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广泛性侵袭性牙周炎的牙根异常与非手术治疗

Root abnormalities and nonsurgical management of generalized aggressive periodontitis.

作者信息

Lü Da, Meng Huanxin, Xu Li, Wang Xian'e, Zhang Li, Tian Yu

机构信息

Department of Periodontology, Peking University School and Hospital of Stomatology.

出版信息

J Oral Sci. 2017;59(1):103-110. doi: 10.2334/josnusd.16-0258.

Abstract

UNLABELLED

To investigate long-term nonsurgical treatment outcomes in patients with generalized aggressive periodontitis (GAgP) and the impact of root abnormalities (RAs) and other patient-level factors in relation to GAgP progression. Patients (n = 64) from a GAgP cohort who completed active nonsurgical periodontal treatment and consented to re-evaluation after 3 to 11 (mean 5.3) years, were enrolled. RAs were identified using radiographs. Periodontal parameters (e.g., probing depths [PDs], and tooth loss [TL]) were investigated. Multivariate analysis was performed to identify factors contributing to TL and bone level alteration (∆BL). After treatment, the mean number of sites with PDs > 5 mm decreased from 54.3 to 17.2. Annual TL was 0.11/patient. Twenty-one patients (32.8%) had >4 teeth with root abnormalities (RA-teeth) and exhibited a higher risk for TL (univariate odds ration [OR] = 3.52, multivariate logistic OR = 6.57). Factors correlated to ∆BL were sites with residual PD > 5 mm (β = -0.400) and observation time (β = -0.210). Nonsurgical treatment provides beneficial outcomes in GAgP patients. Higher incidence of RAs and high prevalence of residual deep pockets have a negative impact on long-term outcomes.

PRACTICAL IMPLICATIONS

in cases of GAgP with residual deep pockets and high incidence of RAs, clinicians must emphasize that long-term outcomes of nonsurgical treatment may be compromised.

摘要

未标注

为了研究广泛侵袭性牙周炎(GAgP)患者的长期非手术治疗效果,以及牙根异常(RAs)和其他患者层面因素对GAgP进展的影响。纳入了来自GAgP队列的64名患者,他们完成了积极的非手术牙周治疗,并同意在3至11年(平均5.3年)后进行重新评估。通过X线片识别牙根异常。研究了牙周参数(如探诊深度[PDs]和牙齿缺失[TL])。进行多变量分析以确定导致牙齿缺失和骨水平改变(∆BL)的因素。治疗后,探诊深度>5mm的位点平均数从54.3降至17.2。每年的牙齿缺失率为0.11/患者。21名患者(32.8%)有>4颗牙根异常的牙齿(RA-牙齿),并且牙齿缺失风险更高(单变量优势比[OR]=3.52,多变量逻辑OR=6.57)。与∆BL相关的因素是探诊深度>5mm的位点(β=-0.400)和观察时间(β=-0.210)。非手术治疗为GAgP患者带来有益的效果。牙根异常的高发生率和残留深牙周袋的高患病率对长期效果有负面影响。

实际意义

在存在残留深牙周袋和牙根异常高发生率的GAgP病例中,临床医生必须强调非手术治疗的长期效果可能会受到影响。

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