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正畸治疗需求和错牙合特征对儿童口腔健康相关生活质量的影响:一项世代研究中的横断面研究。

Impact of orthodontic treatment need and deviant occlusal traits on oral health-related quality of life in children: A cross-sectional study in the Generation R cohort.

机构信息

The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.

The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands; Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands.

出版信息

Am J Orthod Dentofacial Orthop. 2020 Jun;157(6):764-772.e4. doi: 10.1016/j.ajodo.2019.06.015.

Abstract

INTRODUCTION

Many studies have investigated the impact of orthodontic treatment need (OTN) on children's oral health-related quality of life (OHRQOL). However, few studies have explored the impact of deviant occlusal traits on OHRQOL regarding the severity of OTN. This cross-sectional study aims to address this gap in the literature.

METHODS

This study was conducted within the Generation R Study, a population-based prospective cohort study. We assessed OTN with the Index of Orthodontic Treatment Need and OHRQOL with a parental short-form of the Child Oral Health Impact Profile in 3048 children at a median age of 9.74 years (9.5-10.0). We also further assessed individual malocclusion traits in a subsample of 2714 children. We investigated the association between OTN, malocclusion traits, and OHRQOL using multiple regression analysis with weighted least squares.

RESULTS

Children with definite (adjusted effect estimate = -0.81; 95% confidence interval -1.12 to -0.50) or borderline (adjusted effect estimate = -0.34; 95% confidence interval -0.61 to -0.08) OTN experienced significant decreases in their OHRQOL than those with no need. An impacted tooth, increased overjet, or crowding had significant negative impacts on children's OHRQOL. Children with an overjet experienced negative impacts on OHRQOL even when orthodontic treatment was not necessary.

CONCLUSIONS

Progressively greater OTN has increasingly negative impacts on parent's perception of children's OHRQOL. In particular, children presenting with large overjets and impacted teeth have lower OHRQOL. These perspectives add to better patient-clinician communication and understanding of patient expectations around OTN, which may potentially lead to improvements in quality of care from the patient perspective.

摘要

引言

许多研究已经探讨了正畸治疗需求(OTN)对儿童口腔健康相关生活质量(OHRQOL)的影响。然而,很少有研究探讨异常咬合特征对 OHRQOL 的影响,特别是针对 OTN 的严重程度。本横断面研究旨在填补这一文献空白。

方法

本研究在“世代研究”中进行,这是一项基于人群的前瞻性队列研究。我们使用正畸治疗需求指数(Index of Orthodontic Treatment Need)评估 OTN,使用儿童口腔健康影响简表(Child Oral Health Impact Profile)的家长简表评估 OHRQOL,研究对象为 3048 名儿童,平均年龄为 9.74 岁(9.5-10.0)。我们还在 2714 名儿童的亚样本中进一步评估了个体错颌特征。我们使用加权最小二乘法的多元回归分析,研究 OTN、错颌特征与 OHRQOL 之间的关系。

结果

有明确(调整后的效应估计值为-0.81;95%置信区间为-1.12 至-0.50)或临界(调整后的效应估计值为-0.34;95%置信区间为-0.61 至-0.08)OTN 的儿童,其 OHRQOL 明显低于无需要的儿童。一颗受影响的牙齿、增加的覆𬌗或拥挤对儿童的 OHRQOL 有显著的负面影响。即使不需要正畸治疗,有覆𬌗的儿童也会对 OHRQOL 产生负面影响。

结论

逐渐增加的 OTN 对父母对儿童 OHRQOL 的感知有越来越大的负面影响。特别是,具有较大覆𬌗和受影响牙齿的儿童 OHRQOL 较低。这些观点有助于更好地进行医患沟通,了解患者对 OTN 的期望,这可能会从患者的角度提高治疗质量。

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