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探诊深度的变化能否可靠预测临床附着丧失的变化?

Is change in probing depth a reliable predictor of change in clinical attachment loss?

机构信息

Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, 17-116 Moos Tower, 5151 Delaware St. S.E., Minneapolis, MN 55455, USA.

出版信息

J Am Dent Assoc. 2013 Feb;144(2):171-8. doi: 10.14219/jada.archive.2013.0096.

Abstract

BACKGROUND

Clinicians and researchers need a measure for monitoring the periodontal condition of their patients or study participants. The authors explored the utility of change in probing depth (PD) for predicting change in clinical attachment loss (CAL).

METHODS

The authors used clinical trial data from 363 participants who had received nonsurgical treatment to describe associations between PD and CAL changes. They computed the association between PD and CAL changes-correlation, sensitivity, specificity, and positive and negative predictive values-according to tooth type, tooth site and initial PD.

RESULTS

Depending on the subset of tooth sites, sensitivity of PD change to predict CAL change ranged from 18 to 74 percent; the highest sensitivity was at initially deep sites. Specificity and negative predictive value were higher than sensitivity and positive predictive value. Correlations between person-level mean PD and CAL changes ranged from 0.60 to 0.79 and were highest at initially deep sites.

CONCLUSIONS

Except at initially deep sites, PD change did not reliably predict CAL change. Clinicians and researchers who measure only PD may fail to identify teeth that lose or gain attachment.

CLINICAL IMPLICATIONS

Clinicians should consider monitoring CAL to detect changes in periodontal status more reliably. It is unknown if these findings apply to patients treated surgically or to prediction of tooth loss.

摘要

背景

临床医生和研究人员需要一种方法来监测患者或研究参与者的牙周状况。作者探讨了探诊深度(PD)变化预测临床附着丧失(CAL)变化的效用。

方法

作者使用了 363 名接受非手术治疗的参与者的临床试验数据,描述了 PD 和 CAL 变化之间的关联。他们根据牙齿类型、牙齿部位和初始 PD 计算了 PD 和 CAL 变化之间的关联——相关性、敏感性、特异性、阳性和阴性预测值。

结果

根据牙齿部位的子集,PD 变化对 CAL 变化的敏感性范围为 18%至 74%;在初始深部位的敏感性最高。特异性和阴性预测值高于敏感性和阳性预测值。个体水平平均 PD 和 CAL 变化之间的相关性范围为 0.60 至 0.79,在初始深部位最高。

结论

除了初始深部位外,PD 变化不能可靠地预测 CAL 变化。仅测量 PD 的临床医生和研究人员可能无法识别失去或获得附着的牙齿。

临床意义

临床医生应考虑监测 CAL,以更可靠地检测牙周状况的变化。这些发现是否适用于接受手术治疗的患者或牙齿缺失的预测尚不清楚。

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