微种植钉联合自我效能干预对露龈笑患者侧貌、面型及心理状态的影响

摘要/Abstract

摘要： ［摘要］目的探讨微种植钉联合自我效能干预对青少年骨性Ⅱ类高角露龈笑患者侧貌、面型及心理状态的影响。方法 2016年4月至2018年11月招募就诊于正畸科的90例露龈笑患者，均采用直丝弓矫治技术进行正畸治疗，并采用随机数字表的方法分三组，每组30例，常规治疗组（常规组）采用高位J钩牵引治疗，微种植钉组（微钉组）接受微种植钉法治疗，联合组在微种植钉法治疗基础上加用自我效能干预治疗。比较三组牙龈暴露量、侧貌和面型指标及心理状态。结果三组治疗前牙龈暴露量相比无差异（P>0.05），与常规组相比，治疗后4、6、8个月，微钉组牙龈暴露量均显著降低（P<0.05），而联合组改善效果更优于微钉组（P<0.05）。治疗后8个月，微钉组侧貌、面型指标变化优于常规组（P＜0.01），而联合组与微钉组无差异（P>0.05）。常规组治疗前后心理焦虑、抑郁评分无显著差异（P>0.05），微钉组、联合组治疗后显著降低（P＜0.01），且联合组优于微钉组（P＜0.01）。与常规组相比，微钉组满意度显著提高（P＜0.05），联合组满意度为93.3%，微钉组为70.0%，两组相比差异显著（P＜0.05）。结论微种植钉联合自我效能干预显著改善口腔正畸患者牙龈暴露量，对患者侧貌、面型也有一定效果，且治疗过程负面情绪有效缓解。

关键词: 微种植钉, 自我效能干预, 口腔正畸, 软组织, 心理状态

Abstract: Objective: To explore the effect of micro-implant nail combined with self-efficacy intervention on the profile, facial shape and psychological status of adolescents with orthodontic treatment. Methods: From April 2016 to November 2018, 90 patients with gingiva in orthodontic Department of our hospital were recruited and randomly divided into three groups, 30 in each group. The routine group was treated with high J hook traction, the micro-needle group was treated with micro-implant nail, and the combined group was treated with self-efficacy intervention. The gingival exposure, profile, facial type and psychological status of the three groups were compared.Result: There was no significant difference in gingival exposure among the three groups before treatment (P > 0.05). After 2, 3 and 4 months of treatment, the gingival exposure in the microneedle group and the combined group was lower than that in the conventional group (P< 0.01), and the combined group had better effect (P< 0.01). After 4 months of treatment, the changes of side appearance and facial shape indexes in the micro-needle group and the combined group were better than those in the conventional group (P < 0.01), but there was no difference between the micro-needle group and the combined group (P > 0.05). There was no significant difference in SAS and SDS scores before and after treatment in the conventional group (P > 0.05). Compared with before treatment, SAS and SDS scores in the micro-needle group and the combined group were significantly lower after treatment (P < 0.01), and the combined group was better than the micro-needle group (P < 0.01). Compared with the conventional group, the satisfaction of micro-needle group and combined group was significantly improved (P > 0.01), the satisfaction of combined group was 93.3%, and that of micro-needle group was 70.0%. The difference between the two groups was significant (P > 0.01). Conclusion: Microimplant nail combined with self-efficacy intervention can significantly improve gingival exposure in patients with orthodontic treatment. It also has certain effect on patients'profile and facial shape, and can effectively alleviate negative emotions in the treatment process.

Key words: micro-implant nail, self-efficacy intervention, orthodontics, soft tissue, psychological state

中图分类号:

R783.5

冯道宽刘进. 微种植钉联合自我效能干预对露龈笑患者侧貌、面型及心理状态的影响[J]. 口腔医学, 2020, 40(10): 922-926.

