微种植体支抗植入患者牙科焦虑的调查分析

目的研究微种植体支抗（MIA）植入患者牙科焦虑症的影响因素及术前焦虑程度高对术后疼痛的影响。 方法采用改良牙科焦虑量表（MDAS）和视觉模拟量表（VAS）对2016年8月至2018年5月在佛山市口腔医院进行MIA植入的患者进行焦虑情况及术后疼痛程度的调查,共发出问卷553份,回收有效问卷509份,有效率为92.04%。采用成组设计t检验分别统计不同性别、年龄、文化程度、婚姻状况及收入水平间MDAS值差异是否显著,并采用两因素重复测量方差分析评估不同焦虑程度术后疼痛程度VAS评分差异是否显著。 结果接受MIA植入的患者术前MDAS平均值为（11.24 ± 3.05）分,其中,大于11分占58.9%。男性患者的MDAS值为（9.85 ± 2.12）分,女性患者的MDAS值为（12.41 ± 2.56）分,差异有统计学意义（t = -12.18,P<0.001）;12 ~ 18岁患者的MDAS值为（13.27 ± 3.12）分,18岁以上患者的MDAS值为（10.53 ± 2.36）分,差异有统计学意义（t = 10.51,P<0.001）;未婚患者的MDAS值为（11.06 ± 2.96）分,已婚患者的MDAS值为（11.63 ± 2.75）分,差异有统计学意义（t = -2.07,P = 0.039）;文化程度为专科及以下患者的MDAS值为（11.95 ± 2.37）分,文化程度为本科及以上患者的MDAS值为（10.46 ± 3.01）分,差异有统计学意义（t = 6.23,P<0.001）;收入低于2万/月的患者的MDAS值为（11.13 ± 2.14）分,收入2万/月及以上患者的MDAS值为（11.58 ± 3.02）分,差异无统计学意义（t = -1.82,P = 0.068）。低焦虑组患者及高焦虑组患者在术后2、6、24和48 h的VAS值差异均有统计学意义（P<0.001）。 结论MIA植入患者牙科焦虑症患病率较高,与性别、年龄、文化程度及婚姻状况有密切关系,术前焦虑程度高患者术后疼痛的强度高。

Investigation and analysis of dental anxiety in patients with mini-implant anchorage

ObjectiveTo study the influence factors of dental anxiety in patients with mini-implant anchorage (MIA) and the effect of preoperative anxiety level on postoperative pain. MethodsThe dental anxiety and postoperative pain of patients with MIA implantation in Foshan Stomatology Hospital were investigated by modified dental anxiety scale (MDAS) and visual analogue scale (VAS) . A total of 553 questionnaires were sent out and 509 effective questionnaires were recovered. The effective percentage was 92.04%. Group t-test was used to compare the MDAS among different genders, ages, education levels, marital status and income levels. Two-Way repeated measures ANOVA was used to evaluate the VAS score of postoperative pain in different anxiety levels. ResultsThe mean preoperative MDAS of patients with MIA implantation was 11.24 ± 3.05, 58.9% of which was higher than 11. The MDAS of male patients was 9.85 ± 2.12 while that of female patients was 12.41 ± 2.56 (t=-12.18, P<0.001) . The MDAS of 12-18-year-old patients was 13.27 ± 3.12, and that of over 18-year-old ones was 10.53 ± 2.36 (t = 10.51, P<0.001) . The MDAS of unmarried and married patients were 11.06 ± 2.96 and 11.63 ± 2.75, respectively (t = -2.07, P = 0.039) . The MDAS of the patients with education level of junior college or below was 11.95 ± 2.37 and that of undergraduate or above was 10.46 ± 3.01 (t = 6.23, P<0.001) . The MDAS value of patients with income lower than 20 000/month was 11.13 ± 2.14, and that of income of 20 000/month and above was 11.58 ± 3.02 (t = -1.82, P = 0.068) . There was statistical difference in the level of dental anxiety among the groups of gender, age, education level and marital status, but no statistical difference was found in the level of dental anxiety among the income groups. The VAS value of 2 hours after implantation in low anxiety group and high anxiety group were 2.12 ± 0.78 and 3.13 ± 1.28 (t = -11.23, P<0.001) ; and 6 hours after implantation in two groups were 5.83 ± 1.25 and 6.54 ± 2.12 (t = -4.37, P<0.001) ; and 24 hours after implantation in two groups were 1.93 ± 0.65 and 2.09 ± 1.13 (t = -2.04, P<0.001) ; and 48 hours after implantation in two groups were 0.35 ± 0.12 and 0.54 ± 0.21 (t = -14.78, P<0.001) . There was statistical difference in the VAS value of different anxiety levels at different time points. ConclusionsThe prevalence of dental anxiety in patients with mini-implant anchorage is high, which is closely related to gender, age, education and marital status. The patients with high anxiety before operation have high intensity of pain after operation.