口腔扁平苔藓患者口腔健康相关生活质量的初步研究

目的通过口腔健康影响程度量表（OHIP）-14中文版了解口腔扁平苔藓患者口腔健康相关生活质量情况,探讨其应用于口腔扁平苔藓临床诊疗的可靠性和准确性。方法采用OHIP-14中文版对51例口腔扁平苔藓患者进行问卷调查,同时采用视觉类比标尺（VAS）对疼痛程度进行评分,REU评分系统对病损情况进行评分。通过SPSS 16.0软件对量表的信度和效度进行统计分析。结果OHIP-14的得分为21.67±9.45,量表的内部一致性Cronbach’s α系数为0.901,因子分析提取的5个公因子与量表各领域有密切的逻辑关系,量表得分与REU分值和VAS分值间呈正相关关系（r=0.608,0.807;P<0.000）。结论OHIP-14中文版评测口腔扁平苔藓患者的口腔健康相关生活质量具有较好的信度和效度,可为病情评估提供参考。     

复发性阿弗他溃疡患者心理因素及血浆儿茶酚胺水平变化

目的: 研究复发性阿弗他溃疡（RAU）患者心理因素及血浆儿茶酚胺水平的变化,探讨心理因素与复发性阿弗他溃疡发生、发展间的关系及其可能存在的物质基础。方法: 选择2016年2月—2016年8月在南京大学医学院附属口腔医院口腔黏膜病科门诊就诊的RAU患者30例为实验组,同时选择30名无重大系统性疾病及口腔黏膜疾病的年龄、性别等因素与实验组相匹配的健康人群作为对照组。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）分析2组受试人群的心理状态。于上午9—10点间安静状态下抽取受试者的全血,通过高效液相色谱法检测受试者血浆儿茶酚胺（包括多巴胺、去甲肾上腺素、肾上腺素）水平。数据采用SPSS22.0软件包进行统计学分析。结果: 实验组焦虑自评量表与抑郁自评量表的标准分值显著高于对照组（P<0.01）。血浆儿茶酚胺类物质水平分析,实验组肾上腺素水平显著高于对照组（P<0.01）,多巴胺及去甲肾上腺素值2组间无显著差异。心理量表和血浆肾上腺素水平的相关性分析显示两者显著相关。结论: RAU患者存在明显的心理因素变化,同时伴有体内儿茶酚胺类物质水平明显升高。     

益生菌芦荟发酵凝胶治疗复发性阿弗他溃疡的疗效及对口腔微生物群落的影响

目的:观察复发性阿弗他溃疡(recurrent aphthous ulcer,RAU)患者使用益生菌芦荟发酵凝胶的临床治疗效果和口腔微生物群落构成改变.方法:随机双盲设计.入选35例RAU患者,患者随机分为试验组和对照组.试验组局部涂抹益生菌芦荟发酵凝胶,对照组局部涂抹壳聚糖凝胶.对比试验组和对照组溃疡愈合天数.未用药...     

复发性阿弗他溃疡心理因素生物标志物研究进展

复发性阿弗他溃疡（recurrent aphthous ulcer，RAU）是一种口腔黏膜常见的炎症性溃疡类疾病。据调查，人群中RAU的发病率高，且溃疡发作时灼痛明显，尤其是重型复发性阿弗他溃疡（major recurrent aphthous ulcer，MaRAU）发作时疼痛剧烈，严重影响着人们的日常工作和生活。RAU的病因和发病机制尚不清楚，心理因素对RAU的影响不容忽视。迄今为止，国内外关于心理因素对RAU的研究多倾向于主观量表的评估，对其客观生物标志物的研究较少。本文就近年来国内外RAU心理因素生物标志物的研究进展作一综述。     

复发性阿弗他溃疡诊疗指南(试行)

复发性阿弗他溃疡(recurrent aphthous ulcer,RAU)又称复发性口腔溃疡,是最常见的口腔黏膜溃疡类疾病,调查发现至少10％ ～25％的人群患有该病,在特定人群中,RAU的患病率可高达50％,女性的患病率一般高于男性.RAU的好发年龄为10～30岁,溃疡疼痛明显,且反复发作,影响患者进食、言语、情绪,给患者的生活和工作造成了较大困扰.     

