成人正畸治疗对生活质量的影响

目的：研究正畸治疗对成人患者日常生活质量的影响。方法：随机抽取正畸治疗复诊患者400名进行问卷调查,年龄18～45岁,其中男90名,女310名。采用＂口腔健康状况对日常行为影响量表＂对患者进行测评。结果：正畸治疗对日常生活中进食、清洁、微笑的影响较大,疗程越长对患者工作学习的影响越大（P〈0.05）;正畸治疗对不同性别、不同年龄成人患者影响不同,女性患者认为对口腔卫生的护理更费时间,而男性则认为对社会交往的影响更明显（P〈0.05）;年轻患者（小于25岁）认为佩戴矫治器对日常生活中微笑的影响更显著（P〈0.05）。结论：正畸治疗影响成人患者的生活质量,在矫治初期、长疗程中表现更为明显;而不同性别,不同年龄的成人患者对正畸治疗影响日常生活各个方面的感受各不相同。     

成人正畸的心理特点及对正畸治疗的影响

目的：探讨成人正畸患者的心理特点及对正畸治疗的影响.方法：对82例成人正畸病例进行回顾性研究.结果：成人正畸患者对医嘱的依从性强,审美要求高,要求减少矫治器对外观的影响.存在对疼痛十分敏感,矫治期望值过高,急于求成,过分关注矫治过程中的每个微小变化等心理因素.这就要求正畸医生要有较高的正畸理论、实践知识,还要十分注重和患者的沟通、解释.结论：成人正畸患者有特殊的心理特点.正畸医生要采取个体合适的矫治设计,并就矫治过程中的相关问题作详细解释、说明,取得患者的理解.     

成人正畸治疗相关因素的回顾性分析

目的通过回顾性分析,探讨影响成人正畸治疗的相关因素。方法选取成人正畸患者213例,年龄18-49岁,对患者的就诊原因、拔牙模式及托槽选择进行回顾性分析。结果深圳市成人正畸患者当中,35岁以下的中青年患者较多,占总人数的80.28%;大专及以上学历者占64.79%;45.54%的患者寻求正畸治疗的目的是为了改善牙齿或面部的美观;将近40%的成人患者采取了不拔牙矫治;68.54%的患者选择使用金属矫治器,31.46%的患者选择使用陶瓷矫治器,其中,女性患者显著多于男性患者（P〈0.05）。结论成人正畸患者口腔情况复杂,就诊原因多样,矫治应因人而异。     

艾森克人格因素对成人正畸治疗疼痛的影响研究

目的探讨艾森克人格因素对成人正畸患者治疗过程中疼痛的影响,为正畸治疗过程中进行心理治疗以缓解治疗疼痛提供指导依据。方法选择进行正畸治疗的成人患者100例,治疗前由患者填写个人情况,并完成艾森克人格问卷,戴矫治器后采用视觉模拟评分法填写正畸治疗疼痛情况。对结果进行统计分析。结果艾森克人格E量表标准分同正畸疼痛呈负相关(-0.287～-0.358),而P、N、L量表的标准分均与正畸疼痛不相关。E标准分高的组(E≥60)和E标准分低的组(E<60)的正畸疼痛情况之间存在显著差异(P<0.05)。结论外向人格倾向者对疼痛的评分值低于内向人格倾向者。患者的人格倾向会影响患者的疼痛主诉程度,治疗前应对正畸患者进行必要的心理行为干预,以利于患者的健康与合作,提高口腔治疗效果。     

青少年错畸形患者正畸治疗相关因素分析

目的研究影响青少年错畸形患者正畸治疗的相关因素。方法对153例青少年正畸患者进行问卷调查。问卷调查内容包括正畸治疗的原因、矫治器种类选择、是否认可正畸拔牙、治疗前是否了解过正畸治疗的相关知识等。结果本次调查中,男孩66例,占43.14%,女孩87例,占56.86%;美观是患者寻求正畸治疗的主要原因,其次是家长的要求。大部分的青少年对矫治器的选择无特殊要求,选择陶瓷矫治器的患者中,女孩多于男孩,两者之间差异有统计学意义(χ2=11.369,P<0.05)。在正畸拔牙方面,女孩的接受程度高于男孩(χ2=7.048,P<0.05),而且,24.2%的男孩和44.8%的女孩在就诊前了解过正畸相关知识,男女差异有统计学意义(χ2=6.907,P<0.05)。结论青少年就诊意愿受多种因素影响,应该加强青少年对正畸治疗的认识,促进正畸治疗的全面开展。     