参考文献 20

[1]	Kravitz N D. Interceptive Orthodontics with Resin Turbos for Pseudo-Class III Malocclusions[J]. Case Rep Dent,2019,2019:1909063.
[2]	胡芳. 美学牙冠延长术治疗露龈笑的临床效果观察附20例临床病例[D]. 青岛大学,2018.
[3]	Alammar A M, Heshmeh O A. Lip repositioning with a myotomy of the elevator muscles for the management of a gummy smile[J]. Dent Med Probl,2018,55(3):241-246.
[4]	蒲晓芬，王震东，兰庭超，等. 微种植体支抗辅助矫治Ⅲ类错牙合对上气道的影响研究[J]. 口腔医学,2016,36(11):1020-1022.
[5]	郑衍亮. 自我效能干预在口腔正畸治疗中的应用研究[D]. 青岛大学,2015.
[6]	Alghamidi W A, Alghamdi S B, Assiri J A, et al. Efficacy of self-designed intraoral appliances in prevention of cheek, lip and tongue bite after local anesthesia administration in pediatric patients[J]. J Clin Exp Dent,2019,11(4):e315-e321.
[7]	张利. 改良上颌前方牵引口内装置对牙颌及软组织侧貌的影响[D]. 河北医科大学,2016.
[8]	Ji L L, Tsai W, Sun X L, et al. The detrimental effects of ambivalence over emotional expression on well-being among Mainland Chinese breast cancer patients: Mediating role of perceived social support[J]. Psychooncology,2019,28(5):1142-1148.
[9]	Azeem M, Afzal A, Jawa S A, et al. Effectiveness of electric toothbrush as vibration method on orthodontic tooth movement: a split-mouth study[J]. Dental Press J Orthod,2019,24(2):49-55.
[10]	Chagas T F, Almeida N V, Lisboa C O, et al. Duration of effectiveness of Botulinum toxin type A in excessive gingival display: a systematic review and meta-analysis[J]. Braz Oral Res,2018,32:e30.
[11]	杨丽俊，刘婷婷，林川，等. 青少年口腔正畸患者心理特点及心理干预效果的研究[J]. 临床口腔医学杂志,2018,34(03):157-160.
[12]	刘艺敏，韩杰，朱炎，等. 上海市区成人牙科畏惧症924例调查分析[J]. 同济大学学报(医学版),2007(02):97-99.
[13]	Duruel O, Ataman-Duruel E T, Berker E, et al. Treatment of Various Types of Gummy Smile With Botulinum Toxin-A[J]. J Craniofac Surg,2019,30(3):876-878.
[14]	林根辉，庄兢，郑清健. 下降提上唇肌起点联合唇珠延长治疗露龈笑21例[J]. 福建医药杂志,2017,39(05):77-79.
[15]	丁晓仪. 应用微种植钉改善Ⅱ类高角露龈笑的正畸治疗[D]. 大连医科大学,2016.
[16]	Alobeid A, El-Bialy T, Reimann S, et al. Comparison of the efficacy of tooth alignment among lingual and labial brackets: an in vitro study[J]. Eur J Orthod,2018,40(6):660-665.
[17]	Yang X, He Y, Chen T, et al. Differences between active and passive self-ligating brackets for orthodontic treatment : Systematic review and meta-analysis based on randomized clinical trials[J]. J Orofac Orthop,2017,78(2):121-128.
[18]	郑衍亮，张作记，陈杰. 自我效能干预在口腔正畸治疗中的应用[J]. 国际口腔医学杂志,2017,44(02):161-164.
[19]	李琦，王春玲，王红，等. 正畸患者对姿势位微笑上唇位置的审美评价[J]. 口腔医学,2016,36(02):124-128.
[20]	Kim D H, Sung S J. Nonsurgical correction of a Class III skeletal anterior open-bite malocclusion using multiple microscrew implants and digital profile prediction[J]. Am J Orthod Dentofacial Orthop,2018,154(2):283-293.