牙周支持治疗阶段患者依从性影响因素分析及对策

目的:探讨慢性牙周炎患者牙周支持治疗阶段依从性影响因素及其对策.方法:自行制订调查问卷,对已完成牙周非手术基础治疗,且已进入牙周支持治疗阶段(SPT)的慢性牙周炎患者,2a后通过门诊随访和电话回访获取资料,进行分析.结果:共回收有效问卷101份,相关因素分析显示,疾病知晓度、医疗服务质量、年龄、文化程度、经济状况等多种因素可影响依从性.结论:影响慢性牙周炎患者依从性的因素较多,提高患者依从性的关键在于有针对性地对患者进行口腔健康教育、定期随访和改善医疗服务质量.     

口腔扁平苔藓患者的护理体会

目的 探讨口腔扁平苔藓患者的护理措施,总结口腔扁平苔藓患者的护理体会.方法 口腔扁平苔藓患者190例,患者接受治疗时配合进行心理护理、睡眠指导、饮食指导、运动指导等,并观察疗效.结果 190例口腔扁平苔藓患者中100例患者显效,84例患者有效,6例无效,总有效率为96.8％ (184/190).结论 对口腔扁平苔藓患者加强系列护理指导,有助于疾病的好转及预防复发.     

IL-35在牙周炎及口腔扁平苔藓中的表达及相关性分析

目的:探讨IL-35在牙周炎及口腔扁平苔藓免疫机制中的作用及相关影响,以及牙周炎与口腔扁平苔藓之间的相互关系.方法:按纳入标准选择单纯口腔扁平苔藓患者20例,单纯牙周炎患者20例,牙周炎伴口腔扁平苔藓患者20例和健康者12例;记录患者的一般信息及牙周探诊深度、临床附着丧失、牙龈指数、龈沟出血指数,并收集静脉血清及龈沟液样本,采用酶联免疫吸附测定血清及龈沟液中IL-35的表达水平.采用SPSS19.0软件包对数据进行统计学分析.结果:单纯口腔扁平苔藓组、单纯牙周炎组、牙周炎伴口腔扁平苔藓组龈沟液及血清中IL-35浓度显著高于健康对照组(P＜0.01),牙周炎伴口腔扁平苔藓组龈沟液及血清中IL-35浓度显著高于单纯口腔扁平苔藓组及牙周炎组(P＜0.05);各组牙周临床指标与龈沟液及血清中IL-35表达水平呈正相关关系.结论:牙周炎及口腔扁平苔藓中IL-35表达水平显著升高,其升高程度与两者呈正相关.     

表皮生长因子受体在口腔扁平苔藓、口腔乳头瘤及口腔鳞状细胞癌中的表达

目的:研究表皮生长因子受体(epidermal growth factor receptor,EGFR)在口腔扁平苔藓(OLP)、口腔鳞状细胞乳头瘤(SCP)及口腔鳞状细胞癌(SCC)中的表达,探讨其在口腔黏膜炎症、增生及癌发生过程中的意义.方法:用免疫组化方法检测EGFR在20例口腔黏膜扁平苔藓(单纯增生10例,伴糜烂10例)、20例口腔乳头瘤、20例口腔鳞状细胞癌及5例正常口腔黏膜中的表达.采用Fromowitz法计数阳性细胞.应用SPSS11.5软件包分析EGFR在不同病变中的表达差异.结果:EGFR在非糜烂型扁平苔藓组主要表现为弱阳性表达;糜烂型扁平苔藓组强阳性表达率为20％;乳头瘤组的强阳性表达率为25％;鳞状细胞癌的强阳性表达率为60％.扁平苔藓糜烂组和非糜烂组之间EGFR强阳性表达率有显著差异(P＜0.05);糜烂组OLP与乳头瘤组的强阳性表达率无显著差异;口腔鳞癌组的强阳性表达率显著高于扁平苔藓组及乳头瘤组.结论:EGFR可能成为口腔鳞癌化学预防作用的重要靶点.     

