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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 簡國龍(Kuo-Liong Chien),林俊彬(Chun-Pin Lin) | |
dc.contributor.author | Po-Yen Lin | en |
dc.contributor.author | 林伯彥 | zh_TW |
dc.date.accessioned | 2021-06-12T18:20:27Z | - |
dc.date.available | 2011-10-03 | |
dc.date.copyright | 2011-10-03 | |
dc.date.issued | 2011 | |
dc.date.submitted | 2011-08-08 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/27785 | - |
dc.description.abstract | 背景與目標:牙本質知覺敏感症(敏感性牙齒)為牙科臨床上常遭遇的問題,是牙科病友眾多求診的主訴之一,嚴重時常會影響患者的飲食與日常生活起居習慣,研究報告顯示牙本質知覺過敏症的流行率佔總人口的2.8%到84.0%,差異頗大。本試驗之目的是希望能推估牙本質知覺敏感症之盛行率,並藉由問卷瞭解牙本質知覺敏感症與口腔衛生之相關性;影響因素包括是否有使用去敏感牙膏、是否有找醫師求診等,以及飲食習慣及與口腔健康相關生活品質之關聯性。
方法:本研究為一橫斷式研究,分為兩部分進行。第一部分以一般民眾為研究族群,請民眾填寫與牙本質知覺敏感症有關的問卷。問卷內容包括:基本人口學資料、口腔衛生習慣、飲食習慣、口腔健康相關生活品質之量表。第二部分以台大醫院牙科部的民眾為研究族群,使用問卷方式及臨床檢查同步施行,臨床檢查則由吹氣、溫度及刮觸測試確診牙本質知覺敏感症。 結果:自2010年11月至2011年4月止,共收集了1070筆完整資料。其中單純完成問卷調查的有743人,另外有327人完成問卷及臨床檢查。在第一部分的問卷中,有269位民眾認為自己有牙本質知覺敏感症,盛行率為36.2%;有牙本質知覺敏感症的病人,其口腔健康相關生活品質平均分數為48.0±6.3,顯著低於沒有牙本質知覺敏感症的52.8±5.5 (p value < 0.0001)。在經過年齡、性別、教育程度、抽菸、口腔衛生習慣調整之後,有牙本質知覺敏感症的病人之口腔健康相關生活品質平均分數依然顯著較低,而其中影響最大的是疼痛不適面向(p value < 0.0001)。在第二部分的結合問卷及臨床檢查中,被檢查出有牙本質知覺敏感症的有278位,盛行率為85.0%;認為自己有牙本質知覺敏感症的平均有8.8±6.0顆敏感牙齒,認為沒有的則有3.7±4.3顆。其中最容易被測得敏感性牙齒的為第一大臼齒及小臼齒。隨著年齡的增加,罹患牙本質知覺敏感症的相對危險性也隨之升高。牙周病之患者、牙周病治療、以及攜帶活動假牙、牙齒磨耗、牙齦萎縮等也都會顯著提高罹患牙本質知覺敏感症的危險性,而定期檢查牙齒則會降低其危險性(p value < 0.05)。問卷與臨床檢查之一致性為0.283。另外,敏感性牙齒的顆數與口腔健康相關生活品質分數呈現線性關聯性,平均多一顆敏感性牙齒,生活品質分數會下降0.21分(p value < 0.05)。 結論:本研究發現,年齡、牙周病、牙周病治療、攜帶活動假牙、牙齒磨耗、牙齦萎縮等會顯著提高罹患牙本質知覺敏感症的危險性,而定期檢查牙齒則會降低其危險性。另外,有牙本質知覺敏感症的病人其口腔健康相關生活品質平均分數顯著較低。因此建議未來需進一步研究有效治療牙本質知覺敏感症的方法,以提升病患之口腔健康相關生活品質。 | zh_TW |
dc.description.abstract | Background: Dentin hypersensitivity is a common complaint in dental clinics. Some studies have reported that dentin hypersensitivity was found in adult populations with a prevalence ranging from 2.8%-84.0%. The aim of this study is to investigate the prevalence and possible causal factors including oral hygiene status and diet. The relationships between dentin hypersensitivity and oral health related quality of life will also be evaluated.
