心理干预下青少年正畸患者的心理康复

与成人正畸患者相比,青少年患者由于主动性治疗诉求较少,主要以家长诉求为主,对于正畸治疗的配合不佳,矫治器损坏等情况时常发生,复诊频率高,经常表现出某些焦虑、抑郁症状.本研究对98例青少年正畸患者固定矫治器治疗前后患者的心理、行为等因素进行调查,探讨其心理康复的手段.     

口腔焦虑影响因素及相关口腔专科因素的调查分析

目的：调查影响口腔焦虑的相关因素，并深入分析口腔专科因素。方法：运用DAS量表及特质焦虑问卷对口腔不同专科共929例患者（女性591位，男性338位；20～59岁）进行调查，对数据进行统计分析。结果：多元逐步回归法显示性别、文化程度和口腔专科对口腔焦虑分值的影响有统计学意义。女性口腔焦虑明显高于男性，二者有统计学差异。有大学以上文化程度的患者，其口腔焦虑分值明显高于文化程度为中学、小学的患者，有统计学差异。口外专科患者口腔焦虑分值最高，与口腔修复专科、口内专科有显著性差异，与口腔正畸专科比较无显著性差异；口腔正畸专科、口腔修复专科和口内专科，三者之间口腔焦虑分值无显著性差异。结论：口腔焦虑的主要影响因素为性别、文化程度和口腔专科。口腔各专科患者焦虑状况的不同源于治疗方法的不同。针对口腔焦虑的原因可采取不同的干预措施。     

正畸治疗对患者生活质量的影响

目的：研究正畸治疗对患者日常行为的影响,评价患者在治疗过程中生活质量的变化。方法：随机抽取正畸治疗复诊患者400名进行间卷调查,年龄12～38岁,其中男133名,女267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：①在各项日常行为中,正畸治疗对患者的进食、口腔卫生及社会交往影响较大,疗程越长对患者工作学习的影响越大,并有统计学意义（P〈0．05）。②对正畸治疗影响的主观感受程度,不同疗程及不同年龄组患者之间有显著性差异（P〈0．05）。结论：正畸治疗影响患者的生活质量,并在矫治初期、长疗程及成年患者中表现更为明显。     

颞下颌关节紊乱病不同症状患者心理因素调查

目的研究颞下颌关节紊乱病（TMD）不同症状患者心理社会因素,尤其是焦虑的差别,为心理治疗对策提供试验依据。 方法206例就诊于天津医科大学口腔医院的TMD患者和201名无症状志愿者,填写症状自评量表（SCL-90）和状态-特质焦虑问卷（STAI）,根据患者主诉分组。采用SPSS 17.0统计软件,采用独立样本t检验和单因素方差分析对所有数据进行统计学分析。 结果（1）TMD患者SCL-90量表中的躯体化、抑郁、焦虑、敌对、精神病性因子得分及总分高于无症状志愿者,差异有统计学意义（t_躯体化 = 3.79,P_躯体化 = 0.000;t_抑郁 = 2.14,P_抑郁 = 0.033;t_焦虑 = 2.91,P_焦虑 = 0.004;t_敌对 = 3.93,P_敌对 = 0.000;t_精神病性 = 2.48,P_精神病性 = 0.013;t_总分 = 2.80,P_总分 = 0.005）;女性TMD患者的状态焦虑及特质焦虑得分均高于女性无症状志愿者（t_状态焦虑 = 3.52,P_状态焦虑 = 0.001;t_特质焦虑 = 4.26,P_特质焦虑 = 0.000）,两组男性之间差异无统计学意义（t_状态焦虑 = 0.36,P_状态焦虑 = 0.718;t_特质焦虑 = 0.76,P_特质焦虑 = 0.453）;（2）不同症状TMD患者在躯体化和状态焦虑方面差异有统计学意义（F_躯体化 = 2.714,P_躯体化 = 0.046;F_特质焦虑 = 3.007,P_特质焦虑 = 0.031）,具有单纯疼痛症状者躯体化得分高于单纯弹响患者（P = 0.005）,单纯弹响及疼痛伴弹响患者的特质焦虑得分高于疼痛伴开口受限者（P = 0.016）。 结论TMD患者心理健康水平比无症状人群低,主要表现在躯体化、抑郁、焦虑、敌对和精神病性方面。女性TMD患者有明显焦虑特征。单纯疼痛TMD患者躯体化比单纯弹响者更为明显。     

