摘要
目的 调查石家庄市3～14岁儿童错(牙合)畸形的发生率,并构建错(牙合)畸形的预测模型.方法 采取整群抽样法,于2023年5-10月抽取石家庄市8个区幼儿园、小学及初中共6 591名3～14岁儿童作为调查对象,对其开展牙(牙合)发育情况的检查,并分成错(牙合)组和正常组.收集儿童一般资料、喂养情况、饮食情况、是否存在口腔不良行为等信息开展单因素分析,通过多因素分析确定错(牙合)畸形的影响因素,并据此构建预测模型,然后通过ROC曲线下面积(AUC)、校准曲线及决策曲线检验模型的预测效能.结果 6 591名儿童中,检出错(牙合)畸形4 342名,错(牙合)畸形发生率为65.88％;错(牙合)畸形主要类型为深覆(牙合)、深覆盖、牙列拥挤,发生率分别为26.61％、19.60％、15.73％.Logistic回归分析显示,3～14岁儿童错殆畸形发生的危险因素包括有家族遗传史、奶瓶喂养时间＞12个月、食物精细度高、吮唇、咬物、单侧咀嚼、口呼吸、患有龋齿(P＜0.05).内部验证显示,AUC为0.818(95％CI:0.763～0.873),校准曲线的拟合较佳,拟合优度HL检验x2=9.904,P=0.275,阈值概率处于3％～81％时预测模型净获益率较理想.结论 基于有无家族遗传史、奶瓶喂养时间、食物精细度、是否存在口腔不良习惯(吮唇、咬物、单侧咀嚼、口呼吸)、有无龋齿构建的列线图可对石家庄市3～14岁儿童错(牙合)畸形发生风险进行较好地预测.
Abstract
Objective To investigate the prevalence of malocclusion among children aged 3-14 years in Shijiazhuang City,and to construct a predictive model for malocclusion.Methods Using cluster sampling,a total of 6 591 children aged 3-14 years from kindergartens,primary schools,and junior high schools in eight districts of Shijiazhuang City were selected as subjects for examination of dental development from May to October 2023.Children were divided into malocclusion and normal groups.Univariate analysis were conducted on information collected regarding children's demographic data,feeding practices,dietary habits,and presence of oral maladaptive behaviors.Multivariate analysis identified factors influencing malocclusion,based on which a predictive model was developed.The model's predictive performance was evaluated using the area under the ROC curve(AUC),calibration curves,and decision curves.Results Among the 6 591 children surveyed,4 342 cases of malocclusion were identified,yielding a prevalence rate of 65.88％.The primary types of malocclusion were deep overbite,deep overjet,and crowded teeth,with rates of 26.61％,19.60％,and 15.73％,respectively.Logistic regression analysis revealed that risk factors for malocclusion in children aged 3-14 years included a family history of malocclusion,bottle-feeding duration＞12 months,high food fineness,lip-sucking,object-biting,unilateral chewing,mouth breathing,and presence of dental caries(P＜0.05).Internal validation showed an AUC of 0.818(95％CI:0.763-0.873),good calibration curve fit,and a Hosmer-Lemeshow goodness-of-fit test(x2=9.904,P=0.275).The prediction model demonstrated satisfactory net benefit rates when the threshold probability ranged from 3％to 81％.Conclusion A nomogram constructed based on the presence or absence of a family history of malocclusion,bottle-feeding duration,food fineness,and oral maladaptive behaviors(lip-sucking,object-biting,unilateral chewing,mouth breathing),as well as the presence or absence of dental caries,can predict the risk of malocclusion occurrence reasonably well among children aged 3-14 years in Shijiazhuang City.
万方数据