Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Community Dent Oral Epidemiol. 2021 Oct;49(5):437-444. doi: 10.1111/cdoe.12619. Epub 2021 Mar 14.
There are limited longitudinal data regarding gingival inflammation in adults. This study aimed to assess changes in gingivitis over 4 years and to determine protective factors.
A representative sample of 1023 adults living in Porto Alegre, Brazil, was obtained in the Caries-Perio Collaboration Study. At follow-up, 402 individuals were re-examined. Gingivitis was assessed by the gingival bleeding index (GB) at both time points. Individuals were dichotomized into those showing reductions ≥ 15% and those showing reductions < 15% or increase in bleeding sites. Multivariable Poisson regression models were fitted with 11 possible risk factors, estimating relative risks (RR) and 95% confidence intervals (95% CI).
Percentage of individuals with GB ≥ 10% reduced from 72.4% to 53.8%. Bleeding sites significantly reduced (25.9%-20.1%), and in a higher magnitude in buccal/palatal sites (34.1%-24.0%). 31.0% of individuals presented GB reduction ≥ 15% in all sites. Toothbrushing ≥ 3 times/d increased 72% the probability of ≥15% GB reduction compared with ≤1/d (RR = 1.72; 95% CI 1.01-3.16). For each 10 pack-years smoked, the probability of ≥15% GB reduction was 3% higher (RR = 1.03; 95% CI: 1.01-1.04). At buccal/palatal sites, normal weight individuals had 26% higher probability of reducing GB than overweight-obese individuals (RR = 1.26; 95% CI: 1.01-1.62). A 5% higher decrease in GB sites was observed in the absence than the presence of periodontitis. Younger individuals had higher reduction in GB sites.
In the studied population, gingivitis reduced over time, with younger age, better oral hygiene, absence of periodontitis and normal weight being found to be protective factors. Smoking was associated with lower levels of gingivitis over time, probably due to its vasoconstrictive effect.
关于成年人牙龈炎症的纵向数据有限。本研究旨在评估 4 年内牙龈炎的变化，并确定保护因素。
本研究采用巴西阿雷格里港的龋病-牙周合作研究中的代表性成年人样本。在随访时，重新检查了 402 人。在两个时间点，通过牙龈出血指数 (GB) 评估牙龈炎。将个体分为减少≥15%和减少<15%或出血部位增加的两组。使用 11 个可能的风险因素拟合多变量泊松回归模型，估计相对风险 (RR) 和 95%置信区间 (95%CI)。
GB≥10%的个体百分比从 72.4%降至 53.8%。出血部位显著减少（25.9%-20.1%），颊/腭部位减少幅度更大（34.1%-24.0%）。31.0%的个体在所有部位的 GB 减少≥15%。每天刷牙≥3 次与每天刷牙≤1 次相比，增加 72%的≥15%GB 减少的可能性（RR=1.72；95%CI 1.01-3.16）。每增加 10 个吸烟包年，≥15%GB 减少的可能性增加 3%（RR=1.03；95%CI：1.01-1.04）。在颊/腭部位，体重正常的个体与超重/肥胖的个体相比，GB 减少的可能性高 26%（RR=1.26；95%CI：1.01-1.62）。在不存在牙周炎的情况下，GB 部位的下降幅度比存在牙周炎的情况下高 5%。年轻个体的 GB 部位减少更多。
在所研究的人群中，随着时间的推移，牙龈炎逐渐减轻，年龄较小、口腔卫生状况较好、不存在牙周炎和体重正常被认为是保护因素。吸烟与牙龈炎程度随时间降低有关，这可能是由于其血管收缩作用。
