【作者】 王家佳；

【导师】 张绍伟； 张疆弢；

【作者基本信息】 遵义医学院 ， 口腔临床医学， 2009， 硕士

【摘要】 目的:比较不同干预措施对青少年固定矫治患者口腔卫生维护的影响,探讨一种患者易于接受并能长期坚持的口腔卫生维护办法。方法:按照纳入和排除标准,选择青少年固定矫治患者210例,将其随机分为三组,分别为实验1组:复方茶多酚含漱液+口腔卫生强化组;实验2组:口腔卫生强化组;实验3组:对照组,每组70例。所有患者在干预前1周进行全口洁治,洁治后1周(基线)、干预后的第4、8及第12周时用牙龈指数(GI)、菌斑指数(PLI)对患者牙周状况进行检测,并在基线及复诊时对两个干预组的患者进行问卷调查,通过临床指标检测和患者主观感受评分,来评价干预措施的有效性。结果:(1)干预前,实验各组各项观察指标比较,差异均无统计学意义(P＞0.05),基线可比。(2)GI:①组间比较:干预后第4、8及第12周时,各组组间比较GI均有高度显著性差异(P＜0.01)。②组内比较:随着观察时间的延长,实验1组GI值在第4、8及12周时较基线时降低,经统计学分析,均有高度显著性差异(P＜0.01);其它各个时间检测的GI值两两之间进行比较,均无统计学差异(P＞0.05)。实验2组GI值在基线时与第4周比较,第4周与第12周时比较,统计分析其有高度显著性差异(P＜0.01);而基线与第8周时比较GI值有显著性差异(P＜0.05);基线与第12周比较,第4周与第8周比较及第8周与第12周时比较,GI值均无统计学意义(P＞0.05)。对照组GI值在基线、第4周、第8周及第12周时各不同,从基线至12周,GI逐渐上升,进行两两比较,均有高度显著性差异(P＜0.01)。(3)PLI:①组间比较:干预后第4、8周及第12周时,三个组PLI值各不相同,经方差分析,三个组两两间比较均有高度显著性差异(P＜0.01)。②组内比较:实验1组PLI值基线时分别与第4、8及12周时比较,第4周与第12周及第8周与第12周时比较,PLI均有高度显著性差异(P＜0.01),而第4周与第8周时比较,PLI值无统计学差异(P＞0.05)。实验2组PLI值在基线时与第4、8及第12周时比较均不相同,经统计分析有高度显著性差异(P＜0.01);第4周与第12周时比较,PLI有显著性差异(P＜0.05);第4周与第8周比较,第8周与第12周时比较,PLI值无统计学意义(P＞0.05)。对照组菌斑指数随着观察时间的延长呈逐渐增长趋势,基线时与第8、第12周,第4周与第8、12周及第8周与12周比较,PLI值有高度显著性差异(P＜0.01),第4周PLI值较基线时高,但无统计学差异(P＞0.05)。(4)问卷调查:在两个干预组中,有75%以上的患者均赞同固定矫治期间医生给予的口腔卫生强化教育措施,且干预后赞同人数更多,各个调查项目显示同意率均有所增加,只有1至3例患者对所强化的口腔卫生知识及给予的措施仍“不知道”。80%以上的患者在第4、8及第12周时对含漱液的味道,带来的口气,舒适度及方便性几个方面均较满意,从第4周到第12周,患者满意率上升。结论:两种干预措施均能提高患者的口腔卫生水平,且患者对实施的两种措施满意率高,对复方茶多酚含漱液反应良好,使用复方茶多酚含漱液配合患者口腔卫生强化教育更有助于患者长期积极的维护自身的口腔卫生,其可作为维护固定矫治患者口腔卫生的重要措施,具有良好的应用前景。更多还原

【Abstract】 Objective: The purpose of this study is to compare the effect of two different intervention measures on oral hygiene maintenance in adolescent patients during orthodontic treatment with fixed appliance, and to explore a measure to maintain periodontium which was easy to accept for a long-term.Methods: Inclusion and exclusion were used to select 210 subjects who were randomly divided into three groups, with different oral of hygiene prophylaxis, each group 70 patients. The experimental group one strengthened oral health education combined with using the local application of compound tea polyphenols gargle. The experimental group two only reinforced oral health education. The control group was treated with conventional oral hygiene instruction. The patients accepted scaling one week before intervention. The periodontal indexes were examined at baseline, 4, 8and 12weeks after intervention and questionnaire survey was conducted among the two experimental group patients in order to evaluate the validity of interventions by examining clinical index and subject perception of patients.Results: (1) There were no significant differences for plaque index and gingival index among groups before intervention (P>0.05), the baseline was comparable.(2) GI: The comparison among three groups :there were highly significant differences of the gingival index among the three groups at 4, 8 and 12 weeks after intervention(P<0.01). With the observational time prolonged ,the gingival index decreased at 4, 8, 12weeks compared with baseline in experimental group one(P<0.01). The gingival index was no significant among the other weeks(P>0.05). The gingival index were highly different between baseline and 4weeks, 4weeks and 12weeks in experimental group two(P<0.01); there was difference between baseline and 8weeks(P<0.05).There were no differences of gingival index between baseline and 12weeks, 4 and 8weeks, 8 and 12weeks(P>0.05).The gingival index worked up from baseline to 4, 8,12weeks in control group, there were notably significant differences between baseline, 4, 8 and 12weeks(P<0.01).(3) PLI: The comparison among three groups: there were highly significant differences of the plaque index among the three groups at 4, 8 and 12weeks after intervention (P<0.01). There were highly significant differences of the plaque index between baseline and 4, 8 and 12 weeks, 4 and 12 weeks, 8 and 12 weeks in experimental group one(P<0.01), and no significant difference between 4 and 8weeks(P>0.05).There were highly significant differences between the baseline and 4, 8 and 12weeks (P<0.01), statistically significant differences between 4weeks and 12weeks (P<0.05), and no significant differences between 4 and 8weeks, 8 and 12weeks in experimental group two (P>0.05). With the extension of observation time, the plaque index gradually increased at 4, 8 and 12weeks. There were highly significant differences between the baseline and 8, the baseline and 12weeks, the 4weeks and 8weeks, 4weeks and 12weeks, the 8weeks and 12 weeks (P<0.01). The plaque index was higher than baseline in 4 weeks after the intervention , but there was no significant differences between them(P>0.05).(4) Questionnaire survey: More than 75% patients approved the intervention measure, the data showed that more patients agreed with the reinforced oral hygiene prophylaxis after intervention. Only one or three patients didn’t understand the oral health knowledge and the intervention measure. With the time prolonged, more than 80% patients satisfied with the taste, odor, comfort and convenience of compound tea polyphenols gargle. The satisfaction rate were gradually increased from 4weeks to 12weeks.Conclusion: The datas of clinical examination and questionnaire investigation indicated that whether only strengthened oral health education or reinforced oral health education combined with local application of compound tea polyphenols gargle were helpful for improving oral health status and maintaining periodontium with fixed appliance, furthermore, using the extra compound tea polyphenols gargle was more effective than strengthened oralhealth education only.更多还原