上海口腔医学

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (4): 382-387.doi: 10.19439/j.sjos.2026.04.006

• 论著 • 上一篇    下一篇

不同时间段固定矫治对釉质脱矿及牙周状况的影响

黄俊1, 王坤2, 肖林3   

  1. 1.重庆大学附属涪陵医院 口腔科,重庆 408000;
    2.重庆大学附属涪陵医院口腔分院 口腔颌面外科;
    3.口腔科,重庆 408000
  • 收稿日期:2025-07-24 修回日期:2025-09-22 出版日期:2026-08-25 发布日期:2026-09-01
  • 通讯作者: 肖林,E-mail：dentist100@sina.com
  • 作者简介:黄俊（1994—）,男,学士,主治医师,E-mail：13985125802@163.com
  • 基金资助:
    重庆市科卫联合医学科研项目任务书（合同）（2023GDRC001）

Influences of different timing of fixed orthodontics on enamel demineralization and periodontal conditions

Huang Jun1, Wang Kun2, Xiao Lin3   

  1. 1. Department of Stomatology, Fuling Hospital Affiliated to Chongqing University. Chongqing 408000;
    2. Department of Oral and Maxillofacial Surgery;
    3. Department of Stomatology, Stomatology Branch of Fuling Hospital Affiliated to Chongqing University. Chongqing 408000, China
  • Received:2025-07-24 Revised:2025-09-22 Online:2026-08-25 Published:2026-09-01

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摘要： 目的: 分析不同时间段固定矫治对患者釉质脱矿及牙周状况的影响。方法: 选择2021年1月—2023年12月收治的固定矫治患者180例,按矫治时长分成三组,矫治时间6个月内为A组（n=60）、6~12个月为B组（n=60）、12~18个月为C组（n=60）。采用国际龋病检测与评估系统（International Caries Detection and Assessment System, ICDAS）评估釉质脱矿情况并获得ICDAS评分;采用出血指数（bleeding on probing, BOP）、牙周袋深度（probing depth, PD）、临床附着丧失（clinical attachment loss, CAL）和菌斑指数（plaque index, PI）评估牙周情况;采用Pearson相关性分析釉质脱矿（ICDAS评分）与牙周状况变化（BOP、PD、CAL、PI）的相关性,多元logistic回归分析固定矫治患者釉质脱矿的影响因素。结果: 三组釉质脱矿严重程度相比无显著差异（P>0.05）,釉质脱矿总发生率（A组<B组<C组）和ICDAS评分（A组<B组<C组）相比差异显著（P<0.05）。三组BOP、PD、CAL和PI差异显著,且均为A组<B组<C组（P<0.05）。ICDAS评分与BOP、PD呈中度正相关,与CAL呈弱到中度正相关,与PI呈高度正相关（P<0.05）。矫治时间、PI、高糖饮食频率和氟化物局部应用是固定矫治患者釉质脱矿的独立影响因素（P<0.05）。结论: 固定矫治时间长会导致患者釉质脱矿风险增加,影响牙周健康,PI、高糖饮食频率和氟化物局部应用等也会影响釉质脱矿。临床上应根据患者个体状况,制定个性化计划和定期复查方案,加强口腔卫生指导与预防。

关键词: 固定矫治, 矫治时间, 釉质脱矿, 牙周状况, 相关性, 影响因素

Abstract: PURPOSE: To evaluate the effects of different timing of fixed orthodontics on enamel demineralization and periodontal conditions. METHODS: A total of 180 patients with fixed orthodontic treatment admitted from January 2021 to December 2023 were selected and divided into three groups according to the duration of orthodontic treatment: group A (n=60) with a treatment period of less than 6 months, group B (n=60) with a treatment period between 6 to 12 months, and group C (n=60) with a treatment period between 12 to 18 months. The enamel demineralization was evaluated by International Caries Detection and Assessment System (ICDAS), and ICDAS score was obtained. The periodontal status was evaluated by bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL) and plaque index (PI). The correlation between enamel demineralization (ICDAS score) and changes of periodontal status (BOP, PD, CAL, PI) was analyzed by Pearson correlation analysis. The influencing factors of enamel demineralization in patients undergoing fixed orthodontics were analyzed by multivariate logistic regression analysis. RESULTS: There was no significant difference in the severity of enamel demineralization among the three groups (P>0.05). The total incidence of enamel demineralization (group A < group B < group C) was significantly different from the ICDAS score (group A < group B < group C)(P<0.05). There were significant differences in BOP, PD, CAL and PI among the three groups, and all were group A < group B < group C(P<0.05). ICDAS score was moderately positively correlated with BOP and PD, weakly to moderately positively correlated with CAL, and highly positively correlated with PI (P<0.05). The correction time, PI, frequency of high-glucose diet and local application of fluoride were independent influencing factors of enamel demineralization in patients undergoing fixed orthodontics (P<0.05). CONCLUSIONS: A long duration of fixed orthodontics will increase the risk of enamel demineralization and affect periodontal health of patients. PI, frequency of high-glucose diet and local application of fluoride can affect enamel demineralization. Personalized plans and regular follow-up programs should be formulated based on the individual conditions of patients, and oral hygiene guidance and prevention should be strengthened.

Key words: Fixed orthodontics, Correction time, Enamel demineralization, Periodontal status, Correlation, Influencing factor

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