A meta-analysis of periodontal status, periodontal indexes and clinical efficacy of orthodontic and periodontal tissue regeneration in patients with periodontitis

Periodontitis, as a chronic inflammation occurring in the periodontal tissues, can lead to the destruction of periodontal supporting tissues, and with the aggravation of the severity of the disease, the gums shrink continuously until the loss of teeth. Periodontal tissue regeneration and orthodontics are the main methods commonly used in the treatment of periodontitis in clinical practice. However, in the long-term application process, some scholars have pointed out that the clinical efficacy of single treatment is limited, so it is proposed to use them in combination for the treatment of periodontitis. Based on this, this study conducted a meta-analysis to observe the periodontal status, indicators and clinical efficacy of orthodontic plus periodontal tissue regeneration in patients with periodontitis, laying a theoretical foundation for providing more effective treatment for patients with periodontitis. According to the results of meta-analysis, compared with single treatment, orthodontic plus periodontal tissue regeneration can effectively improve the clinical efficacy of patients with periodontitis, and further improve the periodontal status and periodontal indicators, which is a safe and effective treatment for patients with periodontitis.

Introduction

Periodontitis is also known as destructive periodontal disease. Its pathogenesis is mainly caused by chronic inflammation of periodontal tissues caused by bacteria in dental plaque, which is also one of the more common oral diseases in People's Daily life at present [1]. According to epidemiological survey results, the prevalence of periodontitis increases with the increase of age, and the prevalence of periodontitis increases significantly with people over 35 and reaches its peak at the age of 50-60. However, in recent years, with the change of people's lifestyle and the strengthening of health awareness, the incidence of mild to moderate periodontitis patients has been decreasing year by year [2]. At present, most studies on the etiology of periodontitis indicate that it is closely related to microbial and host reactions, which seriously affects people's oral health. In addition, smoking, drinking and other bad living habits are also high risk factors for causing the growth of dental plaque and the occurrence of periodontitis [3-4]. According to clinical studies, the main symptoms of periodontitis are red and swollen gums, soft texture, loose teeth, and probing bleeding, etc., which can be classified into mild, moderate and severe according to the degree of periodontitis. Therefore, the overall goal of treating periodontitis is to inhibit the growth of plaque, reduce periodontal inflammation, and restore the function and physiological morphology of periodontal tissues [5].

At present, patients with mild periodontitis are mainly treated with general treatment, mainly through oral health knowledge education, oral health maintenance, removal of plaque retention factors and other means [6]. In addition, it can also be treated with local or systemic medication [7]. However, since the clinical symptoms of early periodontitis are not significant, most patients are already in severe periodontitis symptoms when they see a doctor, so surgical treatment is needed to help patients solve the pain. By using biofilm to prevent the growth of gingival creval epithelial root surface, periodontal tissue regeneration can induce the growth and differentiation of periodontal tissue in life, thus forming new periodontal tissue. However, as this procedure is applicable to periodontal defects caused by severe periodontitis, its therapeutic effect on periodontitis alone is limited [8]. By correcting the dislocation of the teeth of patients, orthodontics can restore the normal anatomical structure and maintain normal oral physiological functions [9]. At present, most clinical studies have discussed the clinical efficacy of orthodontics and periodontal tissue regeneration for patients with periodontitis. Based on this, this study conducted a meta-analysis to lay a data foundation for providing effective treatment for patients with periodontitis.

3.  Conclusion

As a common clinical oral inflammatory disease, periodontitis has been clinically found to be the main causes of periodontitis when dental plaque growth, dental calculus, smoking and alcoholism occur [22]. As the disease worsens, some patients will also appear tooth loss and other symptoms, which seriously affect daily life and aggravate oral pain. Currently, for patients with severe periodontitis, orthodontic and periodontal tissue regeneration are both commonly used surgical treatments, but the application of single therapy has limitations. Most scholars have confirmed the clinical efficacy of combined treatment of orthodontic and periodontal tissue regeneration through studies. Based on this, this paper conducted a systematic meta-analysis.

The results of meta-analysis showed that orthodontics and periodontal tissue regeneration could significantly improve the clinical efficacy of patients with periodontitis, significantly improve the periodontal status and reduce the level of periodontal indicators, and greatly reduce the degree of oral pain in patients with periodontitis. The analysis indicated that orthodontics, as a common treatment for patients with periodontitis, could further improve the condition by correcting the teeth in contact with the malocclusion of patients. However, in the process of continuous application, some scholars have pointed out that there are great limitations in the application of this program, which is only suitable for the treatment of patients with crowded teeth and interdental space, and the treatment cycle required by this program is relatively long. Since periodontitis patients are most common in the middle-aged and elderly groups, the tolerance and treatment compliance of this group will also decrease due to the prolongation of the treatment cycle [23].

With the continuous development of oral medical technology, the scope of use of orthodontics is also expanding, which can not only correct teeth, but also correct the dislocation of jaw bone. Since the introduction of new technologies and materials such as guided tissue regeneration, bone grafting, growth factors and biological materials into the treatment of periodontitis, the methods of periodontal tissue regeneration have become more abundant and the clinical effect has been greatly improved [24].