成人正畸期间口腔健康相关生活质量变化的评估研究(1)

http://www.100md.com 2018年3月15日 《中国美容医学》 2018年第6期

     [摘要]目的：探讨固定矫治中不同疗程阶段成人口腔健康相关生活质量的变化。方法：选取在安徽医科大学附属口腔医院接受国产MBT传统托槽正畸矫治的140例成人患者。所有患者在正畸前(T0)、初始弓丝放入24h(T1)，矫治1周(T2)、矫治1个月(T3)、矫治3个月(T4)、矫治6个月(T5)、矫治12个月(T6)这七个时间节点分别行口腔健康影响程度量表(OHIP-14)的问卷调查。比较固定矫治不同时期对患者口腔健康相关生活质量影响的差异。结果：对在固定矫治不同时期OHIP-14量表总分值进行比较，与T0相比除了T6其他时间节点的分值均增高，T2和T3分值最高，T2和T3、T1和T4、T0和T6比较无统计学差异(P>0.05)，其余各两个时间点的比较均有统计学差异(P<0.05)。结论：正畸治疗过程中OHIP-14总分增高，成人口腔健康相关生活质量受到明显影响。不同的矫治疗程中OHIP-14得分不同，在治疗早期，OHIP-14总分明显高于其他时期，成人口腔健康相关生活质量受到明显影响。但随着治疗的进行，OHIP-14总分有所下降，口腔健康相关生活质量的不良影响在不断降低。

    [关键词]固定矫治；不同疗程；成人；口腔健康相关生活质量；口腔健康程度量表

    [中图分类号]R783.5 [文献标志码]A [文章编号]1008-6455(2018)06-0103-04

    Abstract： Objective In this study， we aimed to investigate changes in oral health related quality of life among adults during fixed orthodontic appliance therapy. Methods One hundred andforty adult patients (treated with MBT brackets made in china) were enrolled from a consecutive sample at AnHui Medical university dental hospital. OHRQoL was assessed by standardized instrument (OHIP-14) at seven times： before treatment (T0)，one day after bonding and banding (T1)， one week after bonding and banding (T2)， one month after bonding and banding (T3)， three months after bonding and banding (T4) ，six months after bonding and banding (T5)， and twelve months after bonding and banding (T6).The summary scores of the OHIP-14 were used to compare the relative changes of OHRQoL among the different time points. Results Significant changes in the summary scores of the OHIP-14 during fixed orthodontic treatment. Compared with T0 they are higher (expect T6).There were significant OHRQoL deteriorations at T2 and T3. There was no statistical difference between (P>0.05).T2 and T3， T1 and T4， T0 and T6.The other two time points were statistically significant (P<0.05). Conclusion The total score of OHIP-14 was increased during orthodontic treatment. Changes in OHRQoL occur during fixed orthodontic appliance therapy. OHIP-14 scores were different in different treatment courses. In the early phase of treatment， the greatest deterioration in OHRQoL occurs. There were significant OHRQoL deteriorations in adults. With ongoing treatment， the total score of OHIP-14 decreased. The detrimental effects to OHRQoL are reduced.

    Key words： fixed orthodontic； different treatment courses；adults；OHRQoL；OHIP-14

    提高人們的生活质量是医疗卫生保健系统的最终目标。近年来对不危及生命的状态下提供的医疗服务[1-2]研究越来越广泛，主要是通过评估健康状况和医疗干预措施对生活质量的影响进行研究。口腔学者对此项研究也相当有兴趣，并制定了评估口腔健康相关生活质量(oral health relatedquality of life，OHRQOL)的指标[3-4]。口腔健康相关生活质量是反映口腔疾病对患者的身体、心理和社会功能等方面影响的综合评估[5-6]。这需要借助良好信度、效度和反应度的标准化量表进行评定，即口腔健康影响程度量表(oral health impact profile-14，OHIP-14)[7-8]。本研究通过OHIP-14评价患者在不同矫治疗程的OHRQOL。人们早已认识到错牙合对生活质量的影响，并希望通过正畸治疗来改善。但正畸治疗对生活质量也会带来一定的影响，因此，在正畸治疗对口腔健康相关生活质量的研究方面，临床医生有越来越大的兴趣[9-10]。(陈银妹 李淑华 张晓敏)

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