Methods: The study was cross-sectional designed and divided into 2 parts. The participates in the 1st part were invited from general population. Each participate completed a structured questionnaire which includes demographic data, oral hygiene status, diet, and oral health-related quality of life assessment. The 2nd part would be performed at Department of Dentistry of National Taiwan University Hospital. Each subject completed the questionnaire and further intra-oral examination. The examination would be performed by administering a blast of air, cold water and tactile test to confirm the diagnosis of dentin hypersensitivity. Results: We obtained a total number of 1070 data during Nov. 2010 to Apr. 2011. In the 1st part, the prevalence of dentin hypersensitivity from questionnaire was 36.2% (269/743). The mean score indicated that patients with dentin hypersensitivity reported considerably more impaired oral health related quality of life (48.0±6.3 vs 52.8±5.5, p value < 0.0001) than subjects without dentin hypersensitivity. In multiple regression analyses considering gender, age, education level, and oral hygiene habits, the score was significantly lower in patients with dentin hypersensitivity (p value < 0.0001), especially the pain/discomfort domain. In the 2nd part, 85.0% (278/327) was diagnosed dentin hypersensitivity from intra-oral examination. The patients who thought they got dentin hypersensitivity had 8.8±6.0 sensitized teeth, compared to those who did not think they had dentin hypersensitivity, who had 3.7±4.3 sensitized teeth. The most frequent sensitized teeth were 1st molars and premolars. The risk ratio of dentin hypersensitivity was increased by age, periodontitis, periodontal treatment, removable partial dentures wearing, cervical abrasion and gingival recession, and decreased by periodical oral exams (p value < 0.05). The consistency between the result from the questionnaire and the diagnosis in clinical exam was 0.283. Furthermore, the total numbers of sensitized teeth was correlated to the oral health related quality of life score. In multiple regression analyses, the more sensitized tooth was diagnosed, the lower score would be recorded in questionnaire (p value < 0.05). Conclusion: We clearly demonstrated that the dentin hypersensitivity was associated with a poor oral health related quality of life scores among adult Taiwanese. Patients who were older, had periodontitis, periodontal treatment, removable partial denture wearing, cervical abrasion or gingival recession would have higher risk to get dentin hypersensitivity. Further studies on the improvement of quality of life scores by treating dental hypersensitivity are warranted. | en |
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dc.description.tableofcontents | 中文摘要 ii
英文摘要 iv 目 錄 vi 第一章 實習單位簡介 1 第二章 研究背景 2 第一節 牙本質知覺敏感症(Dentin hypersensitivity) 2 2.1.1 牙本質知覺敏感症的定義 2 2.1.2 牙本質知覺敏感症之發生病因及機轉 2 2.1.3 牙本質知覺敏感症之盛行率 3 2.1.4 牙本質知覺敏感症之相關致病因子 5 第二節 口腔健康相關生活品質(Oral health related quality of life) 7 2.2.1 口腔健康相關生活品質的定義及影響因子 7 2.2.2 口腔健康相關生活品質量表之選擇 8 2.2.3 口腔健康相關生活品質之相關文獻回顧 9 第三節 與過去研究的差異(Gap) 10 第三章 研究動機與目的 12 第一節 研究動機 12 第二節 研究目的 13 第四章 研究材料與方法 15 第一節 問卷調查(Figure 1) 15 4.1.1 研究對象 15 4.2.2問卷資料收集 15 第二節 結合問卷調查及臨床檢查(Figure 2) 19 4.2.1 研究對象 19 4.2.2 問卷資料收集 20 4.2.3 口腔檢查資料收集 20 第三節 資料分析 23 4.3.1 樣本數計算 23 4.3.2 資料整理 24 4.3.3 統計分析方法 24 第五章 研究結果 28 第一節 問卷調查 28 5.1.1 研究樣本之人口學特性 28 5.1.2 以「請問您是否有牙本質知覺敏感症」分成兩組之比較 28 5.1.3 「牙本質知覺敏感症」之相關問題分析 29 5.1.4 口腔健康相關生活品質分數之相關性分析 30 5.1.5 口腔健康相關生活品質總分之相關性分析 31 第二節 結合問卷及臨床檢查 31 5.2.1 人口學變項分析 31 5.2.2 以「請問您是否有牙本質知覺敏感症(Subjective DH)」以及臨床檢查牙本質知覺敏感症的結果(Clinical DH),分成四組之比較 32 5.2.3 「牙本質知覺敏感症」之相關問題分析 33 5.2.4 臨床檢查後有敏感牙齒數量及統計結果 34 5.2.5 臨床檢查後有牙本質知覺敏感症之人口學特性、口腔衛生習慣、飲食習慣 35 5.2.6 多層次迴歸模型分析 37 5.2.7 以牙齒為單位,臨床檢查後有牙本質知覺敏感症之相關誘病因子 38 5.2.8 問卷與臨床檢查之一致性 39 5.2.9 以牙齒為單位,比較三種不同測試之結果 39 5.2.10 以臨床檢查出敏感牙齒總數為單位,比較其與口腔健康相關生活品質分數的關聯性 40 第六章 討論 41 第一節 研究對象之代表性及外推性 41 第二節 牙本質知覺敏感症之盛行率推估 41 第三節 牙本質知覺敏感症之相關致病因子討論 42 6.3.1 性別、年齡、職業、教育程度 42 6.3.2 嚼食檳榔、吸菸、嚼食口香糖 43 6.3.3 牙周病、牙周病治療、牙齒矯正、攜戴活動假牙 44 6.3.4 口腔衛生習慣 44 6.3.5 飲食習慣 45 6.3.6 齒頸部磨耗、填補物、牙齦萎縮 46 第四節 牙本質知覺敏感症之相關討論 47 6.4.1 患病時間 47 6.4.2 去敏感牙膏、尋找牙醫師求診 