교정용 밴드 제거 후 미생물 분포 및 치주 조직의 임상적 변화 = Changes of periodontopathogens and clinical parameters of periodontal tissue after debanding

국문 초록 (Abstract)

본 연구는 밴드 제거 직후 및 4주 경과 후 치주조직의 임상적인 환경변화와 미생물 분포 변화를 알기 위해 시행하였다. 최후방 구치에 밴드를 포함하는 고정식 교정 장치를 장착하고 교정 치료를 1년 이상 시행한 17명의 환자를 대상으로 하였다 (평균 나이 22세, 남자 6명, 여자 11명). 최후방 구치의 밴드를 제거한 직후와 제거 후 4주가 경과한 다음에 치주조직의 탐침 깊이와 출혈 빈도를 측정하였으며, 치은 연하의 치태를 채취하여 미생물의 분포를 조사하였다. 치주질환에 관련성이 깊은 미생물 중 Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola를 직접 Polymerase Chain Reaction 방법으로 존재 여부를 확인하였다. 밴드 제거 직후와 제거 후 4주가 경과한 시점의 치주조직의 탐침 깊이와 출혈 빈도, 병원성 미생물의 존재 여부를 통계적으로 비교하였다. 탐침 깊이와 출혈 빈도는 모두 하악 좌측 구치 협면에서 감소율이 가장 크게 나타났고, 상악 우측 구치 설면에서 감소율이 가장 작게 나타났다. 병원성 미생물 중 T. denticola가 밴드 제거 4주 후에 가장 높은 감소율을 보였으며, 하악보다 상악에서 감소율이 더 크게 나타났다. 이는 비록 밴드를 장착하여 치주 환경이 불량해졌다 하더라도 올바른 구강 위생 관리가 시행된다면 밴드를 제거한 후 정상적인 치주 상태로 회복될 수 있음을 예시한 것으로 생각되었다.

다국어 초록 (Multilingual Abstract)

Objective: The purpose of this study was to evaluate clinical and microbiological changes in periodontal tissue around the banded molars after debanding. Methods: This study included 17 young adult patients treated with fixed orthodontic appliances including bands on the last molars more than 1 years. Probing depth and bleeding frequency were measured and plaque samples were collected from the last banded molars in all quadrants of each patient. All the data were collected immediately after debanding and 4 weeks after debanding. Results: Using polymerase chain reaction based on 16S rDNA, the presence of Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola was detected. After debanding, probing depth, bleeding frequency, and prevalance of periodontopathogens were reduced. Probing depth and bleeding frequency were most decreased in the buccal site of the mandibular left molar and were least decreased in the lingual site of the maxillary right molar. Conclusion: The results of this study indicated that proper management of oral hygiene after debanding can recuperate unfavorable periodontal condition caused by orthodontic treatment.

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