患者对拔牙术后医嘱的依从性

目的 评价口腔颌面外科门诊患者对拔牙术后医嘱的依从性。方法 随机抽取需行切开缝合拔牙术的患者160名，术后第7天拆线时采用无记名问卷形式，问卷内容包括患者是否记得有书面和／或口头医嘱、对术后医嘱的依从性以及他们的评论。结果 160例中有50％记得书面医嘱和口头医嘱，40％只记得书面医嘱，10％只记得口头医嘱；24％没有遵从关于刷牙的术后医嘱。77％没有遵从关于应用抗生素的术后医嘱，其中45％服用了过量的抗生素，29％少服用了抗生素，3％无抗生素医嘱的患者自行服用了抗生素。患者的依从性与所受教育程度无关。结论 简单明了的口头和书面医嘱对患者的依从性很重要，而且可以减轻患者术后的紧张情绪。对应用抗生素给予更好的指导可以提高患者应用抗生素的依从性。     

口腔健康影响程度量表在口腔扁平苔藓中应用的研究进展

口腔扁平苔藓是口腔黏膜病中常见的疾病之一,反复发作,常伴有糜烂等症状,严重影响患者的生活质量,随着医学模式的改变,以患者为中心的临床诊疗活动逐渐成为当今主流,全面评估口腔健康相关生活质量显得愈发重要,其中以患者为主导的口腔健康影响程度量表的在口腔领域的应用日益增多,然而口腔健康影响程度量表在口腔扁平苔藓的临床诊治中应用尚少,该文综述了口腔健康影响程度量表及其在口腔扁平苔藓中的验证研究和应用,以期为临床上口腔扁平苔藓的诊治提供一定的参考。     

口腔健康影响程度量表在口腔扁平苔藓诊疗中的初步应用

目的:通过观察口腔扁平苔藓患者治疗前后的口腔健康相关生活质量状况,分析口腔健康影响程度量表(OHIP-14)中文版应用于口腔扁平苔藓临床诊疗的反应度。方法:采用OHIP-14中文版对口腔扁平苔藓患者在治疗前后进行问卷调查,并结合效应大小、标准化反应均数等指标进行反应度分析。结果:治疗后患者的OHIP-14分值较治疗前明显降低(P0.01)。7个维度中除心理不适外,其余维度分值差异均有统计学意义(P0.01),其效应大小在0.24～0.55之间,标准化反应均数在0.33～0.72之间。结论:OHIP-14中文版具有一定的反应度,通过评测口腔扁平苔藓患者的口腔健康相关生活质量可以为疗效评估提供参考。     

Peplau人际关系理论在口腔正畸治疗中的护理应用

目的探讨Peplau人际关系理论在口腔正畸治疗的护理过程中护士与患者及家属建立良好护患关系、提高患者治疗依丛性的实践效果。方法对286例错胎畸形患者在口腔正畸治疗时采用Peplau人际关系理论指导临床。开展相关护理。结果整个护理过程护患沟通良好．患者对护理服务质量满意率逐年上升,2012年患者的满意率为95．2％、依从性为93．8％,2013年满意率为97．3％、依丛性为95．6％,2014年满意率为99．5％、依丛性为98．5％。结论Peplau人际关系理论应用在口腔正畸治疗中可促进护患关系的良好互动与沟通．提高患者的治疗依从性。     

