宿洪麗 彭謙

宿洪麗 彭謙

錯(cuò)牙合畸形； 口腔健康相關(guān)生活質(zhì)量； 兒童； 家長(zhǎng)

1 資料與方法

1.1 選擇對(duì)象

1.2 方法與測(cè)量工具

表 1 不同DHC兒童的OHRQoL

將英文量表翻譯成中文，然后回譯確保中文版本的準(zhǔn)確性和一致性。調(diào)查前選擇20 對(duì)其他原因就診的兒童和家長(zhǎng)預(yù)測(cè)試，校正可能造成誤解的語(yǔ)句。調(diào)查者向家長(zhǎng)和兒童解釋研究目的和方法后分別獨(dú)立填寫(xiě)調(diào)查表。兒童采用“1=是”/“0=否”2 種回答；家長(zhǎng)采用likert量表計(jì)分(1=偶爾，2=經(jīng)常，3=很頻繁)來(lái)表示兒童受影響的程度。

1.2.3 收集家長(zhǎng)的社會(huì)學(xué)資料 根據(jù)父母受教育程度分組為高中以下(L)、高中(M)、大學(xué)及以上(H)；根據(jù)家庭收入分為低(L)、中等(M)、高收入(H)。

1.3 統(tǒng)計(jì)學(xué)分析

根據(jù)調(diào)查結(jié)果計(jì)算DHC和M-OHRQOL的分值。采用SPSS 10.0版本統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。采用卡方檢驗(yàn)比較DHC和M-OHRQoL關(guān)系；采用組內(nèi)相關(guān)系數(shù)(ICC)分析兒童和家長(zhǎng)生活質(zhì)量的相關(guān)性；校正后的比數(shù)比(OR)及95%可信區(qū)間(CI)用于分析比較不同組間的生活質(zhì)量影響。所有統(tǒng)計(jì)結(jié)果以0.05為標(biāo)準(zhǔn)檢驗(yàn)是否有統(tǒng)計(jì)學(xué)差異。

2 結(jié) 果

本研究共調(diào)查118 名口腔正畸門診就診兒童，25(21.2%)名DHC結(jié)果不需要正畸治療，30 名(25.4%)處于臨界，63 名(53.3%)需要治療。在咀嚼困難、不喜歡牙齒、影響微笑和同伴取笑方面有受影響(表 1)。家長(zhǎng)認(rèn)為在影響咀嚼和學(xué)習(xí)成績(jī)方面對(duì)OHRQoL有影響(表 2)?？刂粕鐣?huì)學(xué)因素的多元邏輯回歸分析：家長(zhǎng)學(xué)歷低、收入低的兒童OHRQoL受影響大；高學(xué)歷、低收入、男孩的家長(zhǎng)受影響大(表 3)。

表 2 不同DHC家長(zhǎng)的OHRQoL值

Tab 2 OHRQoL of the children evaluated by the parents with different DHC

問(wèn) 題DHC從來(lái)沒(méi)有偶爾經(jīng)常P值影響咀嚼G137.534.228.30.038G2/G319.227.753.1影響學(xué)習(xí)成績(jī)G119.130.850.10.014G2/G310.711.777.6孩子對(duì)牙齒很滿意G161.530.87.70.454G2/G361.722.316.0孩子有抱怨牙齒不好看G123.126.950.00.580G2/G316.023.460.6

表 3 兒童、家長(zhǎng)與OHRQoL相關(guān)的多元邏輯回歸分析

注： 不同相關(guān)因素間的比較,P<0.05

3 討 論

3.1 錯(cuò)牙合畸形對(duì)OHRQoL的影響

3.2 影響的相關(guān)因素

3.3 不足及展望

本研究的研究對(duì)象是臨床患者，其結(jié)果不適用于普通人群。盡管目前對(duì)OHRQoL的測(cè)量涵蓋了口腔健康、功能和社會(huì)心理方面，但不能完全代替臨床客觀資料評(píng)價(jià)。家長(zhǎng)和兒童的意見(jiàn)反映了他們的正畸治療需求，制定臨床治療計(jì)劃和評(píng)價(jià)治療結(jié)果時(shí)考慮這些因素，可以彌補(bǔ)醫(yī)生單純依靠臨床資料的偏差，更好地滿足患者需求，這也正是現(xiàn)代正畸治療追求的目標(biāo)。但目前各研究結(jié)果報(bào)道尚存差異，評(píng)價(jià)OHRQoL仍需從測(cè)量工具、方法和參數(shù)的界定等方面統(tǒng)一標(biāo)準(zhǔn)，才能真正成為輔助臨床治療的主觀測(cè)量工具。