口腔正畸医生诊疗行为与患者治疗满意度的相关性研究

目的:探讨口腔正畸医生诊疗行为与患者治疗满意度两者之间的相互关系。方法:选取门诊410名口腔正畸患者,采用“口腔医生行为评价量表”,口腔治疗满意度量表进行问卷调查,并分别按照性别、年龄和疗程进行分组比较。对获得的数据使用SPSS18.0软件进行相关分析、逐步回归和秩和检验等统计分析。结果:口腔正畸医生诊疗行为与患者治疗满意度之间的相关系数R=0.750,有明显的统计学差异(P<0.05)。在24种口腔正畸医生诊疗行为中,有6种与患者治疗满意度产生明显的正相关(P<0.05)。女性较男性对治疗的满意程度更高(P<0.05)。青少年与成人之间以及在不同疗程间的满意度无显著性差异。结论:口腔正畸医生要规范自己的诊疗行为,加强与患者的沟通交流,提高患者治疗满意度。     

成人牙周病正畸治疗的临床体会

成人牙周病正畸治疗的临床体会广东省深圳市福田人民医院（５１８０３３）陈进英本文旨在通过对４０例使用固定矫治器治疗成人牙周病的病例进总结，分析影响牙周病正畸治疗结果的有关因素。资料与方法１．样本选择：４０例牙周病，使用固定矫治器治疗的患者，男性１４例，...     

影响陶瓷托槽再粘接强度的因素

随着寻求正畸治疗的成年患者的增加,人们对矫治器本身美观性要求越来越高。陶瓷托槽自1986年问世以来,因其能够满足患者的美观要求又具有出色的理化性能,深受成人正畸患者和医生的喜爱,在正畸临床应用越来越广泛。     

无托槽隐形矫治青少年患者龋白斑的发病率及其影响因素

目的研究接受无托槽隐形矫治的青少年患者龋白斑（WSL）的发生率及其相关影响因素,为正畸后WSL的预防和治疗提供研究依据。 方法选取空军军医大学第三附属医院口腔正畸科2017年3月至2022年3月接受无托槽隐形矫治的203例青少年患者,通过调查问卷采集患者口腔一般情况及阶段正畸治疗资料;通过目测法对131例无WSL组及72例WSL组患者进行牙齿白斑检测,计算WSL发病率;通过卡方检验、非参数检验及回归法探究接受隐形矫治的患者发生WSL的可能因素。 结果接受隐形矫治的青少年患者WSL的发病率为34.6%,WSL的发生与以下影响因素相关（P<0.05）：性别、每日刷牙次数、每次刷牙时长、使用牙膏类型、使用漱口水频率、饮用碳酸饮料频率、治疗前有无龋齿、佩戴隐形矫治器进食频率及持续时间和佩戴矫治器进食后清洁矫治器频率。Logistic回归分析结果表明,每日刷牙次数、治疗前有无龋齿、饮用碳酸饮料频率及佩戴矫治器进食后清洁矫治器频率可能是WSL的重要危险因素（P<0.05）。 结论青少年患者接受隐形矫治后具有较高的WSL发生率,其中每日刷牙次数较少、治疗前患有龋齿、饮用碳酸饮料频率较高及佩戴矫治器进食后清洁矫治器频率较低的患者更容易发生WSL。     

正畸治疗前后患者颜面美的感知变化及相关因素研究

目的探讨接受正畸治疗的患者对颜面美的感知变化及相关影响因素,用于指导临床治疗提高患者的满意度。方法选取12例矫治完成的病例图像制作调查问卷。随机选择于山东大学口腔医院接受正畸治疗的患者100例,分别在其正畸治疗前(对照组)及治疗一年半后(治疗组),评价问卷中病例颜面美的改变,并进行统计学分析。结果接受正畸治疗的患者对颜面美的感知度显著提高。其中文化水平较高的中年女性患者对颜面美的感知度提高最为显著,而高中以下的少年男性患者对颜面美的感知度提高不明显。拔牙及不拔牙患者对颜面美的感知度均提高,但提高的程度无显著差异。结论患者对颜面美的感知会随着正畸治疗的进行而提高,正畸治疗中要注重患者的审美心理及行为的变化,适时调整矫治方案,加强同患者的沟通,提高患者的满意度。     

