隐形与固定矫治器正畸后白垩斑发病率的比较

Comparison of Incidence of Post-orthodontic White Spot Lesion between Clear Aligners and Fixed Appliances

目的:通过回顾性研究比较使用固定矫治器和隐形矫治器正畸后白垩斑发病率。方法:收集华西口腔医院正畸科完成正畸治疗的患者资料,按照矫治器类型的不同分为隐形矫治器组与固定矫治器组。同一患者治疗前后的口内照片被并排放置在电脑显示器上比较,治疗前不存在,治疗后出现的釉质不透明白色斑块被确定为正畸后白垩斑。使用SPSS软件进行数据统计,分析两组患者白垩斑发病率的差异。结果:隐形矫治器组白垩斑的发病率为4.63%,显著低于固定矫治器组(17.27%,P=0.003)。此外,在所有相关因素中,男性患者比女性患者更容易发生白垩斑(P=0.021);青少年的发病率显著高于成人(P<0.001),同时治疗时间超过25个月的患者更有可能出现为白垩斑(P<0.001)。治疗后口腔卫生较好的患者白垩斑发病率低(P<0.001)。结论:使用隐形矫治器的患者正畸后白垩斑的发病率低于使用固定矫治器的患者。同时,青少年、男性、口腔卫生差、治疗时间长是正畸后白垩斑病变的危险因素。

Objective:To compare the incidence of white spot lesions(WSLs)between fixed appliances(FA)and clear aligner(CA)through retrospective study.Methods:The intraoral photographs of patients who completed orthodontic treatment in the West China Hospital of Stomatology were taken using a digital camera before and after treatment.The photographs were placed side by side on a computer monitor to diagnose orthodontic-related WSLs.Non-existent white spot lesions before treatment and faint white opacities after treatment were identified as orthodontic-related WSLs.Results:The incidence of WSLs in the CA group was 4.63%,which was significantly lower than that in the FA group(17.27%,P=0.003).Teeth of male patients were more likely to develop WSLs than those of female patients in the CA group(P=0.021).The incidence of WSLs in the adolescents was significantly higher than that in the adults(P<0.001).More than 25 months of treatment duration were more likely to develop WSLs(P<0.001).Conclusion:The incidence of post-orthodontic WSLs was lower in the patients with clear aligners than in the patients with fixed appliance.Besides,adolescent,male,poor oral hygiene,and longer treatment duration were risk factors for post-orthodontic WSLs.