[1] Shaw WC,Rees G, Dawe M, et al. The influence of dentofacial appearance on the social attractiveness of young adults[J].Am J Orthod,1985, 87(1): 21-26.

[2] Nagarajappa R, Batra M, Sanadhya S, et al.Relationship between oral clinical conditions and daily performances among young adults in India-A cross sectional study[J].J Epidemiol Glob Health, 2015, 5(4): 347-357.

[3] Brook PH, Shaw WC. The development of an index of orthodontic treatment priority[J]. Eur J Orthod, 1989, 11(3)： 309-320.

[4] 宿洪麗，彭謙，宋巖, 等. 濰坊市區(qū)適齡兒童正畸治療需要調(diào)查[J]. 實(shí)用口腔醫(yī)學(xué)雜志，2011,27(1)：79-83.

[5] Filstrup SL, Briskie D, da Fonseca M, et al. Early childhood caries and quality of life: Child and parent perspectives[J]. Pediatr Dent, 2003, 25(5): 431-440.

[6] Liu Z, McGrath C, H?gg U. The impact of malocclusion/orthodontic treatment need on the quality of life. A systematic review[J].Angle Orthod, 2009, 79(3): 585-591.

[7] Abreu LG, Melga?o CA, Abreu MH, et al. Effect of malocclusion among adolescents on family quality of life[J]. Eur Arch Paediatr Dent, 2015, 16(4): 357-363.

[8] Gomes MC, Clementino MA, Pinto-Sarmento TC, et al. Parental perceptions of oral health status in preschool children and associated factors[J]. Braz Dent J, 2015, 26(4): 428-434.

[9] Hassan AH, Amin Hel-S. Association of orthodontic treatment needs and oral health-related quality of life in young adults[J]. Am J Orthod Dentofacial Orthop, 2010, 137(1): 42-47.

[10]Dimberg L, Lennartsson B, Bondemark L, et al. Oral health-related quality-of-life among children in Swedish dental care: The impact from malocclusions or orthodontic treatment need[J]. Acta Odontol Scand, 2016, 74(2): 127-133.

[11]Kragt L, Dhamo B, Wolvius EB, et al. The impact of malocclusions on oral health-related quality of life in children-a systematic review and meta-analysis[J].Clin Oral Investig, 2016, 20(8): 1881-1894.

[12]Sardenberg F, Martins MT, Bendo CB, et al. Malocclusion and oral health-related quality of life in Brazilian school children[J]. Angle Orthod, 2013, 83(1): 83-89.

Asessmentoftheimpactsofmalocclusiononthechildrensoralhealthrelatedqualityoflife

SUHongli，PENGQian.

261053，DepartmentofStomatology,TheAffiliatedHospitalofWeifangMeidcalUniversity，China

Objective: To study the impacts of malocclusion on the oral health-related quality of life(OHRQoL) of children.MethodsThe study sample comprised 118 children seeking orthodontic treatment.Each participant of the children and parents was assessed by the orthodontic treatment need and OHRQoL using the index of orthodontic treatment need and Michigan-OHRQoL.ResultsThe objective impacts of the teeth to parents and children were consistent; parents evaluated higher than the children themselves in the subjective impacts of their teeth.The impacts were more influential on the children whose parents with higher income and the parents with higher education.ConclusionMalocclusion affects the oral health related quality of life evaluated by both the children and their parents.

Malocclusion;Oralhealthrelatedqulityoflife;Children;Parents

261053， 濰坊醫(yī)學(xué)院附屬醫(yī)院口腔科

宿洪麗 E-mail: orthohongli@hotmail.com

R783.5

A

10.3969/j.issn.1001-3733.2017.04.015

(收稿： 2016-10-22 修回： 2017-04-25)