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无托槽隐形矫治中牙釉质脱矿情况的临床调查

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目的 调查无托槽隐形矫治过程中牙釉质脱矿的发病率及脱矿严重程度,为临床医疗护理工作提供参考依据.方法 收集 2015 年-2022 年于我院进行无托槽隐形矫治的 151 例患者(3 507 颗牙齿),对比观察其治疗前后的牙釉质脱矿情况,使用釉质脱矿指数(enamel decalcification index,EDI)评估脱矿程度,对患者牙釉质脱矿的发病率和脱矿严重程度进行统计分析,比较不同性别、年龄及牙位之间的差异.结果 治疗过程中有 84 例患者出现釉质脱矿,发病率为 55.63%,性别及治疗时间对发病率无影响,青少年患者发病率高于成年患者.在被调查的 3 507 颗牙齿中有 601 颗出现釉质脱矿,发病率为17.14%,其中上颌前牙和下颌后牙的发病率较高,右侧牙齿的发病率显著高于左侧牙齿,粘接附件后釉质脱矿的发病率也显著增加.88%的牙釉质脱矿病损程度为 1~2 度,男女患者釉质脱矿程度相似,青少年的釉质脱矿程度显著高于成年患者,上颌前牙的平均EDI值明显大于下颌,上颌后牙的平均EDI值明显小于下颌,右侧的平均EDI值明显大于左侧.结论 无托槽隐形矫治过程中出现牙釉质脱矿的发病率较高,且青少年是易感人群,不同牙位之间的脱矿情况有显著差异,粘结附件会增加牙齿釉质脱矿风险.因此医护人员应在釉质脱矿的防治工作中采取积极有效的措施.
Clinical investigation of enamel demineralization during clear aligner treatment
Objective To investigate the incidence and severity of enamel demineralization during clear aligner treatment and provide reference for clinical medical nursing work.Methods A total of 151 patients(3 507 teeth)undergoing clear aligner treatment in our hospital from 2015 to 2022 were collected.The enamel demineralization before and after treatment was compared,and the enamel demi-neralization index(EDI)was calculated to evaluate the severity of demineralization.The incidence and severity of enamel demineraliza-tion were analyzed statistically,and the differences among different genders,ages and dental positions were compared.Results Enam-el demineralization occurred in 84 patients during treatment,with an incidence rate of 55.63%.Gender and treatment time had no effect on the incidence,and the incidence of adolescent patients was higher than that of adult patients.Among the investigated 3 507 teeth,601 teeth had enamel demineralization,and the incidence rate was 17.14%.The incidence of maxillary anterior teeth and mandibular posterior teeth was higher;the incidence of right teeth was significantly higher than that of left teeth,and the incidence of teeth with ad-hesive attachments was also significantly increased.88%of the enamel demineralization lesions were 1-2 degrees,and the degree of enamel demineralization was similar in male and female patients.But the degree in adolescents was significantly higher than that in adult patients.The average EDI value of maxillary anterior teeth was significantly higher than that of mandible,but that of maxillary posterior teeth was significantly lower than that of mandible.The average EDI value of right teeth was significantly higher than that of left.Conclusion The incidence of enamel demineralization is high in the process of clear aligner treatment,and teenagers are suscep-tible to it.The demineralization of teeth is significantly different among different tooth positions,and adhesive attachments will increase the risk of enamel demineralization.Therefore,medical staff should take active and effective measures in the prevention and treatment of enamel demineralization.

orthodonticsclear aligner treatmentenamel decalcification

胡丹艳、陈慧芬、吴峻青、李琥、严斌、韶青华

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南京医科大学附属口腔医院正畸科,江苏南京(210029)

江苏省口腔疾病研究重点实验室,江苏南京(210029)

江苏省口腔转化医学工程研究中心,江苏南京(210029)

南京医科大学附属口腔医院牙体牙髓科,江苏南京(210029)

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正畸 无托槽隐形矫治 牙釉质脱矿

江苏省重点研发计划临床前沿技术项目江苏省科教能力提升工程——江苏省研究型医院建设单位江苏省医学创新中心

BE2022795YJXYYJSDW4CXZX202227

2024

口腔医学
南京医科大学口腔医学院

口腔医学

CSTPCD
影响因子:0.641
ISSN:1003-9872
年,卷(期):2024.44(10)