| Objective:(1)To investigate the incidence of gingivitis in fixed orthodontic patients,analyze and explore the influencing factors of gingivitis in patients with fixed orthodontics,and provide reference for the prevention and clinical intervention of gingivitis in patients with fixed orthodontics.(2)To evaluate the therapeutic effect of chlorhexidine and chlorine dioxide gargle solution on gingivitis in patients with fixed orthodontics,to explore more reasonable and effective gargle solutions,and to choose the appropriate gargle solution for the prevention and treatment of gingivitis in patients with fixed orthodontics.Gargle provides a theoretical basis.Methods:Part 1:(1)A questionnaire was designed and produced,and a cross-sectional method was used to investigate 234 patients who met the inclusion criteria;Through electronic questionnaires and clinical examinations,the basic information of patients,clinical examinations,personal oral health behavior scores and scores of related oral knowledge were collected.(2)Clinical examination: at the same time as the questionnaire is issued,the corresponding clinical examination is carried out on the patient by using a combination of inspection and probing to check whether there is gingivitis in the patient’s mouth,and the rings,rubber bands,and brackets have not been removed.Clean adhesive,type of arch wire ligation,etc.,record the patient’s orthodontic time,and record the results on the checklist.(3)Use frequency or frequency data to describe the patient’s clinical examination items,basic information,personal oral health care behavior and relevant knowledge;The χ~2 test was used to compare the incidence of gingivitis in patients with fixed orthodontics in terms of gender,occupation,whether it was an only child,residence,whether there was a ring device,whether there was a rubber band,whether there was excess adhesive,and the type of ligation of the arch wire.distribution differences;Rank sum test was used to compare the differences of gingivitis in patients with fixed orthodontics in different age,family monthly income level,education level,father’s education level,mother’s education level,etc.;Partial correlation was used to analyze the correlation between gingivitis in fixed orthodontic patients and the duration of orthodontic treatment,personal oral health care behavior,and the mastery of relevant knowledge;Logistic binary regression was used to analyze the influencing factors of gingivitis in patients with fixed orthodontics.P<0.05 was considered statistically significant.Part Ⅱ:(1)21 patients who met the inclusion criteria were selected,including 8 males and 13 females,aged 15-25(17.67±2.69)years old;The patients were divided into three groups according to the random number table method,with 7 cases in each group;group A:normal saline group;group B: chlorhexidine gargle group;group C: chlorine dioxide gargle group.(2)After thorough supragingival scaling and oral hygiene education for all patients,use the corresponding gargle solution for gargle treatment;Start using the gargle solution on the day of scaling,once a day in the morning and in the evening,after brushing your teeth,gargle15 ml each time,gargle for 2 to 3 minutes,and use it continuously for 2 weeks.(3)Select 16,11,24 or 25,26,31,36,44 or 45,46 as index teeth,The sulcus bleeding index(SBI),plaque index(PLI),probing depth(PD)of index teeth were measured before treatment and 2 weeks after treatment,and enzyme linked immunosorbent assay(enzyme linked immunosorbent assay)was used to measure the index teeth.The concentration of interleukin-1β(IL-1β)in gingival crevicular fluid was detected by immunosorbent assay,ELISA,and the weight of gingival crevicular fluid was determined by weighing method;The side effects of patients in each group were recorded.(4)SPSS 25.0 was used for statistical analysis,one-way ANOVA was used for comparison between groups,and paired t test was used for comparison before and after treatment within a group;when the data did not obey the normal distribution or the variance was unequal,the rank sum test was used,and P<0.05 was defined as The difference was statistically significant.Results: Part 1:(1)234 questionnaires were distributed,234 questionnaires were recovered,and the recovery rate was 100%.(2)Comparison of demographic variables of basic information: The prevalence of orthodontic gingivitis with fixed gender,age,occupation,educational level and mother’s educational level was compared,and the difference was statistically significant(P<0.05).It shows that the prevalence of males is higher than that of females;the younger the patients,the higher the prevalence;the prevalence of non-medical staff is higher than that of medical staff;the lower the education level of patients,the higher the prevalence;the lower the mother’s education level is higher prevalence of patients.There was no significant difference in the prevalence of orthodontic gingivitis among different family monthly income levels and father’s educational level(P>0.05).(3)Comparison of clinical examination items: There was no correlation between the occurrence of gingivitis and the duration of orthodontic treatment in patients with fixed orthodontics(r=-0.058,P=0.38).The prevalence of gingivitis in those with excess adhesive around the brackets and the archwire ligation method was higher than that of those without excess adhesive around the brackets,and the archwire ligation method was self-locking,and the difference was statistically significant(P<0.05).There was no significant difference in the prevalence of gingivitis with or without a ring device and with or without a rubber band(P>0.05).(4)The occurrence of gingivitis in patients with fixed orthodontics was related to personal oral health care behavior and mastery of relevant knowledge(r=-0.24,P<0.001;r=-0.38,P<0.001).(5)Multivariate analysis of gingivitis: the probability of gingivitis in patients with excess adhesive around brackets was 9.94 times that of patients without excess adhesive around brackets(P<0.05);The probability of gingivitis in patients whose archwire ligation type was ligation wire was 3.44 times higher than that in self-locking patients(P<0.05);The occurrence of gingivitis in patients with fixed orthodontics was negatively correlated with the scores of personal oral health care behaviors and the mastery of relevant knowledge(r=-0.24,P<0.001;r=-0.38,P<0.001),and the scores of personal oral health care behaviors The higher the score of mastery of relevant knowledge,the lower the probability of suffering from fixed orthodontic gingivitis(P<0.05).Part Ⅱ:(1)Comparison of changes in each observation index between groups before and after treatment:the concentration of ΔIL-1β,ΔPD,and ΔSBI values in each group were significantly different(P<0.05),and the groups B and C were higher than those in group A.(P>0.05);there was no statistical difference in the ΔPLI value among the groups(P>0.05).(2)Self-comparison before and after treatment within the group: the concentration of IL-1β,PD,SBI,and PLI values in each group after treatment were significantly lower than those before treatment(P<0.05);there was no statistical difference in the weight of gingival crevicular fluid before and after treatment(P<0.05).P>0.05).(3)Analysis of side effects in each group:2 weeks after treatment,4 patients in group B felt poor taste(bitter and strange taste),2patients had mucous membrane tingling,2 patients had dry mouth,and 1 patient had slightly discolored teeth No side effects were found in groups A and C.Conclusion:(1)Gender,age,occupation,educational level and mother’s educational level are the influencing factors for the occurrence of gingivitis in fixed orthodontics;(2)Whether there is excess adhesive around brackets and the type of ligation of arch wires are the factors that affect the occurrence of fixed orthodontic patients.Independent risk factors for gingivitis;(3)Personal oral health care behavior and relevant knowledge are independent risk factors for gingivitis in patients with fixed orthodontics;(4)Chlorhexidine and chlorine dioxide gargle are used in patients with fixed orthodontics Both can reduce the degree of inflammation of their gingivitis,and the anti-inflammatory effects of the two are basically the same;(5)Compared with chlorhexidine,chlorine dioxide gargle does not have mucosal irritation,dry mouth,bitter taste and tooth staining when used.and other side effects,the clinical applicability is higher. |
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