口腔扁平苔藓组织环状RNA表达谱的筛选与初步探讨

目的: 构建人口腔扁平苔藓（oral lichen planus,OLP）组织的环状RNA(circular RNA, circRNA)表达谱,筛选并验证口腔扁平苔藓组织中异常表达的circRNA,为疾病的诊断和治疗提供理论基础。方法: 选择2018年9月—12月就诊于上海交通大学医学院附属第九人民医院口腔黏膜病科的口腔扁平苔藓初诊患者6例,同期健康志愿者6例,利用高通量测序技术对口腔扁平苔藓和正常口腔黏膜组织中RNA进行测序和鉴定分析,分析组间circRNA的表达差异,然后利用qRT-PCR对分析结果进行验证。采用 SPSS 24.0 软件包对数据进行统计学分析,最后应用生物信息学技术GO（Gene Ontology）富集分析和KEGG（Kyoto Encyclopedia of Genes and Genomes）通路分析差异基因的功能及相关通路。结果: 测序结果显示,与健康口腔黏膜组织相比,在口腔扁平苔藓组织中共检测出85种差异表达2倍以上的circRNA,其中66种高表达,19种低表达。分别取上调、下调最显著的3个circRNA,在更多样本中进行qRT-PCR验证,其结果与测序结果一致。结论: 口腔扁平苔藓组织与正常口腔黏膜组织之间存在差异表达的circRNAs,这些circRNAs可能参与口腔扁平苔藓的致病调控,是潜在的疾病新型诊断和治疗的生物学标志物。     

青少年隐形保持器的适应性和依从性与人格特征的调查

目的:探讨青少年使用隐形保持器的适应性和依从性,及其与人格特征的关系.方法:纳入青少年正畸患者50例,在拆除固定矫治器后以透明压膜式隐形保持器保持.在隐形保持器戴用2个月后,问卷调查患者对隐形保持器的适应性及依从性.以艾森克人格问卷评估患者的人格特征.采用SAS8.0软件包中的Spearman秩相关评估患者隐形保持器适应性和依从性与人格特征的关系.结果:42例患者完成问卷.76％的患者反映隐形保持器无黏膜刺激,95％反映其不影响日常活动.但75％反映隐形保持器有异物感,71％反映影响发音.另外,40％的患者戴用时间不足18h,31％曾遗落保持器,83％不能做到进食后刷牙.患者的人格特征中情绪不稳定性越高,保持器对咀嚼的影响越大,相关系数为0.32;精神质越强,保持器异物感和对面部肌肉酸痛的影响越明显,相关系数分别为0.31和0.35.但精神质越强者,保持器对情绪的影响越小,相关系数为-0.34;越外向的患者越常发生保持器损坏,相关系数为0.31.结论:青少年隐形保持器的适应性较好,但依从性不佳.隐形保持器的适应性和依从性与患者人格特征有关.提示青少年患者选用隐形矫治器时应重视患者依从性,可以通过人格特征预测.     

Satisfaction as a determinant of compliance

In this study the relation between satisfaction and compliance is examined in terms of specificity and predictive value. Satisfaction is assumed to be a determinant of compliance, especially if both concepts are measured at the same level of specificity (i.e., a dental level). A total of 176 subjects reported their satisfaction with dental visits and the dental practice, their dental compliance and their general tendency to comply. The results show a relation between satisfaction and compliance and that compliance can be predicted by satisfaction. Surprisingly, the relation between dental satisfaction and general compliance is stronger than the relation between dental satisfaction and dental compliance. This finding can be explained by the possible relation between different levels of compliance and the complexity of the concept dental compliance.     

Patient attendance compliance in periodontal therapy

Attendance compliance of patients presenting for periodontal therapy during one calendar year at two practice locations (Perth, Western Australia and Darwin, Northern Territory) was observed over a period of three to four years, depending on whether the patients were seen in the earlier or latter part of the initial year. Both venues (full-time practice and visiting practice every quarter) gave very similar results, of around 10 per cent of patients who dropped out after initial consultation, without commencing treatment. As well, both venues showed a similar trend of subsequent patient 'attrition' after the initial phase of treatment, with the retention of approximately 40 per cent of the original group of patients after three to four years. Of these, a very high proportion (90 per cent) were totally compliant with maintenance recall appointments.     

