Müller H P, Heinecke A
Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat.
Clin Oral Investig. 2002 Jun;6(2):69-74. doi: 10.1007/s00784-001-0141-4.
In both cross-sectional and longitudinal studies of young adults with plaque-induced gingivitis it has been observed that bleeding upon probing is only weakly associated with supragingival plaque. It has been speculated that gingival bleeding may be influenced by several independent factors other than plaque. Great intra- and interindividual variation of gingival thickness and width has been reported. Based on respective observations, the existence of different gingival phenotypes has been suggested. The aim of the present study was to investigate the possible influence of gingival thickness and width on bleeding on probing. Forty young adults with mild, plaque-induced gingivitis, 24 non-smokers and 16 smokers, participated in this cross-sectional study. In addition to periodontal probing depth, clinical attachment loss, width of gingiva, bleeding on probing, and presence of plaque, gingival thickness was measured with an ultrasonic device. Multivariable models were separately calculated for buccal, mandibular lingual, and palatal surfaces and generally adjusted for tooth type. Generalised Estimation Equation methodology was employed in order to adjust for correlated observations. Plaque was significantly associated with bleeding upon probing only at buccal sites (odds ratio 1.80, 95% confidence interval 1.19-2.72) An influence of similar magnitude was identified for smoking (odds ratio 1.76; 1.07-2.89). At lingual sites in the mandible, bleeding was influenced by smoking (odds ratio 2.25; 1.18-4.25) and gingival thickness (odds ratio for thick gingiva >1 mm of 1.93; 1.02-3.65), but not plaque. At palatal sites, only periodontal probing depth had an influence (odds ratio 1.89; 1.25-2.84). It was concluded that, apart from supragingival plaque, smoking was an independent risk factor for gingival bleeding on probing. Thin and vulnerable gingiva of insufficient width was not more likely to bleed after probing than thicker tissue.
在针对患有菌斑性牙龈炎的年轻成年人的横断面研究和纵向研究中均观察到,探诊出血与龈上菌斑仅存在微弱关联。据推测,牙龈出血可能受菌斑以外的多种独立因素影响。据报道,牙龈厚度和宽度在个体内和个体间存在很大差异。基于各自的观察结果,有人提出存在不同的牙龈表型。本研究的目的是调查牙龈厚度和宽度对探诊出血的可能影响。40名患有轻度菌斑性牙龈炎的年轻成年人,其中24名不吸烟者和16名吸烟者,参与了这项横断面研究。除了牙周探诊深度、临床附着丧失、牙龈宽度、探诊出血和菌斑存在情况外,还使用超声设备测量了牙龈厚度。分别针对颊侧、下颌舌侧和腭侧表面计算多变量模型,并一般根据牙齿类型进行调整。采用广义估计方程方法来调整相关观察结果。仅在颊侧部位,菌斑与探诊出血显著相关(优势比1.80,95%置信区间1.19 - 2.72)。吸烟也有类似程度的影响(优势比1.76;1.07 - 2.89)。在下颌舌侧部位,出血受吸烟(优势比2.25;1.18 - 4.25)和牙龈厚度(牙龈厚度>1mm的厚牙龈优势比为1.93;1.02 - 3.65)影响,但不受菌斑影响。在腭侧部位,只有牙周探诊深度有影响(优势比1.89;1.25 - 2.84)。研究得出结论,除龈上菌斑外,吸烟是探诊时牙龈出血的独立危险因素。宽度不足的薄而脆弱的牙龈在探诊后出血的可能性并不比较厚组织更高。