Abstract:

Objective　To observe the correlation between different personality characteristics of orthodontic patients and the choices of appliance types, and to explore the influence of different appliance types on the changes of patients' psychological state during orthodontic treatment. Methods　Five hundred malocclusion patients treated in Department of Stomatology, The 73rd Group Army Hospital of Chinese People's Liberation Army from February 2019 to April 2022 were prospectively selected as the study objects. They were divided into a non-orthodontic treatment group (200 cases) and an orthodontic treatment group (300 cases) according to whether or not orthodontic treatment was performed. There were 167 males and 133 females in the orthodontic treatment group; they were (24.98±4.09) years old. There were 113 males and 87 females in the non-orthodontic treatment group; they were (25.14±3.77) years old. The orthodontic treatment group were divided into a labial ligation wing fixed appliance group (S1), a labial self-locking fixed appliance group (S2), an invisible and removable fixed appliance group without brackets (S3), a lateral ligation and wing fixation appliance group (S4), and a lingual self-locking fixation appliance group (S5), with 60 cases in each group. The Eysenck Personality Questionnaire (EPQ) and Frost Multidimensional Perfectionism Questionnaire (CFMPS) were used to assess the patients' personality characteristics. The psychological states of different stages were evaluated by the Symptom Checklist 90 (SCL-90) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The Spearman correlation test was used to analyze the correlation between different appliance types and the changes of the patients' physical and mental states. t test and one-way ANOVA were applied. Results　The scores of EPQ and CFMPS in the orthodontic treatment group were higher than those in the non-orthodontic treatment group [(45.14 ± 8.52) vs. (42.89 ± 8.29) and (77.37 ± 7.46) vs. (64.87 ± 6.95)], with statistical differences (t=2.92 and 9.81; both P<0.05). There statistical differences in the scores of EPQ and CFMPS between the orthodontic groups (F=4.33 and 13.44; both P<0.05). The scores of EPQ and CFMPS in group S3 were (46.47±7.25) and (81.26±7.89), the highest. The SCL-90 scores of the 5 orthodontic groups reached the maximum value at T5 during the treatment period, indicating that as the orthodontic treatment time prolonged, it first increased and then decreased; the scores in group S3 were higher than those in the other 4 groups (all P<0.05). The PIDAQ score gradually increased with the orthodontic treatment time; the scores in group S3 were higher than those in the other 4 groups; the scores in group S4 and S5 were higher than those in group S1 and S2. Spearman correlation test showed that the type of appliance was correlated with SCL-90 and PIDAQ scores (r=0.236 and 0.176, both P<0.05). Conclusions　The changes of physical and mental states of patients with malocclusion during orthodontic treatment are related to the choices of appliance types. It is recommended to choose a targeted diagnosis and treatment plan according to the patients' personality characteristics.

Key words:

Malocclusion, Orthodontic treatment, Personality characteristics, Mental state, Appliance

摘要：

目的　观察正畸患者不同人格特征与矫治器类型选择之间的相关性，并探索不同的矫治器类型在矫治过程中对患者心理状态变化存在的影响。方法　前瞻性选取2019年2月至2022年4月中国人民解放军陆军第七十三集团军医院口腔科500例错牙合畸形患者为研究对象，根据是否进行正畸分为正畸未治疗组（200例）和正畸治疗组（300例）。正畸治疗组男167例，女133例，年龄（24.98±4.09）岁；正畸未治疗组男113例，女87例，年龄（25.14±3.77）岁。正畸治疗组根据其矫治器类型分为唇侧结扎翼固定矫治器组（S1）、唇侧自锁固定矫治器组（S2）、无托槽隐形可摘固定矫治器组（S3）、舌侧结扎翼固定矫治器组（S4）及舌侧自锁固定矫治器组（S5）共五组，每组60例。以艾森克人格问卷（EPQ）和Frost多维完美主义问卷（CFMPS）评估所有患者人格特征，以症状自评量表（SCL-90）和牙科审美社会心理量表（PIDAQ）评估患者在各治疗阶段的心理状态，通过Spearman相关性检验分析不同矫治器类型与患者身心状态变化的相关性。统计学方法采用t检验、单因素方差分析。结果　正畸治疗组EPQ及CFMPS评分均高于正畸未治疗组［（45.14±8.52）分比（42.89±8.29）分、（77.37±7.46）分比（64.87±6.95）分］，差异均有统计学意义（t=2.92、9.81，均P<0.05）；各组正畸患者EPQ和CFMPS评分比较，差异均有统计学意义（F=4.33、13.44，均P<0.05），且S3组EPQ［（46.47±7.25）分］和CFMPS［（81.26±7.89）分］评分较高；五组正畸患者治疗期间SCL-90评分于T₅达到最大值，可见随着正畸治疗时间的延长呈现先升高后降低的趋势，S3组各时间点评分均小于其他四组；PIDAQ评分随着正畸治疗时间的延长呈现逐渐升高的趋势，S3组各时间点评分均高于其他四组，S4、S5组评分均高于S1、S2组；Spearman相关检验结果显示矫治器类型与SCL-90、PIDAQ评分均有相关性（r=0.236、0.176，均P<0.05）。结论　错牙合畸形患者在正畸治疗过程中的身心状态变化与矫治器类型的选择相关，建议根据患者人格特征选择针对性的诊疗方案。

关键词:

错牙合畸形, 正畸, 人格特征, 心理状态, 矫治器