复方甘菊利多卡因凝胶对灼口综合征患者状态焦虑的缓解作用

目的:探讨复方甘菊利多卡因凝胶对灼口综合征(BMS)患者疼痛和焦虑情绪的缓解作用.方法:纳入BMS患者30例,分为安慰剂组、阳性对照组和甘美达治疗组,根据统一的局部给药方法,连续使用2周.采用视觉模拟评分法(VAS)评估治疗前后疼痛情况,状态-特质焦虑问卷(STAI)评估治疗前后状态焦虑(S-AI)和特质焦虑(T-AI...     

与经期有关的RAU患者焦虑水平的对照研究

目的：探讨与经期有关的复发性口腔溃疡（RAU）患者焦虑水平,为治疗女性RAU提供依据。方法：选取35例与经期有关的RAU患者,采用状态—特质焦虑量表（STAI）测查,并与35例健康妇女进行比较。结果：RAU患者的状态焦虑总分（STAI-S）为46．69±7．39,对照组为37．57±6．80（p〈0．01）;RAU病例组特质焦虑总分（STAI—T）为46．31±8．04,对照组为38．06＋7．00（p〈0．01）。结论：与经期有关的RAU患者焦虑水平较高,提示精神焦虑可能是女性RAU的影响因素。     

牙科焦虑与特质焦虑的相关研究

目的 探讨口腔患者牙科焦虑与特质焦虑的相关关系.方法 采用自评焦虑量表(Self-rating Anxiety Scale , SAS)和口腔焦虑测量量表(Dental Anxiety Scale, DAS)问卷对3000位年龄在25～35岁的口腔门诊患者进行牙科焦虑和特质焦虑的调查,对数据进行统计分析.结果 特质焦虑与牙科焦虑相关(P＜0.05 ).结论 特质焦虑患者比非特质焦虑患者更容易表现出牙科焦虑,且特质焦虑患者的牙科焦虑症状比非特质焦虑患者的牙科焦虑症状更不易减轻.为此, 口腔医生应对特质焦虑患者的牙科焦虑给予高度的重视.     

100例中重度牙周炎患者焦虑水平的对照研究

目的 :探讨中重度牙周炎患者的焦虑水平。方法 :选取 10 0例中重度牙周炎患者 (PPD≥ 4mm ) ,采用以状态 -特质焦虑询问表 (STAI)为基础的问卷进行测评 ,并与 10 0例无牙周病的健康自愿者进行比较。结果 :中重度牙周炎患者的状态焦虑总分 (AS)和特质焦虑总分 (AT)皆显著高于对照组 ( p <0 .0 5 )。 结论 :中重度牙周炎患者的焦虑水平较高 ,因而 ,精神焦虑可能是牙周炎的影响因素     

正畸患者就诊原因的调查研究

目的　 调查泸州地区正畸患者就诊的原因。方法　 将在泸州医学院附属口腔医院正畸科进行正畸治疗的452名患者纳为就诊人群组,泸州市第二中学的600名在校学生纳为非就诊人群组,对其进行问卷调查,并将两组问卷结果进行?掊２检验。结果　 就诊人群组收回有效问卷452份,非就诊人群组收回有效问卷529份。统计分析结果表明：①正畸治疗的主要目的是排齐牙列;②37.39％的正畸患者是应父母的要求来接受正畸治疗;③就诊人群组中期望排齐牙齿的患者占调查总人数的76.1%,其显著高于非就诊人群组（43.29％）;④就诊人群组多数人能够接受正畸所需时间及费用,其接受率高于非就诊人群组;⑤大部分正畸患者认为人的相貌很重要。结论　 美观是正畸患者前来就诊的主要原因。     

