预防牙周疾病进展的预测因素的多因素评估。
Multifactorial assessment of predictors for prevention of periodontal disease progression.
作者信息
Ehmke Benjamin, Beikler Thomas, Haubitz Imme, Karch Helge, Flemmig Thomas Frank
机构信息
Department of Periodontology, University of Münster, Waldeyerstr. 30, 48149, Münster, Germany.
出版信息
Clin Oral Investig. 2003 Dec;7(4):217-21. doi: 10.1007/s00784-003-0227-2. Epub 2003 Aug 26.
Univariate approaches have identified single factors influencing periodontal disease progression. The aim of this explorative approach was to assess the influence of various predictive factors responsible for the prevention of periodontal disease progression in the same patient sample. Patients with untreated chronic periodontitis underwent subgingival debridement alone or in combination with adjunctive antimicrobial therapy (systemic amoxicillin and metronidazole/7 days plus supragingival CHX irrigation). Supportive periodontal therapy was performed over a 24-month period. As predictors, clinical, microbial, immunological, and genetic parameters were assessed. The primary outcome variable was the percentage of teeth without attachment loss >/=2 mm over the study period (stability of attachment). At 24 months, multiple regression analysis identified adjunctive antimicrobial therapy for teeth with initially at least one site showing a pocket probing depth of >/=7 mm and IgG(4) reactivity against a 110-kDa protein of A. actinomycetemcomitans at teeth with initial pocket probing depths </=6 mm as main predictors of long-term attachment stability ( p<0.05). Other parameters failed to influence treatment outcome. Adjunctive antimicrobial therapy and antibody reactivity may be dominant factors influencing the prevention of attachment loss in patients receiving periodontal therapy.
单变量方法已确定了影响牙周疾病进展的单一因素。这种探索性方法的目的是在同一患者样本中评估各种预测因素对预防牙周疾病进展的影响。未经治疗的慢性牙周炎患者单独接受龈下刮治或联合辅助抗菌治疗(全身使用阿莫西林和甲硝唑/7天加龈上洗必泰冲洗)。在24个月期间进行支持性牙周治疗。作为预测指标,评估了临床、微生物、免疫和遗传参数。主要结局变量是在研究期间无附着丧失≥2mm的牙齿百分比(附着稳定性)。在24个月时,多元回归分析确定,对于最初至少有一个位点探诊深度≥7mm的牙齿,辅助抗菌治疗以及对于最初探诊深度≤6mm的牙齿,针对伴放线放线杆菌110kDa蛋白的IgG(4)反应性是长期附着稳定性的主要预测指标(p<0.05)。其他参数未能影响治疗结果。辅助抗菌治疗和抗体反应性可能是影响接受牙周治疗患者预防附着丧失的主要因素。