Nascimento Gustavo G, Baelum Vibeke, Dahlen Gunnar, Lopez Rodrigo
Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Community Dent Oral Epidemiol. 2018 Jun;46(3):303-309. doi: 10.1111/cdoe.12367. Epub 2018 Feb 15.
We aimed to investigate the association between dental caries and periodontitis among adolescents participating in a case-control study of periodontitis. In addition, we compared 2 analytical approaches to estimate the association: conventional regression and structural equation modelling (SEM).
Along with periodontal recordings, data were obtained on caries, just as subgingival plaque samples were collected. Sociodemographic information was collected with a questionnaire. We used factor analyses to express the many correlated clinical periodontal dimensions in a smaller number of factors. The association between caries (counts of enamel and dentin lesions, or dentin lesions only) and periodontitis was tested using negative binomial regression with robust variance (conventional regression) and weighted least squares (SEM) estimation.
Factor analysis revealed 2 different latent periodontal variables: "extent" and "severity" of periodontitis. Using conventional regression, the "extent" of periodontitis was positively associated with higher counts of dentin caries lesions, even after adjustments for maternal education and subgingival microbial composition (rate ratio 1.34; 95% CI 1.07-1.68). The "severity" of periodontitis was associated with lower counts of enamel and dentin caries lesions (rate ratio 0.85 95% CI 0.77-0.92). The SEM revealed a positive association between periodontitis "extent" and number of dentin caries lesions (coefficient 0.29; P < .0001). The "severity" of periodontitis was negatively associated with enamel and dentin caries (coefficient -0.44; P < .0001).
We found an association between caries and periodontitis among adolescents. The "severity" of periodontitis was negatively associated with enamel/dentin caries, whereas the "extent" of periodontitis was positively associated with dentin caries irrespective of the analytical approach employed.
我们旨在调查参与牙周炎病例对照研究的青少年中龋齿与牙周炎之间的关联。此外，我们比较了两种估计该关联的分析方法：传统回归和结构方程模型（SEM）。
除了牙周记录外，还获取了龋齿数据，并收集了龈下菌斑样本。通过问卷调查收集社会人口学信息。我们使用因子分析将众多相关的临床牙周维度用较少的因子来表示。使用稳健方差的负二项回归（传统回归）和加权最小二乘法（SEM）估计来检验龋齿（釉质和牙本质病变计数，或仅牙本质病变计数）与牙周炎之间的关联。
因子分析揭示了两个不同的潜在牙周变量：牙周炎的“范围”和“严重程度”。使用传统回归，即使在调整了母亲教育程度和龈下微生物组成后，牙周炎的“范围”与较高的牙本质龋损计数呈正相关（率比1.34；95%CI 1.07 - 1.68）。牙周炎的“严重程度”与较低的釉质和牙本质龋损计数相关（率比0.85，95%CI 0.77 - 0.９2）。SEM显示牙周炎“范围”与牙本质龋损数量之间呈正相关（系数0.29；P <.0001）。牙周炎的“严重程度”与釉质和牙本质龋呈负相关（系数 - 0.44；P <.0001）。
我们发现青少年中龋齿与牙周炎之间存在关联。无论采用何种分析方法，牙周炎的“严重程度”与釉质/牙本质龋呈负相关，而牙周炎的“范围”与牙本质龋呈正相关。
