The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Changes in the oral environment during four stages of orthodontic treatment

교정치료 4단계 동안의 구강 내 환경의 변화

  • Received : 2009.10.10
  • Accepted : 2010.02.09
  • Published : 2010.04.30
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Abstract

Objective: To identify clinical, salivary, and bacterial changes during orthodontic treatment with follow-up to 24 months. Methods: In 30 patients, clinical (decayed, missing, and filled surfaces [DMFS], O'Leary's plaque index, and plaque pH), salivary (unstimulated and stimulated saliva, buffer capacity, pH, and occult blood), and bacterial (Streptococcus mutans and Lactobacillus) markers were evaluated. A questionnaire was employed to evaluate their hygienic-dietary habits. Data were analyzed by ANOVA, logistic regression and Spearman's correlation. Results: DMFS increased significantly, whereas the plaque index diminished, plaque pH was more acidic (p = 0.23), and unstimulated salivary flow showed significant differences during the treatment (p = 0.013). Stimulated saliva flow increased in females after the placement of appliances; buffer capacity was diminished in males during the therapy; salivary pH remained at basal values. Bacterial levels and occult blood increased to high-risk levels and were not statistically significant different between genders (p > 0.05). Two major relationships were confirmed: initial plaque with use of dental aids (r = 0.429; p = 0.018) and final DMFS with unstimulated salivary flow (r = -0.372; p = 0.043). Conclusions: The increase in retentive surfaces increased the bacterial levels, plaque pH became acidified, and gingival damage was greater. Buffer capacity was altered but maintained a healthy salivary pH during the treatment.

교정치료 중 구강 내 환경 변화를 파악하기 위하여 교정치료 시작 후 24개월까지의 임상적 구강위생지수 및 타액, 구강 내 미생물의 변화양상을 평가하였다. 30명의 환자를 대상으로 하여, 임상적 구강위생지수(DMFS [decayed, missing and filled surfaces], O'Leary's plaque index, plaque pH), 타액의 변화(비자극/자극시의 타액량, 완충능(buffer capacity), pH, 잠혈(occult blood)류량, 구강 내 미생물(Streptococcus mutans, Lactobacillus) 변화를 파악하였다. 추가적으로 설문지를 이용하여 구강위생관리 및 식습관을 평가하였다. 분산분석, 회귀분석 및 Spearman의 상관분석을 통해 데이터를 분석하였다. 교정치료 도중 DMFS 값은 유의성있게 증가한 반면, plaque index는 감소하였고, plaque pH는 산성을 나타내었다 (p = 0.23). 비자극 시 타액량은 치료 중 유의성있게 변화하였으며 (p = 0.13), 자극 시의 타액량은 여성에서 장치 부착 이후 증가하는 양상을 보였다. Buffer capacity는 남성에서 치료 도중 감소되었으며, 타액의 pH는 유지되었다. 구강 내 미생물 및 잠혈류량은 고위험 수준까지 증가하였으며 성별의 차이는 나타나지 않았다 (p > 0.05). 치료 전 plaque와 구강위생용품의 사용 (r = 0.429; p = 0.018), 최종 DMFS와 비자극 시의 타액량 (r = -0.372; p = 0.043) 간에 뚜렷한 상관관계가 확인되었다. 교정장치의 부착으로 인해 구강 내 미생물은 증가하고, plaque pH는 산성화되어 치주조직의 손상이 일어나게 되었다. 또한 Buffer capacity는 변하지만, 치료 기간중의 타액의 pH는 유지되었다.

Keywords

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