成人和青少年正畸患者对治疗相关认识的对比性研究

目的:研究成人与青少年正畸患者对正畸治疗的看法和认识差异.方法:对304名正畸初诊患者(分青少年组和成人组)进行有关正畸治疗的认识情况的问卷调查,主要调查内容包括正畸的主要目的、选择正畸的外部影响因素、对咬合及面型的关注程度和认识、治疗时关注因素,将调查结果进行统计学分析.结果:共收回有效问卷288份,显示成人组正畸治疗的目的更加多元化,其正畸治疗的主动性更强,对咬合、面型等更加关注,同时在治疗时的要求也更高.这些都与青少年组存在一定程度上的差异.结论:成年正畸患者对正畸治疗的目的和要求都高于青少年,需要更加慎重的对待.     

Does orthodontic treatment affect patients' and parents' anxiety levels?

The aims of this study were (1) to determine and compare the anxiety levels of two groups of patient and parents, (2) to identify possible gender differences between male and female subjects and (3) to evaluate any changes in anxiety levels after 1 year of treatment. The first group consisted of 40 subjects with a mean age of 15.6 +/- 1.2 years awaiting orthodontic treatment, plus one parent of each subject (mean age 43.4 +/- 2.3 years). The second group comprised 43 patients with a mean age of 16.0 +/- 1.1 years who had been undergoing treatment for a period of 1 year, plus one parent of each patient (mean age 41.0 +/- 1.9 years).Personal information forms and Spielberger's 'State and Trait Anxiety Inventory' (STAI) were applied to both groups. To compare the two groups and to determine the differences between males and females, independent-sample t-tests were used. Internal consistencies for the two scales of the STAI were evaluated with Cronbach's alpha coefficient.Trait anxiety levels of parents (51.05 +/- 5.1) and state anxiety levels of subjects (58.57 +/- 6.73) who were about to start orthodontic treatment were both high. The difference between the groups was statistically significant (P < 0.05). In patients who had undergone treatment for 1 year, the scores were found to be normal (43.28 +/- 5.91). However, their parents' high levels of trait anxiety remained unchanged (50.41 +/- 4.2).     

心理干预对青少年正畸患者心理及疗效影响研究

目的 探讨心理干预对于青少年正畸患者心理及疗效的影响。方法 选择2008年7月至2010年7月江苏省连云港市第二人民医院口腔科就诊的错牙合畸形患者62例,随机分为干预组及对照组,每组各31例,均采用标准直丝弓固定矫治。干预组予以正畸治疗同时辅以心理干预,对照组则仅进行常规正畸治疗。治疗前后根据抑郁自评量表（SDS）与焦虑自评量表（SAS）评分以及疗效标准进行评定。结果 青少年错牙合畸形患者正畸治疗前均有不同程度的焦虑或抑郁心理。干预组心理状况改善明显,两组SAS、SDS评分差异均有统计学意义（均P＜0.05）。两组治疗后疗效差异有统计学意义（P＜0.05）。结论 心理干预可明显降低青少年错牙合畸形患者焦虑抑郁心理,进而影响正畸治疗效果。     

�����Ԥ����������������������ЧӰ���о�

??Abstract??Objective To explore the influence of psychological intervention on juvenile patients in psychology and orthodontic treatment. Methods A total of 62 juvenile patients receiving orthodontic treatment were divided equally into two groups. Patients in control group only received routine orthodontic treatment and were told something to be noted??while patients in experimental group received psychological intervention and orthodontic treatment. A comparative study was carried out according to the Self-rating Anxiety Scale??SAS??and Self-rating Depression Scale??SDS??. Results There were higher prevalence of anxiety and depression in juvenile patients before receiving orthodontic treatment??and there was no significant difference between two groups. The psychological intervention patients in experimental group had lower scores than the control group in both SAS and SDS??P??0.05????and there was significant difference between two groups. After nearly 2 years of treatment??there was also significant difference between two groups in the treatment effect. Conclusion Psychological intervention can reduce the anxiety and depression of patients receiving orthodontic treatment and has greatly improved the curative effect of orthodontic treatment.     

