广泛性侵袭性牙周炎的牙齿缺失：17 年牙周支持治疗后的预后因素。
Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment.
机构信息
Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany.
出版信息
J Clin Periodontol. 2017 Jun;44(6):612-619. doi: 10.1111/jcpe.12725. Epub 2017 Apr 27.
AIM
This retrospective longitudinal study assessed the risk of and prognostic factors for tooth loss in patients with generalized aggressive periodontitis (GAgP) after periodontal treatment in a university setting.
METHODS
Fifty-seven patients (1,505 teeth) were examined before (T0) and after active periodontal therapy (APT, T1) as well as after 17.4 ± 4.8 [range: 9-28] years of supportive periodontal therapy (SPT, T2). Descriptive statistics and a Cox-proportional-hazards shared-frailty model were applied.
RESULTS
Overall, 98 and 134 teeth were lost during APT and SPT, respectively, with 0.14 ± 0.18 teeth being lost per patient and year. During SPT, three patients (5%) lost ≥10 teeth, 14 (25%) lost 4-9 teeth, 40 lost 0-3 (70%) teeth, respectively. One-third (n = 19) of all patients lost no teeth. Mean PPD of the teeth surviving SPT was stable from T1 (3.5 ± 1.1 mm) to T2 (3.4 ± 1.1 mm). Nearly, 84% of all survived teeth showed stable or improved bone level at T2. Risk of tooth loss was significantly increased in active smokers (HR[95% CI]: 4.94[1.91/12.75]), the upper dental arch (1.94[1,16/3.25]), with each mm of residual PPD (1.41[1.29/1.53]), teeth with furcation involvement (FI) (HR 4.00-4.44 for different degrees) and mobility (5.39 [2.06/14.1] for degree III).
CONCLUSION
Within the provided conservative treatment regimen, GAgP patients lost only few teeth.
目的
本回顾性纵向研究评估了在大学环境中进行牙周治疗后，广泛性侵袭性牙周炎（GAgP）患者的牙齿缺失风险和预后因素。
方法
57 名患者（1505 颗牙齿）在牙周治疗前（T0）、牙周治疗后（APT，T1）以及牙周支持治疗后 17.4±4.8 年（范围：9-28 年）（T2）进行了检查。采用描述性统计和 Cox 比例风险共享脆弱性模型进行分析。
结果
在 APT 和 SPT 期间，分别有 98 颗和 134 颗牙齿丢失，每位患者和每年丢失 0.14±0.18 颗牙齿。在 SPT 期间，3 名患者（5%）丢失≥10 颗牙齿，14 名患者（25%）丢失 4-9 颗牙齿，40 名患者丢失 0-3 颗（70%）牙齿。三分之一（n=19）的患者没有丢失牙齿。SPT 存活牙齿的平均 PPD 从 T1（3.5±1.1mm）到 T2（3.4±1.1mm）保持稳定。在 T2 时，近 84%的存活牙齿显示出稳定或改善的骨水平。活跃吸烟者（HR[95%CI]：4.94[1.91/12.75]）、上颌牙弓（1.94[1，16/3.25]）、每个毫米剩余 PPD（1.41[1.29/1.53]）、有分叉受累（FI）的牙齿（不同程度的 HR 为 4.00-4.44）和松动（III 度为 5.39[2.06/14.1]）的牙齿，其牙齿缺失风险显著增加。
结论
在提供的保守治疗方案中，GAgP 患者仅丢失少量牙齿。
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