口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (6): 388-394.DOI: 10.12016/j.issn.2096-1456.2021.06.005

• 临床研究 • 上一篇    下一篇

55例接触性口炎的致病因素及临床表现分析

刘柳(),王翔,段宁,赵毛毛,许开源,吴开慧,黄帆,王文梅()   

  1. 南京大学医学院附属口腔医院口腔黏膜病科,江苏 南京(210008)
  • 收稿日期:2020-08-18 修回日期:2020-10-01 出版日期:2021-06-20 发布日期:2021-04-12
  • 通讯作者: 王文梅
  • 作者简介:刘柳,主治医师,硕士,Email: liushuiying66@163.com
  • 基金资助:
    国家自然科学基金项目(81870767);江苏省临床医学专项(BL2014018);江苏省青年医学人才项目(QNRC2016118)

Analysis of pathogenic factors and clinical manifestations of 55 subjects with contact stomatitis

LIU Liu(),WANG Xiang,DUAN Ning,ZHAO Maomao,XU Kaiyuan,WU Kaihui,HUANG Fan,WANG Wenmei()   

  1. Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2020-08-18 Revised:2020-10-01 Online:2021-06-20 Published:2021-04-12
  • Contact: Wenmei WANG
  • Supported by:
    grants from National Natural Science Foundation of China(81870767);Jiangsu Provincial Clinical Medicine Special Program(BL2014018);Jiangsu Young Medical Talents Program(QNRC2016118)

摘要:

目的 探讨接触性口炎的致病因素及临床表现,为临床诊断及预防提供参考。方法 对55例明确诊断为接触性口炎的患者进行临床资料的回顾性分析,包括年龄、性别、致病因素、病损类型、发生部位。结果 55例患者中,各个年龄段均有发生,男性19例,女性36例,男女比例为1∶1.89。55例患者中,78.18%(43/55)因口腔黏膜接触牙科材料致病,银汞合金充填物致病占52.73%(29/55),金属冠致病占9.09%(5/55),活动义齿塑料基托致病占9.09%(5/55),树脂充填物致病占5.45%(3/55),藻酸盐印模材料致病占1.82%(1/55);因口腔黏膜接触食物、日用品等致病占21.82%(12/55)。接触性口炎的临床病损类型表现为苔藓样反应、红斑型及糜烂型。本组病例接触性口炎发生部位以颊部最多见,舌部次之,再次之为唇部,而牙龈和腭部则相对少见。在颊部黏膜,苔藓样反应的发生率为55%(22/40),高于糜烂型20%(8/40)和红斑型25%(10/40),差异具有统计学意义(P<0.05)。而对于舌、唇、龈、腭部位,3种病损类型的发生率差异无统计学意义(P>0.05)。结论 接触性口炎患者各年龄段均可发生,女性较多,牙科材料,尤其金属类和丙烯酸酯类(活动义齿塑料基托、树脂充填物、粘接剂、自凝塑料)材料,是其主要致病因素。在颊部黏膜,苔藓样反应的发生率较高。

关键词: 接触性口炎, 致病因素, 临床表现, 苔藓样反应, 红斑型, 糜烂型, 过敏, 牙科材料

Abstract:

Objective To investigate the pathogenic factors and clinical manifestations of contact stomatitis, and to provide references for its clinical diagnosis and prevention. Methods The data of 55 subjects with contact stomatitis were analyzed retrospectively, including age, gender, pathogenic factors, type of lesions and site of occurrence. Results Among the 55 patients, contact stomatitis occurred at all ages, 19 were male, 36 were female, and the ratio of males to females was 1∶1.89. Among 55 patients, 78.18% (43/55) were caused by oral mucosal contact with dental materials: amalgam fillings accounted for 52.73% (29/55), metal crowns accounted for 9.09% (5/55), removable denture plastic bases accounted for 9.09% (5/55), resin fillings accounted for 5.45% (3/55), and alginate impression materials accounted for 1.82% (1/55); 21.82% (12/55) were caused by oral mucosal contact with food and daily necessities. The clinical manifestations of contact stomatitis include lichenoid reaction, erythema and erosion. The most common site of contact stomatitis was the cheek, followed by the tongue, and the lips, and the gingival and palatal areas were relatively rare. In the buccal mucosa, the incidence of lichenoid reaction was 55% (22/40), which was higher than that of erosion (20%) and erythema (25%), and the difference was statistically significant (P < 0.05). For tongue, lip, gingiva and palate, there was no significant difference in the incidence of the three lesion types(P > 0.05). Conclusion Contact stomatitis occurred at all ages, and there are more female patients than males with contact stomatitis. Dental materials, especially metal and acrylic materials (such as the plastic base of removable dentures, resin fillings, adhesives, and self-setting plastics), are the main pathogenic factors. In buccal mucosa, the incidence of lichenoid reaction is higher.

Key words: contact stomatitis, pathogenic factors, clinical manifestations, lichenoid reaction, erosion, erythema, allergy, dental materials

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