基于多准则决策模型对隐形和固定矫治器治疗儿童错[牙合]畸形的效益-风险分析

Benefit-risk analysis of invisible and fixed appliances in the treatment of Children′s malocclusion based on multi-criteria decision-making model

目的:基于多准则决策模型对隐形和固定矫治器治疗儿童错[牙合]畸形进行效益-风险分析。方法:选择2022年1月至10月进行正畸治疗的110例错[牙合]畸形患儿,采用无托槽隐形矫正器治疗(隐形组)55例,采用多托槽固定矫治器治疗(固定组)55例。比较两组患儿治疗前后牙龈指数(GI)、菌斑指数(PLI)、龈沟出血指数(SBI)和龈沟探诊深度(SPD)、咀嚼功能、口腔健康影响程度量表(OHIP)得分、龈沟液中TNF-α和IL-1β含量、牙槽骨密度、牙槽骨高度的差值,以及治疗费用和并发症发生状况。建立多准则决策模型,比较两组的效益值和风险值。结果:两组治疗前后SBI、PLI、咀嚼功能、OHIP得分,IL-1β和TNF-α含量、不适感差值比较,差异有统计学意义(P<0.05),隐形组治疗费用高于固定组(P<0.05)。多准则决策决策模型显示效益指标中对治疗影响最大的是PLI,风险指标是牙周脓肿;隐形组和固定组的效益值分别为78和63,风险值分别为74和57,隐形组效益-风险总值比固定组高出16;在0%~100%相对风险权重范围内,隐形组的效益-风险总值总是高于固定组。结论:隐形矫治器治疗儿童错[牙合]畸形有助于保持牙周健康,具有更高的安全性。

Aim:To analyze benefit-risk of invisible and fixed appliances in the treatment of malocclusion in children based on the multi-criteria decision-making model.Methods:A total of 110 children with malocclusion deformity who underwent orthodontic treatment from January to October 2022 were selected.Fifty-five cases were treated with non-bracket invisible appliances(invisible group)and 55 cases with multi-bracket fixed appliances(fixed group).The gingival index(GI),plaque index(PLI),gingival sulcus bleeding index(SBI),sulcus probing depth(SPD),masticatory function,oral health impact profile(OHIP)scores,TNF-αand IL-1βcontents in gingival crevicular fluid,alveolar bone mineral density,alveolar bone height before and after treatment,as well as treatment cost and complications were compared between the 2 groups.A multi-criteria decision-making model was established,and the benefit value and risk value of the 2 groups were compared.Results:The differences of SBI,PLI,masticatory function,OHIP scores,IL-1β,TNF-αand discomfort before and after treatment between the 2 groups were significant(P<0.05),and the treatment cost in the invisible group was higher than that in the fixed group(P<0.05).Multi-criteria decision-making model showed that among the benefit indexes,PLI had the greatest impact on treatment,which was periodontal abscess in the risk indexes.The profit values of the invisible group and the fixed group were 78 and 63,respectively,and the risk values were 74 and 57,respectively.The total benefit-risk value in the invisible group was higher by 16 than that of the fixed group.In the risk relative weight range of 0%~100%,the total benefit-risk value of the invisible group was always higher than that of the fixed group.Conclusion:The treatment of malocclusion in children with invisible appliances is helpful to maintain periodontal health and has higher safety.