壳聚糖抗菌膜治疗RAU临床疗效观察

目的:观察壳聚糖抗菌膜治疗复发性阿弗他溃疡(RAU)的临床疗效。方法:92例RAU患者随机分成两组,对照组46例给予锡类散喷于溃疡表面,4次/d,;治疗组46例,将壳聚糖抗菌膜喷于溃疡表面,4次/d。结果:治疗组总有效率95.12%,对照组总有效率75.00%,两组疗效比较,差异有统计学意义(P<0.01)。结论:壳聚糖抗菌膜治疗RAU临床疗效好。     

复发性阿弗他溃疡患者唾液及血清中TNF-α的表达及其相关性研究

目的:研究复发性阿弗他溃疡(RAU)患者唾液及血清中TNF-α的含量的相关性.方法:临床收集轻型RAU组和健康对照组各30 例,对每个对象采集唾液和血清样本,采用酶联免疫吸附法检测所有样本中TNF-α的含量.结果:RAU组唾液及血清中TNF-α的含量明显高于相应的正常对照组(P<0.001),且RAU患者唾液和血清中TNF-α的含量有显著的相关性(r=0.826,P<0.01).结论:复发性阿弗他溃疡患者唾液及血清中TNF-α的含量具有显著相关性,可通过检测唾液中TNF-α的含量来观察病情变化和临床疗效.     

幽门螺杆菌与复发性阿弗他溃疡的关系

幽门螺杆菌是人类口腔中的条件致病菌,在复发性阿弗他溃疡(RAU)患者和部分健康人的唾液和牙菌斑中均可检出,但幽门螺杆菌与RAU有无关系尚无定论.本文就此作一综述.     

口腔中幽门螺杆菌与RAU的关系研究

目的:检测复发性阿弗他溃疡(RAU)患者口腔中幽门螺杆菌(H.pylori),探讨H.pylori感染与RAU的关系.方法:采用巢式PCR方法,利用内引物(ET-5U/ET-5L)、外引物(EHC-U/EHC-L),检测42例RAU患者口腔溃疡表面的假膜和上皮组织刮取物以及患者口腔其他部位正常黏膜上皮刮取物.结果:RAU患者溃疡组织、患者正常完整黏膜中H.pylori阳性率分别为16.7%(7/42)、7.1%(3/42),两者之间无显著性差异(P＞0.05);并且RAU患者溃疡组织与对照组正常完整口腔黏膜中H.pylori阳性率4.8%(2/42),两者之间也无显著性差异(P＞0.05).结论:H.pylori和RAU的发病可能无直接相关性.     

康复新液联合低能量钇铝石榴石激光治疗复发性阿弗他溃疡短期疗效对比研究

目的:比较康复新液联合低能量钇铝石榴石(Nd:YAG)激光治疗复发性阿弗他溃疡短期疗效。方法:收集129例口腔黏膜复发性阿弗他溃疡患者，随机分为A组(灭菌注射用水治疗),B组(康复新液治疗),C组(低能量激光联合康复新液治疗)。评价3组患者治疗后疼痛指数、溃疡数量以及溃疡面积。结果:A、B、C 3组疼痛缓解总有效率分别为88.37%、97.67%、100%,3组疗效差异有统计学意义(P<0.05)。3组溃疡数量减少总有效率分别为51.16%、81.40%、97.67%,3组疗效差异有统计学意义(P<0.05)。3组溃疡面积减少总有效率分别为86.05%、97.67%、100%,3组疗效差异有统计学意义(P<0.05)。结论:联合低能量钇铝石榴石激光可以提高康复新液治疗口腔黏膜复发性阿弗他溃疡的短期疗效。     

慢性咽炎患者口腔健康相关生活质量的调查

目的 测评慢性咽炎对患者口腔健康相关生活质量的影响,为临床诊疗提供参考.方法 收集慢性咽炎患者(慢性咽炎组)130例,另外选取362名常规来院进行口腔检查的普通人群(健康常规组)为对照,采用中文版口腔健康程度量表(oral health related impact profile-14,OHIP-14)进行口腔健康情况测评,并记录个体基本情况和专科检查情况.对OHIP-14得分与各健康因素进行Spearman相关分析与线性回归分析.结果 慢性咽炎组OHIP-14总分为(9.52±7.41)分,显著高于健康常规组(7.45±7.90)分,差异主要体现在功能限制、生理性疼痛、心理不适几个方面.Spearman相关分析结果显示OHIP-14得分与患者的年龄(rs=0.238,P=0.01)、咽部不适程度(rs=0.473,P<0.001)和龋失补牙数(rs=0.26,P=0.005)具有相关性.多重线性分析显示OHIP-14得分与咽部不适程度(steβ=0.353,P<0.001)、龋失补牙数显著相关(steβ=0.186,P=0.037),确定系数R2=0.294.结论 慢性咽炎患者总体口腔健康相关生活质量低于普通人群,应采取相应的预防措施改善患者的口腔健康.     

