Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany.
J Clin Periodontol. 2017 Jun;44(6):612-619. doi: 10.1111/jcpe.12725. Epub 2017 Apr 27.
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.
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.
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).
Within the provided conservative treatment regimen, GAgP patients lost only few teeth.
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。
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。
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。
在提供的保守治疗方案中，GAgP 患者仅丢失少量牙齿。
