Greenstein Gary
Department of Periodontology, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
J Periodontol. 2005 Aug;76(8):1398-402. doi: 10.1902/jop.2005.76.8.1398.
Clinical parameters used to monitor periodontal patients are usually measures of the disease process. They are considered surrogate variables because changes in their status are interpreted to have an impact on the ultimate goal of periodontal therapy, which is tooth retention. However, their ability to reflect tooth survivability has been questioned because there is a lack of long-term data to validate that stable or improved surrogates result in reduced tooth loss. Therefore, to clarify the utility of employing surrogates to reflect long-term tooth retention, a number of issues related to their use are discussed in this commentary: phraseology, benefits and shortcomings, biologic credibility, and their previous successful utilization in monitoring the effects of therapy. This commentary supports the reasonableness of using surrogates to monitor periodontal status and suggests that a combination of surrogates that represent "periodontal clinical health" should be considered a true endpoint of periodontal therapy, since this outcome provides a condition conducive to tooth retention.
用于监测牙周病患者的临床参数通常是疾病进程的测量指标。它们被视为替代变量，因为其状态的变化被解释为对牙周治疗的最终目标（即保留牙齿）有影响。然而，它们反映牙齿留存率的能力受到了质疑，因为缺乏长期数据来证实稳定或改善的替代指标会导致牙齿缺失减少。因此，为了阐明使用替代指标反映长期牙齿保留情况的效用，本评论讨论了与其使用相关的一些问题：术语、优缺点、生物学可信度以及它们以前在监测治疗效果方面的成功应用。本评论支持使用替代指标监测牙周状况的合理性，并建议将代表“牙周临床健康”的替代指标组合视为牙周治疗的真正终点，因为这一结果提供了有利于牙齿保留的条件。