固定矫治中青少年及成人患者口腔健康生活质量的比较

目的:比较青少年及成人患者在固定矫治过程中口腔健康生活质量的不同变化特点。方法:选择81例于2013年9月—2015年8月就诊于山东大学口腔医院正畸科的患者,年龄15~25岁,分为青少年组（43例）和成人组（38例）。在矫治前及矫治中3个阶段完成填写口腔健康影响程度量表（OHIP-14）。采用SPSS 20.0软件包对数据进行Friedman双向方差分析、Wilcoxon秩和检验和Bonferroni校正检验。结果:矫治过程中,青少年及成人患者的总得分及除社交障碍、社会功能障碍外5个维度得分均呈下降趋势,差异具有显著性。社交障碍维度仅成人患者得分差异显著。社会功能障碍维度2组得分无显著差异。结论:口腔正畸医师应重视青少年及成人患者矫治中生活质量的变化特点,并根据其特点加强与患者的交流。     

The impact of fixed orthodontic appliances on daily life

OBJECTIVE: i) To develop a measure of the impact of fixed orthodontic appliances on daily life. ii) To assess the impact of fixed appliances over time after initial appliance placement. iii) To investigate factors that may influence the impact of fixed appliances (age, gender and socioeconomic status). RESEARCH DESIGN: Questionnaire. CLINICAL SETTING: University Dental Hospital and Hope Hospital, Manchester. SAMPLE: Sixty-six patients, whose orthodontic appliances had just been placed. Twenty-eight patients whose orthodontic appliances were in place for at least six months were used for the reliability study. METHOD: The Impact of Fixed Appliances Questionnaire was developed using standard qualitative methods and pre-tested on 10 patients. This resulted in a questionnaire with nine conceptual impact sub-scales: aesthetic, functional limitation, dietary, oral hygiene, maintenance, physical, social, time constraints and travel/cost. The questionnaire was piloted on 66 patients, at the first, second and third visits after their fixed appliance had been placed, to assess the impact of fixed appliances over time. Questionnaire reliability, over a one-month time interval, was assessed on 40 patients who had been in treatment for at least six months. MAIN OUTCOME MEASURE: Impact of fixed appliances on daily life. RESULTS: The internal reliability of the questionnaire ranged from moderate to very good (Cronbach's alpha 0.56-0.89). Test-retest reliability was stable for most subscales (intra-class correlation coefficient 0.26-0.65). The questionnaire was said to have face validity and also content validity because of the method of questionnaire development through interviewing children with fixed appliances. None of the subscales scores reduced over time except aesthetic impact (p< 0.05) but this was probably not a clinically significant change. Age was the predominant variable to influence the impact of fixed appliances with younger children being less affected during their daily life (p<0.05). CONCLUSIONS: The questionnaire developed in this study is a reliable tool for assessing the impact of fixed appliances on the daily life of children. It is unlikely that the impact of fixed appliances on daily life reduces as the patient progresses through treatment. Younger patients are probably more adaptable to treatment with fixed appliances, in terms of reduced impact on daily life, so arguably treatment should be started as early as possible. This information could also be used to educate, reassure and motivate patients at the start of treatment.     

口腔固定矫治对患者生活质量影响的分析

目的：探讨口腔正畸固定矫治对患者日常生活质量的影响。方法：对410名门诊口腔正畸复诊患者,采用”口腔治疗影响日常行为量表”（OIDP）进行问卷调查,比较在不同日常行为方面影响程度的大小,并按不同疗程、不同年龄、不同性别对患者进行分组比较。所得数据采用秩和检验和x。检验进行统计处理。结果：正畸固定矫治对患者各项日常行为活动的影响程度大小不一致（P〈0．01）,其中对口腔清洁影响最大,体育运动影响最小。疗程在19～30个月者相比疗程在7～18个月者（P=0．046）以及疗程大于31个月者（P=0．027）,更能感觉正畸固定矫治对日常生活的影响。青少年组患者感受影响的程度是成年组的1．815倍,两者间有显著性差异（P=0．014）。不同性别之间患者的感受程度无显著性差异（P=0．751）。结论：口腔正畸医师要关注患者,尤其是关注影响相对较重的患者,在正畸治疗过程中的心理变化,加强心理疏导,保证临床治疗顺利进行。     

Orthodontic evolution: an update for the general dental practitioner. Part 2: psychosocial aspects of orthodontic treatment, stability of treatment, and the TMJ-orthodontic relationship