成人固定正畸治疗前后的口腔健康相关生活质量

目的 探讨错(牙合)畸形及正畸治疗对患者口腔健康相关生活质量(OH-QoL)的影响趋势和程度,分析可能影响患者生活质量的因素.方法 用口腔健康研究量表(OHIP-14中文版)测量不同类型错(牙合)畸形人群治疗前后的口腔健康生活质量.运用统计分析方法比较162例成人患者正畸治疗开始后1个月(T1)、3个月(T2)、6个月(T3)、12个月(T4)、治疗结束拆除矫正器(T5)、治疗结束后6个月(T6)的口腔健康生活质量变化,分析患者OH-QoL的变化趋势和可能的影响因素.结果 量表各领域中Angle Ⅰ类错殆组及Angle Ⅱ类错(牙合)组在心理不适(领域3)得分最高,而Angle Ⅲ类错(牙合)组在功能限制(领域1)得分最高,患者正畸治疗开始后1个月(T1)OHIP-14平均总得分最高(P＜0.05);同时T0与T1 、T1与T2、T2与T3、T4与T5、T5与T6比较差异均有统计学意义(P＜0.05).正畸治疗后(T6)得分低于治疗前(T0)(P＜0.05),即患者治疗后总体OH-QoL比治疗前提高.各条目中,正畸治疗前(T0)“其他人面前觉得不自在”最常给错(牙合)畸形患者带来负面影响,T1“出现过明显疼痛”、“吃什么东西都不舒服”、“在其他人面前觉得不自在”、“感到紧张不安”、“对自己的饮食不满意”给固定正畸患者带来负面影响最大,与正畸治疗前(T0)比较差异均有统计学意义(P＜0.05).结论 口腔健康状况对本研究患者OH-QoL的影响主要体现在心理不适领域,而对于AngleⅢ类错(牙合)畸形患者的负面影响主要体现在功能障碍方面;错(牙合)畸形的固定正畸矫治过程会对患者产生一定的消极影响,治疗后能改善患者口腔健康,提高患者的口腔健康相关生活质量.     

牙列缺损种植义齿修复的口腔健康相关生活质量研究

目的研究牙列缺损患者种植前后口腔健康相关生活质量（OH-QoL）状况．并结合其他主观指标探讨治疗的效果。方法以口腔健康影响程度量表（OHIP-14中文版）对种植患者治疗前后的OH—QoL进行问卷调查,比较治疗前后生活质量变化。结果量表各领域中．“生理性疼痛”得分最高,该领域OH—QoL最差,其次为“心理不适”。“吃什么东西都不舒服”是出现负面影响最多的条目（16．7％）;治疗后总体OH-QoL比治疗前提高,差异有统计学意义（P〈0．05）。主要体现在“生理性疼痛”及“心理障碍”两个领域。94．4％的患者治疗后口腔健康改善．94．4％的患者对修复体满意。结论口腔健康状况对本研究缺牙人群OH-QoL的影响主要体现在生理性疼痛及心理不适两个领域;种植义齿修复能改善患者口腔健康．提高患者的口腔健康相关生活质量。     

Oral health-related quality of life and periodontal status

BACKGROUND: As patient-centered approaches become more popular, increasing attention is being given to assess the effects of various human health situations on an individual's overall quality of life (QoL). Measures have been used in dentistry to study the effects of orthodontic treatment and oral surgery, but so far little has been reported about the effects of periodontal disease. OBJECTIVE: This study assessed the impact of periodontal health status on QoL. METHODS: A subsample of 767 subjects were selected from a community study (n=1000) which investigated the association between psychological factors and clinical periodontal attachment level (CAL). The sample included subjects with full-mouth mean CAL3 mm (high/severe periodontal attachment loss group). The subjects were requested to complete the Chinese short-form version of Oral Health Impact Profile (OHIP-14S) and a checklist of self-reported periodontal symptoms during the previous 12 months. RESULTS: A total of 727 subjects (95%) completed the questionnaire. The OHIP-14S and subscale scores were significantly associated with six of seven of the self-reported periodontal symptoms. A comparison of the mean OHIP-14S scores of the healthy/low and the high/severe periodontal attachment loss groups revealed significant differences in respect of the subscales of functional limitation, physical pain, psychological discomfort, physical and psychological disabilities. CONCLUSION: This study demonstrates a significant association between oral health-related QoL and periodontal disease.     

Impact of malocclusion on oral health–related quality of life in young adults

Objective:To assess oral health–related quality of life (OHRQoL) in young adult patients with malocclusion and to measure the association between orthodontic treatment need and OHRQoL.Materials and Methods:The study sample comprised 190 young adults aged 18 to 25 years who were attending orthodontic clinics at the Faculty of Dentistry. The Index of Orthodontic Treatment Need-Dental Health Component was used to measure orthodontic treatment need. Each participant was assessed for OHRQoL before and after treatment by using the Oral Health Impact Profile, Chinese version (OHIP-14).Results:Patients who had little or no, borderline, and actual need for orthodontic treatment represented 21.6%, 50.5%, and 27.9% of the total sample, respectively. OHRQoL (total OHIP-14 score and score for each domain) improved after treatment (P < .05). Significant differences in summary OHIP-14 scores were apparent with respect to orthodontic treatment need. Participants with high treatment need reported a significantly greater negative impact on the overall OHRQoL score. The greatest impact was seen in the psychological discomfort domain and the psychological disability domain.Conclusion:Malocclusion has a significant negative impact on OHRQoL. This is greatest for the psychological discomfort and psychological disability domains. The orthodontic treatment of malocclusion improves OHRQoL of patients.     