Cross-infection compliance of UK dental staff and students

OBJECTIVES: The objectives of the study were to determine the compliance of a group of dental health care workers and students in aspects of cross-infection control.
DESIGN: The dentists and dental students working in a dental clinic were observed by a 'hidden' ceiling-mounted video camera. Procedures were recorded onto videotape and the actions of the observed clinicians and students assessed by two suitably qualified assessors.
SETTING: An emergency Oral Medicine clinic in a dental hospital.
SUBJECTS Seventy nine dentists and 35 dental undergraduates.
METHODS: The action of staff and students were recorded on videotape and assessed retrospectively.
MAIN OUTCOME MEASURES: Degree of compliance with recognised infection control policies.
RESULTS: Compliance with recommended guidelines for control of cross-infection was poor. In only 56% of health care worker-patient contacts were protective gloves changed between patients. Facemasks and protective eyewear were only worn in 38% and 29% of such contacts respectively.
CONCLUSIONS: Compliance with cross-infection control measures are poor in dentistry - even when clinicians are provided with appropriate facilities.     

Patient compliance with maintenance therapy in an Italian periodontal practice

Abstract. A sample of 414 patients, treated between 1985 and 1988 by an Italian periodontal practice for supportive periodontal therapy, was studied to determine compliance with recommended maintenance programmes. Patients included in the study had attended for supportive periodontal therapy for at least 1 year prior to the close of data collection in 1989. Based on their compliance with the suggested maintenance schedule, patients were classified as complete attending (100% of programmed visits), partial (at least 50% of programmed visits), or insufficient (less than 50% of programmed visits). Only 30%) of the initial patient sample was found to be compliant at the end of 1989. Complete compliance decreased as the number of years after active therapy increased, from 38% at 1 year to 20% at 4 years. The % of patients with insufficient compliance increased from 37% to 46% from the 1st to the 2nd year, then remained stable over the following years, indicating that the 1st year represented the critical period when subjects decided whether to follow recommended maintenance therapy. No significant relationships were found between degree of compliance and patient gender, recall schedule or type of treatment procedure performed. However, complete compliant subjects were younger than the other groups ( p <0.03), and compliance increased with the number of surgeries ( p <0.002).     

Survival analysis for degree of compliance with supportive periodontal therapy

BACKGROUND, AIMS: The purpose of this investigation was to evaluate the degree of compliance for supportive periodontal therapy (SPT) and to determine factors in relation to patients who failed to continue SPT programs. METHOD: A sample of 1896 patients who were treated between 1988 and 1999 was studied. The patients were classified by gender, age group and the distance between their house and the hospital. The number of visits was counted based on an electronic patient record for SPT. Data were analyzed by survival analysis. Survival probabilities in SPT were estimated by the Kaplan-Meier method and compared by the generalized Wilcoxon test. RESULTS: 28% of patients did not comply with the first visit for SPT. The older patients had higher tendencies to continue the SPT program than the younger patients. No significant differences in compliance were found between males and females or between short-distance and long-distance groups. However, when these factors were adjusted by age, significantly different patterns were shown on the curves of survival probability: in males, significant differences were found between the 20 s and 30 s (p<0.00001) and between the 50 s and 60 s (p<0.01). In females, significant differences were found between the 40 s and 50 s (p<0.001) and between the 60 s and 70 s (p<0.001). The differences of the survival probability by age group were greater in the short-distance group than in the long-distance group. CONCLUSIONS: The results suggest that age is the most important factor for compliance of the patients with SPT, not only alone but also in relation to the other factors.     

The theory of reasoned action and patient compliance during orthodontic treatment

OBJECTIVES: The aim of the present study was to investigate the potential of the theory of reasoned action (TRA) for the prediction and understanding of patients' intention to comply during orthodontic treatment and to analyze the effect of two additional variables in the model, namely perceived behavioral control and anticipated regret. Moreover, (the determinants of) intentions of orthodontic patients to comply during treatment were compared with (the determinants of) intentions of parents to stimulate this cooperation. METHODS: A questionnaire was handed out to patients and parents visiting the Department of Orthodontics of the Academic Centre of Dentistry in Amsterdam. In both the patient and parent sample, independent-sample t-tests, correlation analyses and stepwise regression analyses were conducted. Variables in both samples were compared and tested. RESULTS: The extended version of the TRA explained 20% of the variance in the patients' intention to comply. The patients' anticipated regret, attitude and motivation to comply were significant determinants of the patients' intention to comply. In addition, the parents' attitude toward compliance was a significant predictor. The role of parents in enhancing patients' intentions to comply cannot be neglected. CONCLUSION: Our findings suggest that patients' intentions to comply during orthodontic treatment are influenced by factors outside of the TRA. Therefore, it is recommended to develop a new model, in which factors of the TRA are included, which can be used specifically for the study of compliance in orthodontics.     