唇腭裂患者家长寻求正畸治疗的Q方法调查

目的 探讨唇腭裂（cleft lip and/or palate,CLP）患儿家长的正畸治疗动机,为制定更加合理的治疗方案提供帮助。方法 采用Q方法对40例患儿家长进行调查,主要分为5部分— ①语句集合即收集所有关于CLP患儿家长寻求矫正的动机观点;② Q样本,由从语句集合中整理出的36条观点组成;③P样本,由40例寻求正畸治疗的CLP患儿家长组成;④Q排序,P样本被要求完成一张从“最同意”到“最不同意”的Q分布量表; ⑤分析,利用PQMethod 进行数据处理和分析。结果 根据参与者完成的Q分布处理分析,提取得到3个主要动机因素,将CLP患儿家长分为3种相应类型。类型1,“责任动力型”（13人）;类型2,“担忧型”（8人）;类型3,“混合功能型”（9人）。部分持分散观点的参与者不包括在以上3组内。结论 大多数参与者都能归类到以上3种类型中,结果有助于对CLP患儿制定更加合理的正畸治疗方案,提高家长及患儿的合作性,以期取得更满意的效果。     

The influence of a structured telephone call on orthodontic pain and anxiety.

INTRODUCTION: This purpose of this study was to examine the effects of a structured telephone call after orthodontic appliance placement on self-reported pain and anxiety. METHODS: One hundred-fifty orthodontic patients were randomly assigned to 1 of 3 groups and matched for age, sex, and ethnicity. The subjects completed baseline questionnaires to assess their levels of pain (on a 100-mm visual analog scale) and anxiety (Spielberger's State-Trait Anxiety Inventory) before orthodontic treatment. After the initial archwires were placed, all subjects completed the pain questionnaire and state-anxiety inventory at the same time daily for 1 week. One group also received a structured telephone call demonstrating care and reassurance; the second group received an attention-only telephone call, thanking them for participating in the study; the third group served as a control. RESULTS: Although both telephone groups reported significantly less pain (P = .005) and state-anxiety (P = .033) than the control group, there was no difference between the 2 telephone groups (P > .12 for pain; P > .81 for state-anxiety). CONCLUSIONS: A telephone call from a health-care provider reduced patients' self-reported pain and anxiety; the content of the telephone call was not important.     

个体化口腔卫生强化教育对固定矫治的青少年患者口腔卫生的影响

目的：探讨个体化口腔卫生强化教育对固定矫治的青少年患者口腔卫生的影响.方法：11～15岁的正畸初诊患者80例随机分为实验组和对照组各40例,实验组进行个体化口腔卫生强化教育,由口腔医生对学生进行个体化的口腔强化教育和有效刷牙教育,并同时得到家长和老师的监督;对照组进行一般口腔卫生知识宣教,不采取任何干预措施.记录两组治疗前后的正畸菌斑指数（PLI-O）和牙龈出血指数（BI）.结果：3个月后个体化口腔卫生强化教育组青少年患者的正畸菌斑指数（PLI-O）和牙龈出血指数有显著差异（P＜0.05）.结论：个体化口腔卫生强化教育对改善正畸青少年口腔卫生状况有显著作用.     

The evaluation of anxiety and salivary cortisol levels in patients with oral lichen planus

OBJECTIVE: The aim of this study was to determine any association between anxiety and salivary cortisol levels in oral lichen planus (OLP) patients by the case-control method. DESIGN RELEVANT: Forty patients with OLP were evaluated. The OLP diagnosis was established through a composite of accepted clinical and histopathological characteristics. Forty patients from the register of patients who obtained general dental care were selected as controls. MATERIAL AND METHOD: The saliva samples collected between 9:00 and 9:15 am were analysed for the level of cortisol with Cortisol EIA that used competitive enzyme-linked immunosorbent assay method. Trait and state anxiety levels of 80 patients were measured using the Spielberger's State-Trait Anxiety Inventory. RESULTS: The mean level of cortisol from 40 saliva samples in study group was 1.46 and 0.93 microg dl(-1) in 40 controls (P=0.001). The mean level for state anxiety in the study group were 48.85 and 39.45 in control group (P=0.001). Trait anxiety levels in study group were 49.77 and 38.51 in control group (P=0.001). We found that salivary cortisol, state and trait anxiety levels in OLP group were significantly higher than in the control group. CONCLUSION: Because of the fact that the level of anxiety and salivary cortisol of OLP patients were high, our findings concluded that this disease is closely related with stress. Thus besides traditional treatment of OLP patients, our findings suggest that psychological support is also needed.     

