[Comprehensive assessment of atypical-extraction orthodontic treatment].

OBJECTIVE: To discuss through retrospective study associated factors influencing orthodontists to develop orthodontic treatment plans and to calculate constituent ratio of a typical extraction in orthodontic treatment. METHODS: Systematic sampling was performed among 7 344 orthodontic patients, who received orthodontic treatment from April 2012 to March 2014 in the Department of Orthodontics, West China Hospital of Stomatology, Sichuan University. The study included statistical data on factors that may influence development of treatment plans. Samples were used to calculate extraction-ratio and atypical-extraction-ratio. Research focused on associated factors influencing development of treatment plans while evaluating correlation significances of each factor. Finally, treatment outcomes of atypical-extraction were compared with those of typical-extraction. RESULTS: Among studied patients, 55.31% (406/734) received orthodontic extraction treatment. In orthodontic-extraction-treated patients, typical-extraction accounted for 59.11% (240/406), orthodontists-selected atypical-extraction accounted for 23.15% (94/406), and passive atypical-extraction accounted for 17.73% (72/406). With statistical analysis, we inferred associated factors influencing development of treatment plans as follows: sex and age of patients, sex of orthodontists, accurate condition of specific teeth, Angle's classification, and degree of midline deviation. Tooth loss before treatment also directly influences passive atypical-extraction. Statistically significant factors were not obtained. Significant difference of treatment outcome was not observed between atypical-extraction and typical-extraction-orthodontic treatment (P>0.05). CONCLUSIONS: Above mentioned factors may influence orthodontists to develop treatment plans. However, orthodontists should also consider expected results of treatment strategies to prepare individual treatment plans on the basis of comprehensive analysis. 
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Distribution of Oral Pathogenic Bacteria and Analysis of Drug Resistance in the Infective Patients after Orthodontic Treatment in a Hospital from 2011 to 2016 / 中国药房

OBJECTIVE:To provide reference for clinical rational drug use and the prevention and treatment of drug-resistance bacteria.METHODS:A total of 148 patients with oral infection after orthodontic treatment were selected from a hospital during Jul.2011-Jul.2016.The distribution of pathogenic bacteria and drug resistance were analyzed retrospectively.RESULTS:Among 148 patients with oral infection,275 clinical specimens were detected,including 209 positive specimens with positive rate of 76.00％.A total of 332 pathogenic bacteria were detected,including 85 Gram-positive bacteria (25.60％) and 247 Gram-negative bacteria (74.40％).Top 7 isolated bacteria in the list of quantity were Actinobacillus pleuropneumoniae (54 strains,16.27％),Porphyromonas gingivalis (41 strains,12.35 ％),Tannerella forsythia (37 strains,11.14 ％),Streptococcus oralis (33 strains,9.94％),Klebsiella pneumoniae (30 strains,9.04％),Staphylococcus aureus (26 strains,7.83％) and Pseudomonas aeruginosa (25 strains,7.53％).Resistance rates of S.aureus to penicillin G,gentamicin,ciprofloxacin,oxacillin and tetracycline were all in high level (resistance rate＞50％),but it was sensitive to vancomycin and teicoplanin (resistance rate of 0).Enterococcus faecalis showed high resistance to penicillin G,erythromycin and oxacillin (resistant rate＞50％),but was sensitive to vancomycin and rifampicin (resistant rate of 0).K.Pneumoniae showed high resistance to gentamicin,ciprofloxacin,levofloxacin and cefazolin (resistant rate＞ 50％),but was sensitive to imipenem,ceftazidime,cefepime,ampicillin sodium and sulbactarn sodium,amoxicillin and clavulanate potassium (resistant rate＜ 10 ％).Resistant rates of P aeruginosa to gentamicin and levofloxacin were ≥ 80 ％,but it was sensitive to aztreonam (resistant rate of 8.00 ％).Resistant rate of Escherichia coli to piperacillin was 84.21％,but it was sensitive to imipenem and ampicillin sodium and sulbactam sodium (resistance rate of 5.26％).CONCLUSIONS:After orthodontic treatment,the pathogens of oral infection are various,mainly Gram-negative bacteria,and their drug resistance is not optimistic.The drugs with high sensitivity to the main pathogens include vancomycin,imipenem and enzyme inhibitor complex preparations,etc.Clinical attention should be paid to the cultivation of pathogenic bacteria and drag sensitivity test;according to the results of drug sensitivity test,targeted antibiotics should be selected to improve the antibacterial effect and delay the emergence of drug-resistant bacteria.