[摘要]目的：探讨正畸治疗患者发生牙龈炎的危险因素，并构建相关预测模型。方法：收集2017年5月-2022年1月于合肥市第三人民医院行正畸治疗的204例患者的临床资料（性别、年龄、吸烟、矫治器装置不良、每日刷牙次数、每次刷牙时间和口腔卫生健康教育情况），使用单因素和多因素Logistic回归分析正畸治疗患者发生牙龈炎的危险因素，并据此建立列线图预测模型。结果：吸烟（OR=2.988，95%CI=1.331～6.706）、矫治器装置不良（OR=2.712，95%CI=1.239～5.936）、每日刷牙次数＜2次（OR=2.808，95%CI=1.451～5.435）、每次刷牙时间短（OR=1.991，95%CI=1.233～3.214）和未受到口腔卫生健康教育（OR=2.423，95%CI=1.160～5.062）是正畸治疗患者发生牙龈炎的独立危险因素（P＜0.05）。依此建立预测正畸治疗患者发生牙龈炎的列线图风险模型，模型验证结果显示C-index为0.807，校正曲线趋近于理想曲线，ROC曲线的AUC为0.810（95%CI=0.775～0.843），在2%～85%范围内，模型净获益值较高。结论：正畸治疗患者发生牙龈炎的危险因素包括吸烟、矫治器装置不良、每日刷牙次数＜2次、每次刷牙时间短和未受到口腔卫生健康教育，据此构建的列线图模型能有效预测正畸治疗患者发生牙龈炎的风险概率。

[关键词]正畸；牙龈炎；危险因素；列线图；风险概率

[中图分类号]R783.5" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0144-05

Establishment of A Nomogram Prediction Model of Risk Factors for Gingivitis in Orthodontic Treatment Patients

LIU Xin1， GONG Naisheng1， DU Ruohong2

（ 1.Department of Stomatology， Hefei Third People's Hospital， Hefei Third Clinical College of Anhui Medical University， Hefei 230001， Anhui， China; 2.Department of Stomatology， the First Affiliated Hospital of Anhui Medical University， Hefei 230002， Anhui， China ）

Abstract： Objective" To investigate the risk factors of gingivitis in orthodontic patients and establish the related prediction model. Methods" The clinical data （gender， age， smoking， poor appliance device，brushing times per day， single brushing time and oral health education） of 204 patients who received orthodontic treatment in Hefei Third People's Hospital from May 2017 to January 2022 were collected. The risk factors of gingivitis in orthodontic patients were analyzed by univariate and multivariate logistic regression， and a nomogram prediction model was established." Results" Smoking（OR=2.988， 95%CI =1.331-6.706）， poor appliance（OR=2.712， 95%CI=1.239-5.936），brushing times per day＜2（OR=2.808， 95%CI=1.451-5.435），short single brushing time（OR=1.991， 95%CI=1.233-3.214）and no oral health education（OR=2.423，95%CI=1.160-5.062）were independent risk factors for gingivitis in orthodontic patients （P＜0.05）. Based on the data， a nomogram risk model for predicting gingivitis in orthodontic patients was established. The model verification results showed that the C-index was 0.807， the correction curve was close to the ideal curve， and the AUC of ROC curve was 0.810 （95% CI= 0.775-0.843）. Within the range of 2%-85%， the model had a high net benefit value. Conclusion" The risk factors of gingivitis in orthodontic patients include smoking， poor appliance devices， brushing times per day＜2， short single brushing time and no oral health education. The nomogram model can effectively predict the risk probability of gingivitis in orthodontic patients.

Key words： orthodontics; gingivitis; risk factors; nomogram; risk probability

错牙合畸形是指牙颌、颅面间关系不调而引起的各种畸形，临床表现多样，虽然目前尚未形成统一的流行病学调查标准，但荟萃分析显示世界范围内患病率呈上升趋势[1]。正畸是纠正错牙合畸形的重要治疗手段，但治疗期间由于托槽、弓丝、带环、结扎圈、牵引钩等装置会使口腔内易残留食物残渣，长期可引起牙龈红肿、出血、菌斑聚集等炎性症状，从而损害牙周组织，严重者可导致矫正失败[2-3]。……