Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
J Periodontol. 2020 Jan;91(1):26-36. doi: 10.1002/JPER.18-0637. Epub 2019 Aug 31.
Prospective studies investigating the influence of adjuvants to oral hygiene procedures on the recurrence of periodontitis (RP) during periodontal maintenance therapy (PMT) programs have not been previously reported. The aim of this study was to compare the effect of oral irrigator devices or interdental brushes as adjuncts to toothbrushing associated with dental flossing to improving periodontal condition and reducing RP among individuals under PMT.
From a 6-year prospective PMT cohort study (n = 268), 142 individuals who attended at least one PMT visit within 12 months were determined to be eligible. According to oral hygiene adjuvants use, they were categorized into three groups: 1) manual brushing/dental flossing + interdental brushes (BDF + Ib; n = 44); 2) manual brushing/dental flossing + oral irrigator (BDF + Oi; n = 36); and 3) only manual brushing/dental flossing (BDF; n = 62). Full-mouth periodontal examination and oral hygiene habits were evaluated at two time points: T1 (after active periodontal therapy) and T2 (6 years).
RP was significantly higher among BDF when compared with BDF + Ib and BDF + Oi. The final logistic model in T2 for RP included the following items: manual brushing/dental flossing alone (odds ratio [OR] = 1.94); age > 50 years (OR = 1.98), smoking (OR = 3.51), bleeding on probing >30% sites (OR = 4.10), and the interaction between manual brushing/dental flossing alone and smoking (OR = 6.1). A protective effect on RP was observed in BDF + Oi individuals (OR = 0.52).
BDF + Ib and BDF + Oi individuals presented lower rates of RP and better periodontal condition when compared to BDF individuals. Including these adjuvants to conventional oral hygiene have shown to improve biofilm control during PMT leading to a better periodontal status maintenance.
目前还没有研究调查口腔卫生程序的助剂对牙周炎(RP)在牙周维护治疗(PMT)方案中的复发的影响。本研究的目的是比较口腔冲洗器或牙间刷作为牙间刷与牙线结合的刷牙辅助手段对改善牙周状况和减少 PMT 中个体 RP 的效果。
从一项为期 6 年的前瞻性 PMT 队列研究(n=268)中,确定了 142 名在 12 个月内至少参加过一次 PMT 就诊的个体符合条件。根据口腔卫生助剂的使用情况,将他们分为三组:1)手动刷牙/牙线+牙间刷(BDF+Ib;n=44);2)手动刷牙/牙线+口腔冲洗器(BDF+Oi;n=36);3)仅手动刷牙/牙线(BDF;n=62)。在两个时间点(T1[牙周治疗后]和 T2[6 年后])评估全口牙周检查和口腔卫生习惯。
与 BDF+Ib 和 BDF+Oi 相比,BDF 中 RP 明显更高。T2 时 RP 的最终逻辑模型包括以下项目:单独手动刷牙/牙线(比值比[OR] = 1.94);年龄>50 岁(OR=1.98),吸烟(OR=3.51),探诊出血>30%的部位(OR=4.10),以及单独手动刷牙/牙线与吸烟之间的相互作用(OR=6.1)。BDF+Oi 个体对 RP 有保护作用(OR=0.52)。
与 BDF 个体相比,BDF+Ib 和 BDF+Oi 个体的 RP 发生率较低,牙周状况较好。将这些助剂纳入常规口腔卫生中,已被证明可改善 PMT 期间的生物膜控制,从而更好地维持牙周状况。