Brägger U, Schürch E, Salvi G, von Wyttenbach T, Lang N P
Department of Crown and Bridge Prosthetics and Comprehensive Dental Care, School of Dental Medicine, University of Berne, Switzerland.
Cleft Palate Craniofac J. 1992 Mar;29(2):179-85. doi: 10.1597/1545-1569_1992_029_0179_pciapw_2.3.co_2.
The present study assessed the progression rate of periodontal disease over 8 years in a group of 52 adult patients with various forms of cleft lip, alveolus, and palate considered at risk for progression of periodontal disease. Of special interest was the evaluation of periodontal disease progression at sites adjacent to cleft regions compared to changes found at control sites not directly affected by such defects. High incidences of generalized plaque accumulation and bleeding on probing were noted at both examinations in 1979 and 1987. A mean apical shift of the clinical attachment level amounting to 0.2 mm had occurred over the 8-year observation period. A slight apical displacement of the mesial and distal mean crestal alveolar bone was also noted. The rate of progression of periodontal disease over the 8 years was not found to be different at statistically significant levels at cleft sites compared to control sites. However, the results of this study documented that the cumulative periodontal destruction at 26 to 28 years of age was statistically significant and more pronounced at cleft sites as revealed by greater probing pocket depth and loss of clinical attachment. The differences between test and control sites amounted to 0.3 and 0.4 mm respectively for probing depth and 0.6 mm for loss of clinical attachment. In addition, the discrepancy between alveolar bone height and the levels of the clinical attachment at cleft sites demonstrated the presence of a long supracrestal connective tissue attachment adjacent to cleft defects. Therefore, the alveolar bone height as visualized in radiographs at such sites was considered an unreliable diagnostic tool for the assessment of the degree of periodontal destruction.
本研究评估了52名患有各种唇裂、牙槽裂和腭裂形式且被认为有牙周病进展风险的成年患者在8年期间的牙周病进展率。特别令人感兴趣的是，与未直接受此类缺陷影响的对照部位的变化相比，评估腭裂区域相邻部位的牙周病进展情况。在1979年和1987年的两次检查中均发现，菌斑普遍堆积和探诊出血的发生率很高。在8年的观察期内，临床附着水平平均向根尖方向移动了0.2毫米。还注意到近中及远中平均嵴顶牙槽骨有轻微的根尖移位。与对照部位相比，腭裂部位8年期间的牙周病进展率在统计学上没有显著差异。然而，本研究结果表明，26至28岁时的累积牙周破坏在统计学上具有显著意义，且在腭裂部位更为明显，表现为探诊袋深度增加和临床附着丧失。试验部位与对照部位在探诊深度上的差异分别为0.3毫米和0.4毫米，临床附着丧失的差异为0.6毫米。此外，腭裂部位牙槽骨高度与临床附着水平之间的差异表明，腭裂缺陷相邻处存在较长的龈上结缔组织附着。因此，在此类部位X线片上显示的牙槽骨高度被认为是评估牙周破坏程度的不可靠诊断工具。
