摘要
目的探讨正畸治疗中颞下颌关节紊乱病(TMD)发生的危险因素并初步建立风险列线图模型。方法选择2018年1月至2020年1月于清华大学附属北京清华长庚医院口腔科初次完成正畸治疗的209例患者进行问卷调查并收集病例资料,采用单因素和多因素Logistic回归分析正畸治疗中TMD发生的危险因素,并据此建立列线图预测模型。结果偏、大开口习惯、偏侧咀嚼、夜磨牙症、邻面龋及焦虑抑郁是正畸治疗中TMD发生的危险因素(OR=4.455,95%CI 1.478~13.424;OR=9.104,95%CI 1.613~51.384;OR=3.322,95%CI 1.339~8.246;OR=10.843,95%CI 2.558~45.957;OR=4.085,95%CI 1.344~12.417;OR=4.115,95%CI 1.622~10.442)(P<0.05或P<0.01)。基于以上危险因素建立预测正畸治疗中TMD发生风险的列线图模型并对该模型进行验证:一致性指数为0.753(95%CI 0.717~0.791),预测曲线趋近于标准曲线,受试者工作特征曲线下面积为0.748(95%CI 0.713~0.783)。结论偏、大开口习惯、偏侧咀嚼、夜磨牙症、邻面龋及焦虑抑郁是正畸治疗中TMD发生的危险因素,据此建立的列线图模型能够有效预测正畸治疗中TMD的发生风险。
Objective To explore the risk factors of temporomandibular disorder(TMD)in orthodontic treatment and preliminarily establish the nomograph model for predicting the risk.Methods A questionnaire survey was conducted on patients who completed orthodontic treatment for the first time in the Department of Stomatology of Beijing Tsinghua Changgung Hospital,Tsinghua University from Jan.2018 to Jan.2020 and their medical records were collected.The risk factors of TMD in orthodontic treatment were analyzed by univariate and multivariate Logistic regression,and the nomogram prediction model was established.Results Partial jaw,large mouth opening habit,unilateral chewing,bruxism,adjacent caries and anxiety and depression were risk factors for TMD in orthodontic treatment(OR=4.455,95%CI 1.478-13.424;OR=9.104,95%CI 1.613-51.384;OR=3.322,95%CI 1.339-8.246;OR=10.843,95%CI 2.558-45.957;OR=4.085,95%CI 1.344-12.417;OR=4.115,95%CI 1.622-10.442)(P<0.05 or P<0.01).Based on the above risk factors,a nomogram model to predict the occurrence of TMD in orthodontic treatment was established and verified.The C-index was 0.753(95%CI 0.717-0.791),the prediction curve was close to the standard curve,and the area under curve of the receiver operating characteristic was 0.748(95%CI 0.713-0.783).Conclusion Partial jaws,large mouth opening habits,unilateral chewing,bruxism,adjacent caries and anxiety and depression are risk factors for TMD in orthodontic treatment,and the nomogram model established based on the above factors can effectively predict the risk of TMD in orthodontic treatment.
作者
田震
朱静
马征
梁雪莹
TIAN Zhen;ZHU Jing;MA Zheng;LIANG Xueying(Department of Stomatology,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China;School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Gastroenterology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《医学综述》
CAS
2022年第24期4983-4987,共5页
Medical Recapitulate
关键词
颞下颌关节紊乱病
正畸治疗
危险因素
列线图
Temporomandibular disorder
Orthodontic treatment
Risk factors
Nomogram
作者简介
通信作者:田震,Email:fxphxf@163.com。
