Stenman J, Wennström J L, Abrahamsson K H
Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Int J Dent Hyg. 2018 May;16(2):298-304. doi: 10.1111/idh.12308. Epub 2017 Aug 24.
To evaluate (ii) whether inclusion of a single motivational interviewing (MI) session, as an adjunct to periodontal therapy, might be beneficial for preventing relapse in oral hygiene behaviours among patients treated for chronic periodontitis and (ii) whether individual and clinical characteristics can be of predictive value for retention of sufficient oral hygiene behaviours.
MATERIAL & METHODS: This 3-year follow-up of a previously reported randomized controlled trial (RCT) study of 6-month duration included 26 patients. Patients in the test group had received one MI session by a clinical psychologist before initiation of the periodontal treatment. Otherwise, all patients followed the same treatment protocol for conventional educational intervention and non-surgical periodontal therapy. Efficacy variables assessed for evaluation of the standard of self-performed periodontal infection control were marginal bleeding index (MBI; primary efficacy variable) and plaque score (PI).
The patterns of change in MBI and PI scores were similar for test and control groups over the observation period. At 3 years, both groups showed a desirable mean full-mouth MBI of 15%, a figure that was comparable to that at the short-term evaluation after active periodontal treatment. The post-treatment MBI was the only variable identified as a predictor of retained adequate oral hygiene behaviours.
A single MI session as an adjunct to conventional periodontal therapy could not be proven to be of long-term beneficial additive effect with regard to prevention of relapse in oral hygiene behaviour. Desirable standard of self-performed infection control after active periodontal treatment predicted the retention of sufficient oral hygiene behaviour over time.
(i)评估在慢性牙周炎患者接受牙周治疗时,增加一次动机性访谈(MI)作为辅助手段,是否有助于预防口腔卫生行为的复发;(ii)评估个体和临床特征对维持足够口腔卫生行为是否具有预测价值。
本研究是对一项为期6个月的随机对照试验(RCT)进行的3年随访,共纳入26名患者。试验组患者在开始牙周治疗前,由临床心理学家进行了一次动机性访谈。除此之外,所有患者均遵循相同的常规教育干预和非手术牙周治疗方案。评估自我进行牙周感染控制标准的疗效变量为边缘性出血指数(MBI;主要疗效变量)和菌斑评分(PI)。
在观察期内,试验组和对照组的MBI和PI评分变化模式相似。3年后,两组患者全口平均MBI均达到理想的15%,这一数值与牙周积极治疗后的短期评估结果相当。治疗后的MBI是唯一被确定为维持足够口腔卫生行为预测指标的变量。
在预防口腔卫生行为复发方面,尚未证明在传统牙周治疗基础上增加一次动机性访谈具有长期有益的附加效果。积极牙周治疗后理想的自我感染控制标准可预测长期维持足够的口腔卫生行为。