University of Bern, Bern, Switzerland.
The University of Honk Kong, Hong Kong, China.
J Clin Periodontol. 2017 Dec;44(12):1182-1191. doi: 10.1111/jcpe.12782. Epub 2017 Sep 22.
To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years.
Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined.
PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age.
These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.
评估未经治疗的牙周病患者在 40 多年中牙周附着丧失和牙周炎相关牙齿缺失（PTL）的长期情况。
数据来自于斯里兰卡茶工牙周炎自然史研究，该研究于 1970 年首次进行。2010 年，对原始队列中的 75 名受试者（15.6%）进行了重新检查。
40 多年的 PTL 变化范围为 0 至 28 颗牙齿（平均 13.1 颗）。有 4 名受试者没有 PTL，而 12 名受试者无牙。逻辑回归显示附着丧失是 PTL 的统计学显著协变量（p<.004）。马尔可夫链分析表明，吸烟和牙石与疾病的发生有关，而牙石、菌斑和牙龈炎与附着丧失和疾病进展到晚期有关。30 岁时的平均附着丧失<1.81mm 对将受试者分配到 60 岁时至少有 20 颗牙齿的队列中具有最高的敏感性和特异性（0.71）。
这些结果强调了在 30 岁以下人群中，除了戒烟外，还需要积极治疗早期牙周炎。它们进一步表明，去除牙石、控制菌斑和控制牙龈炎对于预防疾病进展、进一步丧失附着和最终牙齿缺失至关重要。
