Hughes Francis J, Syed Mahnaz, Koshy Bindhu, Marinho Valeria, Bostanci Nagihan, McKay Ian J, Curtis Michael A, Croucher Raymond E, Marcenes Wagner
Collaborative Group in Risk Factors for Periodontal Disease, Institute of Dentistry, Queen Mary's School of Medicine, London, UK.
J Clin Periodontol. 2006 Sep;33(9):663-70. doi: 10.1111/j.1600-051X.2006.00966.x. Epub 2006 Jul 20.
The aims of this study were to investigate prognostic factors for initial response to non-surgical periodontal treatment for generalized aggressive periodontitis.
Seventy-nine patients with generalized aggressive periodontitis were included in this prospective follow-up intervention study. Patients' clinical and demographic parameters were collected at baseline and 10 weeks following a standard course of treatment (four visits of non-surgical root surface debridement together with OHI as required). The relationship between clinical variables and treatment outcome were analysed at site-specific level by chi(2) analysis and for patient-specific variables by logistic regression.
In general, there was a good response to the treatment provided. In deep sites the mean pocket depth reduction was 2.11+/-2.01 mm. Site-specific analysis showed that the presence of plaque had a small but significant predictive effect on outcome (odds ratio 1.4). Sites on teeth with grade II/III mobility showed a significantly reduced response to treatment. Twenty-five patients were classified as "non-responders". Current smoking was strongly associated with non-responding patients (odds ratio 3.8) in a logistic regression model; plaque, baseline bleeding and initial pocket depth were not significantly associated with treatment outcomes.
Overall, the results emphasize the importance of smoking as a negative prognostic factor, and suggest that treatment outcomes may be determined by a wide range of different determinants requiring further study.
本研究旨在调查广泛侵袭性牙周炎非手术牙周治疗初始反应的预后因素。
本前瞻性随访干预研究纳入了79例广泛侵袭性牙周炎患者。在基线时以及标准疗程治疗（四次非手术根面清创术并根据需要进行口腔卫生指导）10周后收集患者的临床和人口统计学参数。通过卡方分析在特定部位水平分析临床变量与治疗结果之间的关系，并通过逻辑回归分析患者特定变量。
总体而言，所提供的治疗反应良好。在深度牙周袋部位，平均袋深减少2.11±2.01毫米。特定部位分析表明，菌斑的存在对结果有微小但显著的预测作用（优势比1.4）。II/III度松动牙的部位对治疗的反应明显降低。25例患者被归类为“无反应者”。在逻辑回归模型中，当前吸烟与无反应患者密切相关（优势比3.8）；菌斑、基线出血和初始袋深与治疗结果无显著关联。
总体而言，结果强调了吸烟作为不良预后因素的重要性，并表明治疗结果可能由多种不同的决定因素决定，需要进一步研究。
