目的:探究血清及龈沟液髓细胞相关蛋白-8/14(MRP-8/14)、Toll样受体4(TLR4)、Toll样受体9(TLR9)评估伴错牙合畸形牙周炎患者牙周-正畸疗效的价值。方法:选取2022年1月至2023年7月永城市人民医院收治的72例伴错牙合畸形牙周炎患者为观察组,另选取同期健康体检者72名为对照组。比较2组治疗前血清及龈沟液MRP-8/14、TLR4、TLR9水平,比较观察组不同疗效患者治疗前、治疗3个月血清及龈沟液各指标、炎症反应指标[超敏C反应蛋白(hs-CRP)、可溶性细胞间黏附分子(sICAM-1)、单核细胞趋化蛋白-1(MCP-1)]及牙周指标[菌斑指数(PLI)、出血指数(SBI)、探诊深度(PD)],分析血清及龈沟液各指标与炎症反应指标、牙周指标的关系及评估价值。结果:治疗前观察组患者的血清及龈沟液MRP-8/14、TLR4、TLR9水平高于对照组(P＜0.05);疗效良好、疗效不良患者的血清及龈沟液MRP-8/14、TLR4、TLR9水平在治疗3个月后均明显低于治疗前(P＜0.05),疗效良好患者的血清及龈沟液MRP-8/14、TLR4、TLR9水平在治疗前、治疗3个月后均明显低于疗效不良患者(P＜0.05);观察组治疗前疗效良好患者的SBI、PLI、PD、血清hs-CRP、sICAM-1、MCP-1水平低于疗效不良患者;血清及龈沟液MRP-8/14、TLR4、TLR9与hs-CRP、PLI、sICAM-1、SBI、MCP-1、PD均呈正相关(P＜0.05);治疗前、治疗3个月血清及龈沟液各指标联合评估的AUC最大(P＜0.05)。结论:错牙合畸形牙周炎患者血清及龈沟液MRP-8/14、TLR4、TLR9高表达与炎症反应、牙周指标及牙周-正畸疗效有关,其联合预测患者牙周-正畸疗效具有较高参考价值。
Objective: To investigate the value of serum and gingival crevicular fluid myeloid cell-associated protein-8/14 (MRP-8/14), Toll-like receptor 4 (TLR4), Toll-like receptor 9 (TLR9) in evaluating periodontal-orthodontic efficacy in periodontitis patients with malocclusion. Methods: A total of 72 periodontitis patients with malocclusion admitted to Yongcheng People's Hospital from January 2022 to July 2023 were selected as the observation group, and 72 healthy subjects in the same period were selected as the control group. The levels of MRP-8/14, TLR4 and TLR9 in serum and gingival crevicular fluid were compared between the two groups before treatment. The indexes of serum and gingival crevicular fluid, inflammatory response indexes [high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule (sICAM-1), monocyte chemoattractant protein-1 (MCP-1)] and periodontal indexes [plaque index (PLI), bleeding index (SBI), probing depth (PD)] were compared between the two groups before treatment and 3 months after treatment. The relationship between the indexes of serum and gingival crevicular fluid and the indexes of inflammatory response and periodontal indexes and the evaluation value were analyzed. Results: Before treatment, the levels of MRP-8/14, TLR4 and TLR9 in serum and gingival crevicular fluid in the observation group were higher than those in the control group(P＜0.05). The levels of MRP-8/14, TLR4 and TLR9 in serum and gingival crevicular fluid of patients with good efficacy and poor efficacy were significantly lower than those before treatment after 3 months of treatment (P＜0.05). The levels of MRP-8/14, TLR4 and TLR9 in serum and gingival crevicular fluid of patients with good efficacy were significantly lower than those of patients with poor efficacy before treatment and after 3 months of treatment (P＜0.05). The levels of SBI, PLI, PD, serum hs-CRP, sICAM-1 and MCP-1 in patients with good efficacy before treatment in the observation group were lower than those in patients with poor efficacy. MRP-8/14, TLR4 and TLR9 in serum and gingival crevicular fluid were positively correlated with hs-CRP, PLI, sICAM-1, SBI, MCP-1 and PD (P＜0.05). The AUC of combined evaluation of serum and gingival crevicular fluid indexes before treatment and 3 months after treatment was the largest (P＜0.05). Conclusion: The high expression of MRP-8/14, TLR4 and TLR9 in serum and gingival crevicular fluid of periodontitis patients with malocclusion is related to inflammatory response, periodontal index and periodontal-orthodontic efficacy. The combined prediction of periodontal-orthodontic efficacy has a high reference value.
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