Tsami Alexandra, Pepelassi Eudoxie, Kodovazenitis George, Komboli Mado
Department of Periodontics, School of Dentistry, University of Athens, Greece.
J Am Dent Assoc. 2009 Sep;140(9):1100-7. doi: 10.14219/jada.archive.2009.0336.
Investigators have evaluated predictive parameters of tooth loss during the maintenance phase (MP). The authors conducted a retrospective study to evaluate the rate of tooth loss and to explore the parameters that affect tooth loss during MP in a Greek population.
A periodontist administered periodontal treatment and maintenance care to 280 participants with severe periodontitis for a mean period +/- standard deviation of 10.84 +/- 2.13 years. The periodontist recorded the following parameters for each participant: oral hygiene index level, simplified gingival index level, clinical attachment level, probing depth measurements, initial tooth prognosis, smoking status, tooth loss during active periodontal treatment and MP, and compliance with suggested maintenance visits.
The authors found that total tooth loss during active treatment (n = 1,427) was greater than during MP (n = 918) and was associated with the initial tooth prognosis, tooth type group, participants' compliance with suggested maintenance visits, smoking status and acceptability of the quality of tooth restorations. Most of the teeth extracted during maintenance had an initial guarded prognosis (n = 612). Participants whose compliance was erratic had a greater risk of undergoing tooth extraction than did participants whose compliance was complete.
Participants' initial tooth prognosis, tooth type, compliance with suggested maintenance visits and smoking status affected tooth loss during MP. Initial guarded prognosis and erratic compliance increased the risk of undergoing tooth extraction during maintenance.
Determining predictive parameters for disease progression and tooth loss provides critical information to clinicians so that they can develop and implement rational treatment planning.
研究人员已对维护期（MP）牙齿脱落的预测参数进行了评估。作者开展了一项回顾性研究，以评估希腊人群在MP期间的牙齿脱落率，并探索影响牙齿脱落的参数。
一名牙周病医生对280名重度牙周炎患者进行了牙周治疗和维护护理，平均时长为10.84±2.13年（均值±标准差）。牙周病医生记录了每位患者的以下参数：口腔卫生指数水平、简化牙龈指数水平、临床附着水平、探诊深度测量值、初始牙齿预后、吸烟状况、牙周治疗活跃期和MP期间的牙齿脱落情况，以及是否遵守建议的维护复诊。
作者发现，活跃治疗期间的牙齿脱落总数（n = 1427）多于MP期间（n = 918），且与初始牙齿预后、牙齿类型组、患者对建议维护复诊的依从性、吸烟状况以及牙齿修复质量的可接受性有关。维护期间拔除的大多数牙齿最初预后为谨慎（n = 612）。依从性不稳定的患者比依从性良好的患者拔牙风险更高。
患者的初始牙齿预后、牙齿类型、对建议维护复诊的依从性和吸烟状况会影响MP期间的牙齿脱落。初始谨慎预后和不稳定依从性会增加维护期间拔牙的风险。
确定疾病进展和牙齿脱落的预测参数可为临床医生提供关键信息，以便他们制定和实施合理的治疗计划。
