Scharf Susanne, Wohlfeil Martin, Siegelin Yasemin, Schacher Beate, Dannewitz Bettina, Eickholz Peter
Department of Periodontology, Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany.
Clin Oral Investig. 2014;18(2):453-60. doi: 10.1007/s00784-013-1013-4. Epub 2013 Jun 10.
This study aims to analyze factors influencing treatment results in aggressive (AgP) and chronic (ChP) periodontitis.
ChP [probing pocket depth (PPD) ≥ 3.5 mm, attachment loss ≥ 5 mm at >30 % of sites; age > 35 years] and AgP (clinically healthy; PPD ≥ 3.5 mm at >30 % of sites, radiographic bone loss ≥ 50 % at 2 teeth; age ≤ 35 years) were examined prior and 3 months after nonsurgical therapy according to the full-mouth disinfection concept. Adjunctive systemic antibiotics were used if Aggregatibacter actinomycetemcomitans had been detected at baseline.
In 31 ChP (12 female, 10 smokers; 4,808 sites) and 28 AgP (16 female, 9 smokers; 4,769 sites), overall mean PPD reductions were less favorable in AgP (0.9 ± 0.5 mm) than in ChP (1.3 ± 0.4 mm; p = 0.033). PPD reductions and relative vertical probing attachment level gain were more favorable at sites with initial PPD ≥ 6 mm, bleeding on probing, and for adjunctive systemic antibiotics. Furthermore, PPD reductions were more favorable for increased baseline tooth mobility and maxillary teeth, whereas AgP, female sex, and multirooted teeth were associated with less favorable PPD reduction.
Regarding PPD reduction, AgP responded less favorably to nonsurgical treatment than ChP.
本研究旨在分析影响侵袭性牙周炎（AgP）和慢性牙周炎（ChP）治疗效果的因素。
根据全口消毒理念，在非手术治疗前及治疗后3个月对慢性牙周炎[探诊深度（PPD）≥3.5 mm，超过30%的位点附着丧失≥5 mm；年龄>35岁]和侵袭性牙周炎（临床健康；超过30%的位点PPD≥3.5 mm，2颗牙齿的影像学骨丧失≥50%；年龄≤35岁）进行检查。如果在基线时检测到伴放线聚集杆菌，则使用辅助性全身抗生素。
在31例慢性牙周炎患者（12例女性，10例吸烟者；4808个位点）和28例侵袭性牙周炎患者（16例女性，9例吸烟者；4769个位点）中，侵袭性牙周炎患者的总体平均PPD降低幅度（0.9±0.5 mm）不如慢性牙周炎患者（1.3±0.4 mm；p = 0.033）。在初始PPD≥6 mm、探诊出血的位点以及使用辅助性全身抗生素时，PPD降低幅度和相对垂直探诊附着水平增加更为明显。此外，基线时牙齿松动度增加和上颌牙齿的PPD降低更为明显，而侵袭性牙周炎、女性和多根牙与PPD降低幅度较小有关。
关于PPD降低，侵袭性牙周炎对非手术治疗的反应不如慢性牙周炎。