47 6.4.3 何種刺激 48 6.4.4 患病原因 48 6.4.5 患病齒位 49 6.4.6 臨床檢查出有敏感症狀之牙齒數量 50 第五節 牙本質知覺敏感症檢查流程之標準化 51 6.5.1 標準化檢查模式之建立 51 6.5.2 不同檢查結果之解釋 52 第六節 牙本質知覺敏感症問卷與臨床檢查之一致性 52 第七節 口腔健康相關生活品質之討論 53 6.7.1 口腔健康相關生活品質之影響因子 53 6.7.2 牙本質知覺敏感症與口腔健康相關生活品質之相關性及應用 55 第八節 臨床應用 56 第九節 研究限制 56 第七章 結論 58 第八章 參考文獻 59 Table 1 - Literature reviews about prevalence of dentin hypersensitivity 66 Table 2 - Literature reviews about oral health-related quality of life 70 Table 3 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,人口學特性之比較 71 Table 4 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,口腔衛生習慣之比較 73 Table 5 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,飲食習慣之比較 74 Table 6 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,口腔健康相關生活品質之相關性分析 77 Table 7 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,其他相關問題之分析 78 Table 8 - 認為自己患有牙本質知覺敏感症之「患病時間」、「是否使用去敏感牙膏」、「是否曾經求診牙醫師」 79 Table 9 - 認為自己患有牙本質知覺敏感症之「何種刺激」、「患病原因」 80 Table 10 - GOHAI scores with simple linear regressions (Part 1: Questionnaire survey, N=743) 81 Table 11 - Multiple regression model for GOHAI scores (Part 1: Questionnaire survey, N=743) 84 Table 12 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒平均數量及統計結果 85 Table 13 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(任一測試) 87 Table 14 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(溫度測試cold test) 88 Table 15 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(吹氣測試air test) 89 Table 16 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(刮觸測試tactile test) 90 Table 17 - Poisson regression model (Univariate) for demographic characteristics 91 Table 18 - Poisson regression model (Univariate) for oral hygiene habits 92 Table 19 - Poisson regression model (Univariate) for diet 93 Table 20 - Poisson regression model (Multiple) for demographic characteristics and oral hygiene habits 94 Table 20 - Poisson regression model (Multiple) for demographic characteristics and oral hygiene habits 94 Table 21 - Poisson regression model (Multiple) for diet 95 Table 22 – Multilevel regression model 96 Table 23 – Some predisposing factors of hypersensitive teeth (Unit of analysis: tooth) 99 Table 24 – Consistency of dentin hypersensitivity between questionnaire and clinical exam 100 Table 25 – Comparisons of 3 tests (Unit of analysis: tooth) 101 Table 26 - Multiple linear regression model for GOHAI scores (Part 2: Questionnaire survey/Clinical exam, N=327) 102 Figure 1 – Study theme for Part 1 (Part 1: Questionnaire survey) 103 Figure 2 – Study theme for Part 2 (Questionnairesyrvey/clinical exam) 104 Figure 3 – Customized dentin hypersensitivity testing device 105 Figure 4 – Tohoku University-type constant load periodontal probe 106 Figure 5 – Sample size estimation 107 Figure 6 - 以口腔相關生活品質總分(GOHAI,總分為60分)為X軸,有牙本質知覺敏感症及沒有牙本質知覺敏感症之機率分配圖 108 Figure 7 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(任一測試) 109 Figure 8 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(溫度測試cold test) 110 Figure 9 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(吹氣測試air test) 111 Figure 10 - 以問卷「您覺得您是否有牙本質知覺敏感症」分組,經臨床檢查後有敏感的牙齒數量及統計結果(刮觸測試tactile test) 112 Figure 11 - 統整病患所有之臨床測試有敏感的牙齒總數(X軸),以比較與口腔健康相關生活品質總分(Y軸)之關聯性 113 Appendix 1 – Questionnaire 114 Appendix 2 – Case Report Form 119 Appendix 3 – Permission for Chinese version of GOHAI 120 Appendix 4 – SAS code 121 | |
dc.language.iso | zh-TW | |
dc.title | 牙本質知覺敏感症之盛行率、相關危險因子調查及與口腔相關生活品質之關聯 | zh_TW |
dc.title | Prevalence and Risk Factors of Dentin Hypersensitivity and Association with Oral Health Related Quality of Life | en |
dc.type | Thesis | |
dc.date.schoolyear | 99-2 | |
dc.description.degree | 碩士 | |
dc.contributor.advisor-orcid | ,林俊彬(pinlin@ntu.edu.tw) | |
dc.contributor.oralexamcommittee | 李文宗(Wen-Chung Lee),連盈如(Yin-Ju Lien),季麟揚(Lin-Yang Chi) | |
dc.subject.keyword | 牙本質知覺敏感症,橫斷式研究,口腔健康相關生活品質, | zh_TW |
dc.subject.keyword | Dentin hypersensitivity,cross-sectional study,oral health related quality of life, | en |
dc.relation.page | 121 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2011-08-08 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
顯示於系所單位: | 公共衛生碩士學位學程 |
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