Elter J R, Beck J D, Slade G D, Offenbacher S
Center for Oral and Systemic Diseases, Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, 27599-7450, USA.
J Clin Periodontol. 1999 Feb;26(2):113-23. doi: 10.1034/j.1600-051x.1999.260209.x.
Etiologic factors for incident periodontal attachment loss (ALOSS) have not been conclusively identified. The purpose of this study was to develop etiologic models for ALOSS in older adults. Data on 697 older blacks and whites were obtained from 5 sequential examinations over 7 years in the Piedmont 65+ dental study, a complex random sample of older adults in North Carolina. Multivariable Poisson regression models were fit for average number of ALOSS events per person or site month at risk. In models for whites, molar sites, sites with adjacent caries, sites in persons who had: Porphyromonas gingivalis (P.g.) at least 2% of total microbial count (TMC), never had a dental checkup, more depression symptoms, fewer than 12 years of education, higher BANA score, or smoked, had significantly higher rates of ALOSS. In a separate model for blacks, interproximal and molar sites, sites in blacks who had: P.g. at least 2% of TMC, higher BANA score, never had a dental checkup, lower socioeconomic status (SES), or smoked, had significantly higher rates of ALOSS. These results confirm a multifactorial etiology for ALOSS in older adults and indicate that interventions aimed at infection, smoking, and preventive dental care utilization, may be most useful.
牙周附着丧失（ALOSS）的病因尚未得到最终确定。本研究的目的是建立老年人ALOSS的病因模型。在皮埃蒙特65岁及以上牙科研究中，通过对北卡罗来纳州老年人进行复杂随机抽样，在7年的时间里进行了5次连续检查，获得了697名老年黑人和白人的数据。对处于风险中的每人或每个部位每月的ALOSS事件平均数量拟合多变量泊松回归模型。在白人的模型中，磨牙部位、有邻面龋的部位、在以下人群中的部位：牙龈卟啉单胞菌（P.g.）占总微生物计数（TMC）至少2%、从未进行过牙科检查、抑郁症状较多、受教育年限少于12年、BANA评分较高或吸烟的人群，其ALOSS发生率显著更高。在黑人的一个单独模型中，邻面和磨牙部位、在以下黑人中的部位：P.g.占TMC至少2%、BANA评分较高、从未进行过牙科检查、社会经济地位（SES）较低或吸烟的人群，其ALOSS发生率显著更高。这些结果证实了老年人ALOSS的多因素病因，并表明针对感染、吸烟和预防性牙科护理利用的干预措施可能最有用。
