固定正畸青少年患者牙釉质脱矿的相关研究

Survey of demineralization of the enamel in fixed orthodontically treated adolescents

目的:分析固定正畸青少年患者牙釉质脱矿的发病率及危险因素。方法:选择132名进行固定正畸治疗的青少年患者,在粘接托槽前、粘接托槽半年后、粘接托槽1年后及拆除托槽时4个时间点,检查患者所有恒牙牙釉质脱矿情况,并收集调查问卷,记录分析拟调查因素,发病率及相对危险度。结果:固定正畸治疗后,78.8%的患者发现新发白垩斑,53.8%出现新发龋。其中上切牙为白垩斑最好发牙位,下颌第一和第二磨牙为龋最好发牙位。氟斑牙患者不易患白垩斑(RR=0.081)。使用非自锁托槽患者有易患白垩斑的趋势(RR=0.750)。口腔卫生差者更易出现新发白垩斑及新发龋,治疗前有龋者更易出现新发龋(P<0.05)。结论:患者在固定正畸过程中出现新发白垩斑,多与氟牙症、托槽类型及口腔卫生有关;出现新发龋与口腔卫生及治疗前的患龋情况有关。

Objective： To determine the incidence of demineralization of the enamel fixed orthodontically treated adolescents and explore the related risk factors. Methods： One hundred and thirty-two patients scheduled for fixed appliance treatment were enrolled in this study and assessed for demineralization at 4 checkpoints by direct visual examination. Results： White spot lesions（ WSLs） increased or worsen in 78. 8% of the patients after treatment with the maxillary anterior teeth the most susceptible. Caries were identified in 53. 8% of the patients after treatment,with the mandible molars the most susceptible. Patients who exhibited fluorosis（ RR = 0. 081） before treatment and who were treated with self-ligating brackets（ RR = 0. 750） were significantly less likely to develop new WSLs. And oral hygiene was associated with the highest risks of developing WSLs and caries. Additionally,patients with preexisting caries were more likely to develop caries during the treatment（ P 0. 05）. Conclusion： The patients developed WSLs depending on fluorosis,oral hygiene and the type of the brackets,while developed caries in treatment depending on preexisting dentine caries and oral hygiene.