结合菌斑显示进行口腔卫生宣教对牙周支持治疗依从性的影响

目的:探讨结合菌斑显示进行口腔卫生宣教对牙周支持治疗依从性的影响。方法:将20～60岁以"刷牙出血"为主诉的轻中度慢性牙周炎病人进行口腔卫生宣教、洁治和刮治。刮治后第1次复诊主诉刷牙出血消失[所有牙的龈沟出血指数(sulcus bleeding index,SBI)≤1,探诊深度(probing depth,PD)≤4]的97例男性病人和93例女性病人确定为研究对象。按就诊顺序随机分为实验组(96例,男49例,女47例)和对照组(94例,男48例,女46例)。实验组在菌斑显示后行口腔卫生宣教,对照组直接行口腔卫生宣教;制定复诊时间,记录1个月、3个月及6个月后复诊情况。用SPSS11.5软件进行数据处理,卡方检验分析每阶段两组复诊率的差异。结果:实验组在1个月、3个月及6个月的复诊率分别为42.7%、34.4%和46.9%;对照组分别为27.7%、14.9%和31.9%。实验组和对照组在各时间点的复诊率的差异均具有显著统计学意义(P<0.05)。结论:结合菌斑显示进行口腔卫生宣教可提高病人牙周支持治疗的依从性。     

Evaluation of cause-related periodontal therapy and compliance with maintenance care recommendations

Abstract An evaluation of the long-term clinical effects of an intense period of cause-related periodontal therapy provided by dental hygiene students, was made in patients with moderately advanced periodontitis. By the evaluation, we also intended to gain information about compliance with given recommendations for periodontal health maintenance. The results after 3 years without supervision by the specialist team showed that achieved beneficial effects on the gingival conditions were maintained despite a significant increase in plaque prevalence. Recommendations as to the daily use of a variety of additional oral hygienic measures besides toothbrushing met with a considerable lack of compliance. Maintenance visits to the referring general practitioner were mostly made once a year and included regular dental care. Despite this, no further deterioration of periodontal status was observed. The results indicate that it may be possible to maintain successful effects of periodontal therapy in this patient category with less personal and professional effort than traditionally recommended.     

Dental students' knowledge and compliance in cross infection control procedures at a UK dental hospital

OBJECTIVES: To assess the knowledge and clinical practice of dental students in infection control procedures at a UK dental hospital.
DESIGN: A questionnaire concerning various aspects of infection control was completed by all clinical dental students under examination conditions. Their actual clinical practice was later observed and certain aspects recorded.
SETTING: A UK dental hospital.
SUBJECTS: One hundred and eleven dental students from three clinical years completed the questionnaire. Clinical practice for all 3 years was observed in a total of 280 treatment events.
METHODS: The questionnaire was marked by two of the authors and observations recorded by another author. MAIN OUTCOME MEASURES: Degree of compliance with recognised policy for infection control.
RESULTS: Knowledge of infection control procedures was variable particularly concerning duties usually undertaken by the dental nurse. The suggested high compliance with masks and eye protection was not always apparent in clinical practice, although virtually all students washed their hands prior to donning gloves, which were worn by all students.
CONCLUSION: There can be marked differences between what students say they would do and what they actually do in clinical practice. The topic of infection control requires a pro-active approach throughout the course, since results for the final year were not significantly different from the other clinical yearS. Ways of improving compliance are discussed.