전부터 연구되어오고 있으나 아직도 논란이 많은 부분이다. 그 중에서도, 교합삭제를 이용한 수동적 정출(passive eruption)의 치료 효과에 대한 연구는 아직 보고된 바가 많지 않다. 본 연구의 목표는 교합삭제를 이용한 수동적 정출이 치주부착수준, 치주낭깊이 등의 치주임상지표들에 미치는 효과를 평가하는 것이다. 본 연구는 부산대학교 치과병원 치주과에서 중등도 치주염으로 치료받은 환자 중, 연구대상조건을 만족하는 16명의 환자, 40개의 치아를 대상으로 하였다. 연구 시작 단계에서 임의로 분류한 실험군과 대조군 치아 모두 임상적, 방사선적 검사를 시행하였다. 치석제거술과 치근활택술, 구강 위생 교육을 포함한 초기 치료를 시행하고 4주 후 임상적, 방사선적 검사를 재실시하였다. 이 때 실험군은 교합면 삭제를 이용한 수동적 정출을 시행하고 대조군은 아무런 처치를 하지 않았다. 그 후 6개월 이후 임상적, 방사선적 검사를 재실시하였다. 그 결과 1)연구시작 단계와 비교 시, 초기치료에 의해 임상지표를 통한 치주조직의 염증상태가 개선되었으며, 2) 실험군에서 치주낭깊이, 치아동요도, 치조골 소실 감소와 각화치은 폭경 증가가 더 큰 것으로 나타났다 (p<0.05). 이 결과로 볼 때, 초기치료와 함께 교합조정을 이용한 수동적 정출술이 치주치료에 도움을 줄 수 있을 것으로 사료된다.
Abstract
The relationship between occlusion and periodontal health has been extensively studied. However, reports on the effects of passive eruption using occlusal reduction has not been sufficient. The purpose of the present randomized clinical trial was to assess the influence of passive eruption using occlusal reduction on the clinical periodontal parameters consisting of attachment level, pocket depth, tooth mobility, width of keratinized gingiva and osseous defect. The study was performed on 40 teeth of 16 subjects who have been treated for the moderate periodontitis at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, after hygienic-phase and after 6 month from passive eruption using occlusal reduction, clinical parameters were monitored and radiographs were taken. The 20 teeth in the test group received passive eruption using occlusal reduction while the 20 control teeth did not receive any occlusal reduction. The results were as follows; 1) Degree of inflammation of periodontium was improved by initial therapy 2) Teeth received passive eruption using occlusal reduction demonstrated significantly greater reduction in pocket depth, tooth mobility and amount of bone loss, and increase in the width of keratinized gingiva, but no significant changes in the attachment level compared to the control teeth 3) There was significantly greater reduction in pocket depth, mobility, amount of bone loss and attachment level in the test teeth after initial hygienic phase when compared with baseline data. Taken together, these results suggest that the passive eruption using occlusal reduction would be helpful to improve periodontal health.
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