Effect of text message follow-up on patient's self-reported level of pain and anxiety

Objectives:To determine whether a text message reduces the severity of patient self-reported levels of pain and anxiety following initial placement of orthodontic appliances.Materials and Methods:Thirty-nine orthodontic patients were randomly assigned to one of two groups and matched for age, gender, and bracket type (self-ligating vs conventional). The subjects completed baseline questionnaires to ascertain their levels of pain and anxiety before initiating orthodontic treatment. Following the initial appointment, subjects completed the pain questionnaire and anxiety inventory at the same time daily for 1 week. One group received a structured text message showing concern and reassurance, while the second group served as a control and received no postprocedural communication.Results:There was a statistically significant difference in pain in relation to time between the text message group and the control group as it was demonstrated that demonstrated that compared with the text message group, mean pain intensity increased and selfreported discomfort was longer in the control group. Anxiety was determined to be at its peak the day following initial orthodontic appliance placement and gradually tapered off from that time point. No intergroup difference was noted when analyzing anxiety.Conclusions:This study demonstrated that a text message sent from an orthodontic office following initial appliance placement resulted in a lower level of patient''s self-reported pain. Additionally, patient anxiety is at its peak the day following the initial appointment and decreases from that point forward.     

边缘骨性Ⅲ类错[牙合]手术与非手术效果的对比分析

目的：比较边缘骨性Ⅲ类错[牙合]正颌手术与正畸掩饰治疗（拔牙）后的效果差异。方法：对两组骨性Ⅲ类手术边缘病例治疗前后的X线头颅侧位片进行对比分析,其中手术治疗组12例,单纯正畸组13例,所有病例治疗前ANB角都〉-5°。结果：手术组治疗的主要变化是下颌骨前齿槽区的后移及下切牙的直立,正畸组的主要变化是下切牙的后倾及后移。两组治疗后的X线头影测量值经Mann-Whitney U检验显示ANB角,上下颌骨长度比（M/M ratio）,NAPog角,下切牙倾斜角（∠L1/ML）,上下切牙交角（∠U1/L1）有显著性差异,而标志软组织凹陷度的Holdaway角和Z角没有差异。结论：对于骨性Ⅲ类手术边缘错而言,选择合适的病例,手术与正畸掩饰治疗都可以获得可接受的咬合和美观效果。     

芬必得胶囊减轻固定矫治器初戴后疼痛的临床观察

目的探讨芬必得胶囊(Fenbid Capsules,布洛芬缓释胶囊)对固定矫治器患者初戴后疼痛的治疗效果及不良反应。方法用随机、双盲法研究芬必得胶囊对固定矫治器患者初戴后疼痛的的治疗效果,与安慰剂对照。通过改良牙科焦虑量表筛选出128例非牙科焦虑症患者,随机分为芬必得组(实验组)和安慰剂组(对照组),每组64例,通过0~10数字疼痛强度量表对患者7d内的正畸疼痛水平(自发痛、激惹痛)进行评分,对比其治疗效果及不良反应。结果在固定矫治器患者初戴后的2h、6h、1d、2d、3d,实验组的正畸疼痛水平(自发痛、激惹痛)均明显低于对照组,差异有统计学意义(P<0.05);在第7d,2组疼痛水平无统计学差异(P>0.05);未发现用药不良反应。结论芬必得对固定矫治器患者初戴后疼痛(自发痛、激惹痛)的缓解有较好的临床效果。