中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (28): 6030-6036.doi: 10.12307/2025.461

• 组织工程口腔材料 tissue-engineered oral materials • 上一篇    下一篇

视觉评分系统分析透明矫治器和固定矫治器对牙齿光滑面的影响

芦  琳1，栗亚楠2，张  帆1，窦晨雷1，李秋童3，单丽华1   

  1. 河北医科大学第二医院，1口腔正畸科，3骨科，河北省石家庄市   050000；2山西医科大学第二医院口腔科，山西省太原市   030001
  • 收稿日期:2024-03-22 接受日期:2024-06-07 出版日期:2025-10-08 发布日期:2024-12-07
  • 通讯作者: 单丽华，主任医师，教授，河北医科大学第二医院口腔正畸科，河北省石家庄市 050000
  • 作者简介:芦琳，女，1985年生，河北省石家庄市人，汉族，硕士，主治医师，主要从事隐形矫治研究。
  • 基金资助:
    河北省青年科技课题项目(20170628)，课题名称：正畸后着色、脱矿牙的美白修复治疗基础与研究，项目负责人：芦琳

Effect of clear and fixed aligners on smooth surface of teeth analyzed by Universal Visual Scoring System

Lu Lin1, Li Yanan2, Zhang Fan1, Dou Chenlei1, Li Qiutong3, Shan Lihua1   

  1. 1Department of Orthodontics, 3Department of Orthopedics, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China; 2Department of Stomatology, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
  • Received:2024-03-22 Accepted:2024-06-07 Online:2025-10-08 Published:2024-12-07
  • Contact: Shan Lihua, Chief physician, Professor, Department of Orthodontics, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
  • About author:Lu Lin, MS, Attending physician, Department of Orthodontics, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
  • Supported by:
    Youth Science and Technology Project of Hebei Province, No. 20170628 (to LL)

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摘要：


文题释义：

龋病视觉评分系统：由于临床中辅助龋齿检测和诊断工具的局限性、有效性和可重复性并不完善，以及难以控制所有可能的混杂因素，为此开发了简单有效并且可重复的龋齿判断评分系统——龋病视觉分析法。龋病视觉分析法对牙齿咬合面和光滑面进行系统化评价，可以应用于乳牙和恒牙。
白斑病变：是指釉质局部脱矿而没有形成孔洞的区域，被定义为“龋齿脱矿引起的釉质表面孔隙增加”，多位于牙齿光滑面，表现为乳白色不透明斑块，标志着龋齿形成的初级阶段。白斑病变是正畸中常见的不良反应，影响牙齿美观和健康。


背景：白斑病变是传统正畸治疗中常见的不良反应。目前有关透光透明矫治器和固定正畸矫治器对正畸治疗患者牙周健康状况、白斑病变发生率、唾液及相关细菌的影响差异仍存在一些争议。

目的：采用视觉评分系统对比透明矫治器和固定矫治器对正畸牙齿光滑面的影响。
方法： 选择2018年1月至2022年12月河北医科大学第二医院口腔正畸科收治的患者80例，采用随机数字表法随机分为对照组(n=40)与观察组(n=40)，对照组接受固定矫治器正畸治疗，观察组接受透明矫治器接正畸治疗。治疗前及治疗6，12，24个月后，每位患者选取13、33、16、36牙唇侧或颊侧作为研究对象，采用视觉评分系统评估白斑病变。

结果与结论：①治疗前及治疗6，12，24个月后，两组患者牙齿白斑颜色与龋坏严重程度比较差异均无显著性意义(P > 0.05)；②对于13牙，治疗12个月后的白斑颜色级别与龋坏严重程度均高于治疗前(P < 0.05)；对于33牙，治疗12个月后的白斑颜色级别与龋坏严重程度均高于治疗前(P < 0.05)，治疗12个月后的龋坏严重程度高于治疗6个月后(P < 0.05)；对于16牙，治疗12个月后的白斑颜色级别与龋坏严重程度均高于治疗6个月后(P < 0.05)；③多水平有序多分类Logistic回归模型分析显示，不同牙位的白斑颜色、严重程度变化与矫治器类型相关性较小，受矫治时间因素影响较大，其中33、13牙初始白斑颜色变化和严重程度在治疗第12，24个月比较有统计学意义；④研究结果尚不能说明固定矫治器和透明矫治器对牙齿光滑面白斑病变的影响有所差异，但可以发现随着正畸治疗时间的延长，牙齿龋坏的风险有所增加。

https://orcid.org/0009-0009-7198-5920 (芦琳) 

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料；口腔生物材料；纳米材料；缓释材料；材料相容性；组织工程

关键词: 白斑病变, 视觉分析法, 固定矫治器, 隐形矫矫治器, 正畸矫治

Abstract: BACKGROUND: Leukoplakia is a common adverse reaction to traditional orthodontic treatment. There are still some controversies about the difference between light-transmitting clear and fixed aligners in the periodontal health status, incidence of leukoplakia, saliva and related bacteria in patients undergoing orthodontic treatment.
OBJECTIVE: To compare the effects of clear and fixed aligners on the smooth surface of orthodontic teeth using Universal Visual Scoring System. 
METHODS: A total of 80 patients admitted to Department of Orthodontics, Second Hospital of Hebei Medical University from January 2018 to December 2022 were selected and randomly divided into a control group (n=40) and an observation group (n=40) using a random number table method. The control group received orthodontic treatment with fixed aligners, and the observation group received orthodontic treatment with clear aligners. Before treatment and after 6, 12, and 24 months of treatment, the labial or buccal sides of teeth 13, 33, 16, and 36 were selected for each patient as the research subjects, and the visual scoring system was used to evaluate the white spot lesions. 
RESULTS AND CONCLUSION: (1) Before treatment and after 6, 12, and 24 months of treatment, there was no significant difference in the color of tooth white spots and the severity of caries between the two groups of patients (P > 0.05). (2) For tooth 13, after 12 months of treatment, the color grade and caries severity of white spots were both higher than before treatment (P < 0.05). For tooth 33, the color grade and caries severity after 12 months of treatment were both higher than before treatment (P < 0.05). The severity of caries after 12 months of treatment was higher than that after 6 months of treatment (P < 0.05). For tooth 16, the color grade of white spots and the severity of caries after 12 months of treatment were both higher than those after 6 months of treatment (P < 0.05). (3) Multi-level ordered multi-classification Logistic regression model analysis showed that the color and severity of white spots on different teeth had little correlation with the type of appliance and were greatly affected by the correction time factor. Among them, the color change and severity of the initial white spots on teeth 33 and 13 were statistically significant at 12 and 24 months of treatment. (4) It is not possible to conclude that there is a difference in the effect of fixed and clear aligners on the white spot lesions of smooth surfaces of the teeth, but an increase in the risk of dental caries with the increase in the duration of treatment can be detected.

Key words: white spot lesions, Universal Visual Scoring System, fixed aligners, clear aligners, orthodontic treatment

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