个体化口腔预防训练（iTOP）对正畸患者牙龈健康的影响

实验性的：iTOP 使用校准牙缝刷进行口腔卫生培训

实验性

行为的：Individually Trained Oral Prophylaxis (iTOP) Oral Hygiene Training

Participants receive individualized oral hygiene training using the Individually Trained Oral Prophylaxis (iTOP) method. The intervention is delivered in a one-to-one chairside session and uses the Touch-to-Teach technique, where the clinician guides the participant's hand to demonstrate correct toothbrushing and interdental cleaning movements. Calibrated interdental brushes are selected based on individual interdental space measurements using a color-coded interdental access probe. Participants practice the technique under supervision until proper technique is achieved. Reinforcement sessions are provided at 1 month and 3 months to ensure adherence and correct oral hygiene performance.

其他名称：

• 触摸教学技术
• 个性化

有源比较器：Conventional Oral Hygiene Instruction

Participants receive conventional oral hygiene education through model demonstration and video-based instruction. The session includes verbal explanation of toothbrushing and interdental cleaning techniques without individualized hands-on training. Reinforcement sessions are conducted at 1 month and 3 months.

行为的：Conventional Oral Hygiene Instruction

Participants receive conventional oral hygiene education consisting of verbal explanation, model demonstration, and video-based instruction illustrating standard toothbrushing and interdental cleaning techniques. This educational approach provides visual and verbal guidance but does not include individualized calibration of interdental brushes or hands-on correction of brushing technique. Participants are instructed to brush twice daily and perform interdental cleaning once daily using the provided oral hygiene kit. Reinforcement sessions using the same demonstration and video-based instruction are conducted at 1 month and 3 months.

其他名称：

• 模型演示与视频口腔卫生教育

近中邻面菌斑指数（API）变化

近中菌斑指数（API）用于评估邻面菌斑积聚情况。 使用菌斑显示剂显示菌斑，每个邻面根据菌斑存在与否进行评分。 API评分按可见菌斑的邻面数占检查总面数的百分比计算。 数值越低表明菌斑控制效果越好。

牙龈指数（GI）变化

牙龈指数用于评估牙龈炎症的严重程度。 每颗牙齿周围的牙龈在四个表面（近中、远中、颊侧和舌侧）进行评估，评分从0到3，其中0表示健康牙龈，3表示严重炎症伴自发性出血。 分数越低表明牙龈健康状况有所改善。

全口出血评分（FMBS）的变化

全口出血评分通过记录每颗牙齿六个位点的探诊出血情况来评估牙龈炎症程度。 该评分以轻柔探诊后显示出血的位点百分比进行计算。 较高百分比表示牙龈炎症较严重，而较低数值则反映牙龈健康状况改善。

Patient-Reported Outcome Measures (PROMs)

Participant experience, satisfaction, and compliance-related behaviors will be evaluated using a structured exit survey across five key domains:

1. Acceptability and interdental brush handling (good / fair / poor)
2. Procedure-related discomfort (minimal / moderate / high)
3. Self-perceived efficacy regarding cleanliness and bleeding reduction (good / fair / poor)
4. Participant satisfaction with the clarity and usefulness of assigned instructions (good / fair / poor)
5. Adherence to daily interdental cleaning regimen (Yes / No)

In addition, specific barriers to routine use (e.g., procedural confusion, technique uncertainty, lack of time, or lack of motivation) are recorded