School of Dentistry, University of Queensland, Brisbane, Queensland, Australia.
Private practice, Sydney, New South Wales, Australia.
J Periodontol. 2017 Sep;88(9):869-875. doi: 10.1902/jop.2017.160774. Epub 2017 May 18.
A previous study investigated differences in the severity of periodontal disease on referral for specialist care between 1980 and 2000 across the United States. The present study finds patients referred in 2000 had greater severity of periodontal disease than those referred 20 years ago.
A retrospective analysis of 384 charts was completed from three periodontal practices across the east coast of Australia. Two time periods were investigated: 2000 to 2001 and 2015 to 2016. From these charts, the following data were recorded: 1) age; 2) sex; 3) smoking status; 4) number of missing teeth; and 5) number of teeth planned for extraction as part of a treatment plan at initial examination. Additionally, degree of periodontal severity was determined and recorded. The classification system was based on that used by the previous study, wherein case Types I to IV defined increasing severity of periodontal disease, and Type V defined referrals for needs other than periodontal disease (e.g., crown lengthening and implants).
Overall, patients seen in 2015 presented with a greater percentage of Type IV and Type V cases. Smoking prevalence reduced significantly across the three locations between the two time periods. No consistent or noteworthy trends were identified with regard to number of missing teeth or number of teeth planned for extraction.
Consistent with the results of a similar previous study, there appears to be a trend for more severe periodontal conditions being referred to periodontists. This is concerning given that more severe periodontal conditions tend to be more difficult to manage conservatively and reliably.
先前的研究调查了美国在 1980 年至 2000 年期间,因专业护理而转诊的患者牙周病严重程度的差异。本研究发现,与 20 年前相比,2000 年转诊的患者牙周病的严重程度更大。
对澳大利亚东海岸三家牙周病诊所的 384 份病历进行了回顾性分析。调查了两个时期:2000 年至 2001 年和 2015 年至 2016 年。从这些图表中记录了以下数据:1)年龄;2)性别;3)吸烟状况;4)缺牙数量;5)初始检查时作为治疗计划一部分计划拔牙的牙齿数量。此外,还确定并记录了牙周病严重程度。该分类系统基于先前研究中使用的系统,其中病例类型 I 至 IV 定义了牙周病严重程度的增加,而类型 V 则定义了因牙周病以外的需求而转诊(例如,冠延长术和种植体)。
总体而言,2015 年就诊的患者出现 IV 型和 V 型病例的比例更高。三个地点的吸烟率在两个时期之间显著降低。在缺牙数量或计划拔牙数量方面,没有发现一致或值得注意的趋势。
与类似的先前研究结果一致,似乎有更多严重牙周状况被转诊给牙周病医生的趋势。鉴于更严重的牙周状况往往更难以保守和可靠地治疗,这令人担忧。