- 學位論文
人格特質及牙齒狀況與口腔扁平苔癬的關係
The relationships of personality characteristics and dental conditions to oral lichen planus
摘要
研究目的： 本研究欲探討何種人格特質可能與口腔扁平苔癬有關，及分析牙齒狀況與口腔扁平苔癬之相關性。 材料與方法： 本研究設計為關聯性研究。納入條件：疾病組患者之口腔扁平苔癬病灶需至少出現於兩個部位以上，經臨床或病理切片診斷確診為口腔扁平苔癬。對照組收案對象依年齡、性別與疾病組配對，各收案36位。排除條件：有精神科病史者、罹患自體免疫疾病、曾接受過放療或化療、有胃食道逆流、磨牙習慣者。受試者皆填寫“基本人口學與習慣問卷”與“健康、性格、習慣量表”，並接受口腔檢查。以SAS、SPSS(第20版)進行統計分析，配對資料之類別變項比較以McNemar檢定分析，而連續變項平均值之比較以成對t檢定分析。非配對資料之比較以卡方、Fisher’s 精確檢定、單因子變異數分析、獨立t檢定進行分析。與口腔扁平苔癬有關之風險因子再以條件式邏輯迴歸做進一步分析。設定p<0.05為有顯著差異。 結果： 疾病組之牙齒齒頸部刷耗(cervical abrasion)顆數平均為8.46顆（±6.50），對照組平均為4.39顆（±4.57），兩組於齒頸部刷耗顆數具統計上顯著差異（p=0.002）。兩組間於使用牙間刷的人數（p=0.041）及平均每次刷牙時間（p=0.001）具統計上顯著差異。疾病組於牙位14（p=0.013）、25（p=0.012）、32（p=0.008）、33（p=0.021）、35（p=0.008）、44（p=0.019）之刷耗人數顯著較對照組多。 在人格特質之比較結果，疾病組有較多“強迫型人格違常傾向”的趨勢，但此差異未呈現統計上顯著意義。 結論： 疾病組之平均刷牙時間雖較短，但牙齒齒頸部刷耗(cervical abrasion)顆數較多，具統計上顯著差異，疾病組刷耗顆數之相對危險值(odd’s ratio)為對照組之1.617倍(OR=1.617 ; 95％CI: 1.042~2.509)。 疾病組有“強迫型人格違常傾向”之潛力，未來可朝此方向做更深入之探討。
並列摘要
Objective: The purpose of this study was to identify possible personality characteristics to patients with oral lichen planus, and to analyze the relationships between dental conditions and oral lichen planus. Materials & Methods： The current study design was an association study. Inclusion criteria of the disease group subjects (n=36) were diagnosed as oral lichen planus only if the lesion involved at least two sites and were clinically or histopathologically diagnosed. The control group subjects (n=36) were matched with disease subjects by age and gender. Exclusion criteria include history of mental or psychological disorders, autoimmune diseases, radiation therapy or chemotherapy, gastroesophageal reflux, and bruxism habit. The subjects of both groups were required to answer the “demographic data and life habits questionnaire”, “HPH (Health, Personality, and Habit) questionnaire” and undergo a dental examination. Statistical analyses were performed by means of SAS、SPSS version 20. The categorical data of pair-matched subjects were examined by using McNemar test, whereas the interval data of pair-matched subjects’ means were examined by paired t-test. In addition to the above-mentioned statistical methodologies, chi-squared test, Fisher’s exact test, one-way ANOVA and independent t-test were also conducted in the current study to investigate whether there were any significant differences between subgroups. Furthermore, the significant risk factors related to patients with oral lichen planus were analyzed by conducting conditional logistic regression. Statistical significance was set at the level of p<0.05. Results: The average tooth number of cervical abrasion in the disease group (8.46 ± 6.50) was significantly higher than the number in the control group (4.39 ± 4.57) (p = 0.002). Significant differences were also noted between groups in the percentage of subjects using interdental brush (p=0.041) and the average brushing time (p=0.001). Moreover, compared to the control group, subjects in the disease group had significant higher numbers of cervical abrasion respectively over tooth 14 (p=0.013), tooth 25 (p=0.012), tooth 32 (p=0.008), tooth 33 (p=0.021), tooth 35 (p=0.008), and tooth 44 (p=0.019). In the comparison of personality characteristics, subjects in the disease group had a higher tendency of having “obsessive compulsive personality disorder traits”; however, no significant differences were determined. Conclusions: Although the average brushing time of subjects in the disease group is shorter, this study suggests that the average tooth number of cervical abrasion in the disease group is significantly higher than that of the control group. The tooth number of cervical abrasion among patients with OLP was higher than the participants in the control group(OR=1.617; 95%CI:1.042 ~ 2.509). Patients with oral lichen planus had potential higher “obsessive compulsive personality disorder traits”, but future studies would be required for a more confirmative result.