As a result of recent innovations and improvements, orthodontic treatment has become easier and more efficient to carry out, allowing greater numbers of patients to receive treatment. The main result of orthodontic treatment is improved dental alignment and aesthetics. Treatment has no effect on caries or periodontal disease, and the dental health gain is modest, apart from a very small percentage of destructive malocclusions. Psychological improvements using different psychological parameters show differing results and it is not clear that any psychological gains are long lasting. Social gain (greater willingness to smile, feeling good about oneself, satisfaction with dental appearance, etc.), and reported improved quality of life (QoL measures), are now becoming more important as consumer-related outcomes and may, ultimately, contribute to psychosocial and psychological status. Stability of orthodontic treatment results cannot be guaranteed and all patients need to be informed of this, and of the need for long-term retention. Malocclusion has little or no relationship to temporo-mandibular joint dysfunction and orthodontic treatment neither causes nor cures such problems. Extractions as part of orthodontic treatment do not cause TMD, nor do they cause collapse of the vertical dimension. The major improvements in dental health in the last 40 years have been accompanied by a great increase in demand for treatment. In any public health service that is free at the point of use, demand for treatment invariably exceeds the ability of resources to supply this. Indices of treatment need are widely used to determine treatment need and eligibility for treatment in public health systems. Demand for orthodontic treatment among adolescents can be as high as 60% in the general population, while the professionally-assessed need for treatment is approximately half this figure. Age, sex, socio-economic status, perceived unattractiveness of dental appearance, and availability of orthodontic services all influence receipt of treatment.     

Orthodontic care in an insured population in Washington: demographic factors

Few studies have used insurance claims data to investigate demographic factors related to orthodontic care. This study sought to describe age and sex distributions in a large, insured population in Washington. Additionally, the demand for orthodontic care was evaluated with respect to county population, and the impact of the availability of orthodontists was investigated. All orthodontic claims in 2001 were retrieved from the Washington Dental Service database, along with associated provider and patient information. A total of 102,984 claims were included in this study. A large percentage of subjects (86%) were less than 20 years old, with most patients in their early teens. Overall, about 64% of all orthodontic patients were female. The demand for orthodontic treatment was the highest in the counties with the largest populations. Although there was considerable variation in the data, the number of orthodontic claims submitted by general dentists tended to decline as the availability of orthodontists increased.     

口腔正畸患者就诊原因和满意度调查分析

目的 研究正畸患者就诊的目的、动机和就诊满意度,促进正畸科口腔医疗服务质量的提高.方法 随机抽取口腔正畸科门诊咨询及治疗患者1065人进行问卷调查,对结果进行描述分析.结果 研究发现正畸治疗的主要原因是影响容貌美观及个人形象;儿童主要是应父母的要求前来就诊,而成人病人主要是为了社交、工作及恋爱、婚姻的需要;患者最为关心的问题主要包括医生技术水平、治疗效果,疗程长短及收费的高低.90％以上的复诊患者对接诊医生服务态度与医疗质量,护士及导医的服务态度及质量,诊疗环境满意或基本满意.结论 最大程度获得颜面部及牙齿的美观是正畸患者就诊的主要原因;患者对西安交通大学口腔医院正畸医疗服务整体满意率相对较高,对等候或排队时间满意率低.     

正畸就诊患者中颞下颌关节结构异常的类型分析

目的 颞下颌关节问题在口腔正畸治疗中日益受到重视,本研究针对正畸就诊患者中颞下颌关节结构常见的问题进行系统分析,为颞下颌关节结构异常患者正畸方案的制订提供参考。方法：随机选取近2年在我科就诊的正畸患者255例作为受试对象,其中男80例,女175例,年龄10~45岁。常规拍摄X线片及双侧颞下颌关节开闭口位磁共振片,并对关节结构进行观察。采用SPSS 17.0软件包对结果进行统计学分析。结果： 255例患者中,颞下颌关节结构异常176例,占69.02%。80例男性患者中,关节结构异常48例,占60.00%;175例女性患者中,关节结构异常128例,占73.14%,显著多于男性患者。结论：颞下颌关节结构异常在正畸就诊人群中的比例很高,约占2/3,但大部分患者没有临床症状,是一种潜在的风险,女性患者显著多于男性。     

牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形远期疗效评价

目的：评价牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形的远期疗效。方法伴牙槽骨缺损的成人错畸形3例,平均年龄29岁。经正颌-正畸联合会诊制订治疗计划,按照牙槽骨再生正畸及正颌-正畸联合治疗模式,分别进行系统治疗并随访2~3 a。结果3例患者均顺利完成治疗,面型及咬合关系获得良好改善;牙槽骨缺损区正畸牙移动到位且未见医源性牙周并发症,牙槽骨缺损区骨量增加明显且远期效果稳定。结论针对伴牙槽骨缺损的成人患者,牙槽骨再生正畸是一种较为理想的技术。