Schätzle Marc, Löe Harald, Bürgin Walter, Anerud Age, Boysen Hans, Lang Niklaus P
Department of Periodontology and Fixed Prosthodontics, University of Berne, School of Dental Medicine, Switzerland.
J Clin Periodontol. 2003 Oct;30(10):887-901. doi: 10.1034/j.1600-051x.2003.00414.x.
The purpose of this study was to determine the influence of long-standing gingival inflammation on periodontal attachment loss. On the basis of repeated examinations, the present report describes the influence of gingival inflammation on the initiation of periodontitis from 16 to 59 years of age.
The data originated from a 26-year longitudinal study of Norwegian males, who practiced daily oral home care and received state-of-the-art dental care. The initial examination included 565 individuals. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. All tooth sites were divided into four categories according to their history of gingival inflammation over the entire observation period: sites always scoring GI = 0, GI = 1 and GI = 2 sites (GI = gingival index). Sites disclosing various GI scores at different observation periods were not considered.
The mean cumulative attachment loss for non-inflamed (GI = 0) sites in individuals approaching 60 years of age was 1.94 mm. Sites always scoring GI = 1 yielded 2.42 mm, and sites that always scored GI = 2 exhibited 3.31 mm of periodontal attachment loss. At interproximal sites of all three groups where gingival trauma was assumed to be minimal or non-existent, only very few sites expressed attachment loss due to gingival recession (2-4%). At interproximal sites always scoring GI = 0, 20% loss of attachment was in the form of pocket formation by 59 years of age. The GI = 1 and the GI = 2 cohorts exhibited attachment loss with pocket formation in 28% and 54%, respectively.
This study has shown that, as men approach 60 years of age, gingival sites that throughout the 26 years of observation bled on probing had approximately 70% more attachment loss than sites that were consistently non-inflamed (GI = 0). Before 40 years of age, there was a slight increase in periodontal attachment loss due to pocket formation, but after this, the frequency increased significantly. Loss of attachment due to gingival recession was very small in all three groups. The fact that sites with non-inflamed gingiva also exhibited some loss of attachment and pocket formation may be explained by fluctuation in the variations of tissue status during long observation intervals combined with the presence of subclinical inflammation.
本研究旨在确定长期牙龈炎症对牙周附着丧失的影响。基于多次检查，本报告描述了牙龈炎症对16至59岁人群牙周炎发病的影响。
数据来源于一项对挪威男性进行的为期26年的纵向研究，这些男性日常进行口腔家庭护理并接受先进的牙科护理。初始检查包括565名个体。随后的检查分别在1971年、1973年、1975年、1981年、1988年和1995年进行。因此，该研究涵盖了16至59岁的年龄范围。根据整个观察期内牙龈炎症病史，将所有牙位分为四类：探诊出血指数（GI）始终为0的部位、GI = 1的部位和GI = 2的部位（GI = 牙龈指数）。在不同观察期显示不同GI评分的部位不予考虑。
接近60岁个体中，非炎症（GI = 0）部位的平均累积附着丧失为1.94毫米。GI始终为1的部位为2.42毫米，GI始终为2的部位牙周附着丧失为3.31毫米。在三组所有邻面部位，假定牙龈创伤极小或不存在，仅有极少数部位因牙龈退缩出现附着丧失（2 - 4%）。在GI始终为0的邻面部位，到59岁时，20%的附着丧失表现为袋形成。GI = 1和GI = 2组中，分别有28%和54%的附着丧失伴有袋形成。
本研究表明，随着男性接近60岁，在26年观察期内探诊出血的牙龈部位的附着丧失比始终无炎症（GI = 0）的部位多约70%。40岁之前，因袋形成导致的牙周附着丧失略有增加，但此后频率显著上升。在所有三组中，因牙龈退缩导致的附着丧失都非常小。牙龈无炎症的部位也出现一些附着丧失和袋形成这一事实，可能是由于在长时间观察期内组织状态变化的波动以及亚临床炎症的存在所致。
