Department of Otolaryngology, University of Uludag, Bursa, Turkey.
Am J Otolaryngol. 2013 Sep-Oct;34(5):501-4. doi: 10.1016/j.amjoto.2013.04.013. Epub 2013 May 30.
To evaluate the impacts of obstructive adenotonsillar disease on periodontal health and to assess the efficacy of adenotonsillectomy in the prevention of chronic periodontitis in children.
This prospective and controlled clinical study was conducted between August 2012 and February 2013 with 35 pediatric patients who had permanent anterior dentition. The study group included twenty patients (n = 20) who had complaints of chronic mouth breathing and snoring and were diagnosed with obstructive adenotonsillar disease. These patients underwent adenoidectomy with or without tonsillectomy. We performed periodontal examinations to assess the periodontal health status in these children before and two months after surgery. The periodontal measures included plaque index (PI), pocket depth (PD) and gingival index scores (GI). Subsequently, these periodontal measures were compared with healthy control group who had no adenotonsillar disease (n = 15).
Among the study group six patients underwent adenoidectomy and 14 patients underwent adenoidectomy combined with either tonsillectomy or tonsillotomy. The preoperative PI, PD and GI scores of the study group were 1.27 ± 0.39, 1.34 ± 0.31 and 0.97 ± 0.37 respectively. These scores were significantly higher compared to the control group (p < 0.001). These periodontal index scores were significantly improved after surgery (p = 0.008 for PI and p < 0.001 for both PD and GI). In addition, we found no difference in postoperative values of PD and GI between the study group and control group.
We concluded that obstructive adenotonsillar disease adversely affects periodontal health in children and surgical management of obstruction improves the clinical findings. However, more comprehensive research is required to elucidate the association between adenotonsillar hypertrophy and periodontal disease.
评估阻塞性腺样体扁桃体疾病对牙周健康的影响，并评估腺样体扁桃体切除术预防儿童慢性牙周炎的疗效。
这是一项前瞻性对照临床研究，于 2012 年 8 月至 2013 年 2 月进行，纳入 35 名具有恒牙列的儿科患者。研究组包括 20 名（n = 20）有慢性张口呼吸和打鼾主诉并被诊断为阻塞性腺样体扁桃体疾病的患者。这些患者接受了腺样体切除术或联合扁桃体切除术。我们对这些儿童进行了牙周检查，以评估手术前后的牙周健康状况。牙周措施包括菌斑指数（PI）、牙周袋深度（PD）和牙龈指数评分（GI）。随后，将这些牙周措施与无腺样体扁桃体疾病的健康对照组（n = 15）进行比较。
研究组中，6 例患者仅行腺样体切除术，14 例患者行腺样体切除术联合扁桃体切除术或扁桃体切开术。研究组术前 PI、PD 和 GI 评分为 1.27 ± 0.39、1.34 ± 0.31 和 0.97 ± 0.37，明显高于对照组（p < 0.001）。这些牙周指数评分在手术后均显著改善（PI 为 p = 0.008，PD 和 GI 均为 p < 0.001）。此外，我们发现研究组和对照组术后 PD 和 GI 的值无差异。
我们的结论是，阻塞性腺样体扁桃体疾病会对儿童的牙周健康产生不利影响，阻塞的手术治疗可改善临床发现。然而，需要更全面的研究来阐明腺样体扁桃体肥大与牙周病之间的关联。
