Thomson W Murray, Broadbent Jonathan M, Poulton Richie, Beck James D
Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand.
J Periodontol. 2006 Jun;77(6):947-54. doi: 10.1902/jop.2006.050319.
Information is lacking on the natural history of periodontitis through the third and fourth decades of life.
Periodontal examinations were conducted at 26 and 32 years of age in a longstanding prospective study of a birth cohort born in Dunedin, New Zealand, in 1972 and 1973. At each age, gingival recession (GR) and probing depth (PD) were recorded at three sites per tooth using a diagonal half-mouth design (measurements were made in all four quadrants at 32 years of age, but longitudinal comparisons were made using only the half-mouth data).
A total of 882 individuals were examined at both ages. The mean number of measured sites fell between 26 and 32 years of age. The overall prevalence of one or more sites with >or=4 mm combined attachment loss (CAL) rose from 18.6% to 21.8%, whereas there were greater increases in the proportion with two or more sites with >or=4 mm CAL (from 8.0% to 12.6%) and one or more sites with >or=5 mm CAL (from 3.6% to 8.0%). The extent and severity of CAL also increased. A total of 403 individuals (45.7%) had an increase in CAL >or=2 mm at one or more sites, whereas 110 (12.5%) had a CAL increase >or=3 mm at one or more sites. Seen in approximately 4% of sites, negative GR (i.e., gingival enlargement) had a substantial effect on PD-based estimates. An increase in PD >or=2 mm at one or more sites was experienced by 345 individuals (39.1%), whereas 88 people (10.0%) had an increase in PD >or=3 mm at one or more sites. The greatest mean attachment loss was experienced at disto-lingual sites on molars, and most manifested as PD increases. Notable increases in GR were seen with lower incisors and canines.
Periodontal loss of attachment continues among a sizable proportion of people from the third to the fourth decade of life; however, contrary to patterns in older adults, changes in the PD component are greater than the changes in the recession component. Incident attachment loss is most frequently observed at proximal sites on posterior teeth.
关于牙周炎在30至40岁年龄段的自然病程，目前缺乏相关信息。
在一项对1972年和1973年出生于新西兰达尼丁的出生队列进行的长期前瞻性研究中，分别在26岁和32岁时进行了牙周检查。在每个年龄段，采用对角半口设计，在每颗牙齿的三个部位记录牙龈退缩（GR）和探诊深度（PD）（32岁时在所有四个象限进行测量，但纵向比较仅使用半口数据）。
共有882人在两个年龄段都接受了检查。测量部位的平均数量在26岁至32岁之间有所下降。一个或多个部位结合附着丧失（CAL）≥4 mm的总体患病率从18.6%上升至21.8%，而两个或更多部位CAL≥4 mm的比例（从8.0%增至12.6%）以及一个或多个部位CAL≥5 mm的比例（从3.6%增至8.0%）上升幅度更大。CAL的范围和严重程度也有所增加。共有403人（45.7%）在一个或多个部位的CAL增加≥2 mm，而110人（12.5%）在一个或多个部位的CAL增加≥3 mm。在约4%的部位观察到，负向GR（即牙龈肿大）对基于PD的评估有显著影响。345人（39.1%）在一个或多个部位的PD增加≥2 mm，而88人（10.0%）在一个或多个部位的PD增加≥3 mm。磨牙远舌侧部位的平均附着丧失最大，且大多表现为PD增加。下切牙和尖牙的GR有显著增加。
在相当一部分人从30岁到40岁的年龄段中，牙周附着丧失仍在继续；然而，与老年人的模式相反，PD部分的变化大于退缩部分的变化。新发附着丧失最常出现在后牙的邻面部位。