Oral health-related quality of life and associated factors in Norwegian adults

OBJECTIVE. To investigate associations between oral health-related quality of life assessed with the Oral Health Impact Profile (OHIP)-14 and demographic factors, number of teeth present, dental visits, dental health behaviour and self-rated oral health in a representative sample of 20-80-year-old Norwegians. MATERIAL AND METHODS. The study was conducted in a stratified random sample of 3538 individuals. Questionnaires including questions on demographic factors, number of remaining teeth, dental visits, dental health behaviour, self-rated oral health and OHIP-14 were mailed to the sample. Bivariate and multivariate analyses were performed. RESULTS. The response rate was 69%. The mean OHIP-14 score was 4.1 (standard deviation = 6.2). No problem was reported by 35% of the respondents. The most frequently reported problems were: physical pain (56%), psychological discomfort (39%) and psychological disability (30%). When the effect of all independent variables was analysed in multivariate analysis, self-rated oral health, frequency of dental visits, number of teeth, age and sex were significantly (P < 0.05) associated with the prevalence of having problems and frequent problems. Self-rated oral health had the strongest association with having problems [odds ratio (OR) 4.5; 95% confidence interval (CI) 3.4-6.0] and with having frequent problems (OR 4.0; 95% CI 2.7-5.8). Dental health behaviour, use of floss and toothpicks and oral rinsing were not associated with having problems related to oral quality of life in multivariate analyses. CONCLUSION. In this Norwegian adult sample, self-rated oral health, frequency of dental visits, number of teeth, age and sex were associated with having problems as estimated using the OHIP-14.     

The assessment of oral health-related quality of life by factor analysis in patients with Behcet''s disease and recurrent aphthous stomatitis

BACKGROUND: The aim of the study was to test multidimensional properties of oral health impact profile-14 (OHIP-14) in Behcet's disease (BD) and recurrent aphthous stomatitis (RAS) patients with active oral ulcers. METHODS: Ninety-six BD patients, 28 patients with RAS and 117 healthy controls (HC) were included in this study. In patients with active oral ulcers, the frequency and healing time of ulcers were recorded. Multidimensional properties of OHIP-14 were examined by factor analysis. RESULTS: Factor analysis revealed three subscales and explained 66.49% of overall variance in these patients with active oral ulcers. The score of Subscale 1 was positively correlated with the recurrence of oral ulcers per month (P = 0.037). Subscale 3 scores of the patients treated with colchicine were worse than those treated with immunosuppressives (P = 0.035). CONCLUSIONS: The factor structure of OHIP-14 was found to be reliable and sensitive to clinical parameters and treatment modalities in active patients.     

Development of a shortened Japanese version of the Oral Health Impact Profile (OHIP) for young and middle-aged adults

OBJECTIVE: The aim of this paper is to develop a short version of the Japanese OHIP (OHIP-J) appropriate for use in young and middle-aged adults, and to evaluate its properties using cross-sectional data. METHOD: A study population of 8,658 workers aged 20-59 years rated their oral health by means of a self-administered questionnaire. Using a factor analysis approach, a shortened version of OHIP-J was derived. Internal consistency, floor effect, and construct validity were determined. RESULTS: We derived a subset of 18 items from OHIP-J (OHIP-JA18), grouped into four subscales: "functional limitation", "physical pain", "psychological discomfort", and "disability & handicap". All four subscales had acceptable internal consistency (Cronbach alpha > 0.79). OHIP-JA18 demonstrated an acceptable floor effect, which was determined by the proportion of subjects who obtained a 0 score (< 30%); however, the floor effect of the ordinary shortened version based on OHIP-14 (OHIP-J14) was not acceptable. We confirmed the conceptual framework of OHIP-JA18 that "disability & handicap" is affected by "functional limitation", "physical pain" and "psychological discomfort", because the model fitted the data moderately well by structural equation modeling (SEM) analysis (GFI = 0.90, RMSEA = 0.08). CONCLUSIONS: OHIP-JA18 demonstrated acceptable measurement parameters to justify its use in outcome assessment for oral health related quality of life (OHQOL) in young and middle-aged adults in Japanese workers. Further studies will be needed to evaluate an intervention such as worksite health promotion.