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非手术牙周治疗在成人牙周炎患者中的疗效:回顾性分析。

Success of non-surgical periodontal therapy in adult periodontitis patients: A retrospective analysis.

机构信息

Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Clinic for Periodontology Utrecht, Utrecht, The Netherlands.

出版信息

Int J Dent Hyg. 2019 Nov;17(4):309-317. doi: 10.1111/idh.12399. Epub 2019 May 16.

Abstract

OBJECTIVE

To evaluate the results of active non-surgical treatment in patients diagnosed with adult periodontitis treated in a specialized clinic for periodontology.

MATERIAL & METHODS: In total, 1182 patients with adult periodontitis received active non-surgical therapy, which involved professional oral hygiene instruction, scaling and root planing, supragingival polishing and elective systemic antimicrobial medication. The results of this therapy were based on a full-mouth periodontal chart as assessed at the time of evaluation. Successful treatment as periodontal pocket depth (PPD) ≤5 mm was the main outcome parameter with bleeding on pocket probing as secondary outcome. Patient-related factors such as smoking and severity of periodontitis at baseline and site-related factors such as tooth type, furcation involvement and endodontic treatment were analysed. Possible relations with assessed parameters and the success of active periodontal therapy were evaluated.

RESULTS

Overall 39% of the patients reached the successful treatment objective and a mean bleeding on pocket probing tendency of 14%. Treatment success appeared to be dependent on tooth type where the results at single-rooted front teeth (85%) and premolar teeth (78%) were more successful than at molar teeth (47%). Analysis revealed that in 55% of the cases furcation involvement at molars was associated with the absence of success. Endodontic treatment was associated with absence of success in 8%-11% of the cases. Smoking negatively influences successful treatment outcome (P < 0.001).

CONCLUSION

Active non-surgical periodontal therapy in patients with adult periodontitis resulted in approximately one third of the cases in the success endpoint of PPD ≤ 5mm. Sub-analysis showed that the outcome appeared to be dependent on tooth type, furcation involvement, severity of periodontal disease at intake and smoking status.

摘要

目的

评估在牙周病专科诊所接受治疗的成人牙周炎患者接受积极非手术治疗的结果。

材料与方法

共有 1182 名成人牙周炎患者接受了积极的非手术治疗,包括专业口腔卫生指导、洁治和根面平整、龈上抛光和选择性全身抗菌药物治疗。该治疗的结果基于评估时的全口牙周图表。主要疗效参数是牙周袋深度(PPD)≤5mm 的成功治疗,探诊出血作为次要疗效参数。分析了患者相关因素,如吸烟和基线时牙周炎的严重程度,以及部位相关因素,如牙齿类型、分叉受累和牙髓治疗。评估了与评估参数和积极牙周治疗成功的可能关系。

结果

总体而言,39%的患者达到了成功治疗的目标,探诊出血倾向的平均率为 14%。治疗成功似乎与牙齿类型有关,单根前牙(85%)和前磨牙(78%)的结果比磨牙(47%)更成功。分析显示,55%的磨牙分叉受累病例与治疗失败有关。牙髓治疗与 8%-11%的病例治疗失败有关。吸烟对治疗成功有负面影响(P<0.001)。

结论

成人牙周炎患者的积极非手术牙周治疗在大约三分之一的病例中达到了 PPD≤5mm 的成功终点。亚分析显示,结果似乎与牙齿类型、分叉受累、初诊时牙周病的严重程度和吸烟状况有关。

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