Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.
Medical Department of Graduate School, Dalian Medical University, Dalian, 116000, Liaoning, China.
Eur J Med Res. 2021 Jun 1;26(1):50. doi: 10.1186/s40001-021-00520-y.
This study is aimed to analyze the prognostic factors affecting the short-term efficacy of non-surgical treatment of patients in periodontitis from stage II to stage IV by the multilevel modeling analysis.
A total of 58 patients with chronic periodontitis were included in this study. Patients were clinically explored before and 3 months after the treatment and the difference in probing depth was determined [Reduction of probing depth (Δ PD) = baseline PD - finial probing depth (FPD)] which is considered as the therapeutic evaluation. Three different levels were analyzed: patients, teeth and sites to construct a multi-layer linear model.
Probing depth (PD) improved significantly compared with that before treatment (p < 0.05), in which FPD was (3.90 ± 1.39) mm, and the ΔPD was (1.79 ± 0.97) mm. Compared with the mesial sites and distal sites of the multi-rooted teeth, the number of PD ≥ 5 mm or PD < 5 mm after the treatment was significantly different (P < 0.05), and the proportion of PD < 5 mm was higher in mesial sites. The null model showed that Δ PD varied greatly between groups at various levels (P < 0.001), with prediction variable of site level, tooth level, and patient level accounted for 66%, 18%, and 16% of the overall difference, respectively. The complete model showed that the Δ PD of smokers was significantly lower than that of non-smokers (P < 0.001). The Δ PD of the mesial and distal sites was larger than that of the buccolingual central site (P < 0.001). The Δ PD of single-rooted teeth was larger than that of multi-rooted teeth (P < 0.001). The baseline PD, tooth mobility (TM), bleeding index (BI), clinical attachment loss (CAL) were significantly negatively correlated with Δ PD (P < 0.001).
Patients with periodontitis from stage II to stage IV, who were non-smoking, have good compliance, good awareness of oral health, and low percentage sites with PD ≥ 5 mm at baseline, single-rooted teeth with hypomobility, less clinical attachment loss and lower bleeding index and sites of mesial or distal can obtain an ideal short-term efficacy of non-surgical treatment.
本研究旨在通过多层次建模分析,分析影响牙周炎Ⅱ-Ⅳ期非手术治疗患者短期疗效的预后因素。
共纳入 58 例慢性牙周炎患者。患者在治疗前和治疗后 3 个月进行临床检查,确定探测深度的差异[探诊深度减少(Δ PD)=基线 PD-终末探诊深度(FPD)],这被认为是治疗评估。对患者、牙齿和部位进行了三个不同层次的分析,以构建一个多层线性模型。
与治疗前相比,探诊深度(PD)显著改善(p<0.05),其中 FPD 为(3.90±1.39)mm,Δ PD 为(1.79±0.97)mm。与多根牙的近中位点和远中位点相比,治疗后 PD≥5mm或 PD<5mm的位点数量差异有统计学意义(P<0.05),近中位点 PD<5mm的比例较高。零模型显示,各水平间的Δ PD 差异较大(P<0.001),部位水平、牙齿水平和患者水平的预测变量分别占总体差异的 66%、18%和 16%。完全模型显示,吸烟者的Δ PD 明显低于不吸烟者(P<0.001)。近中、远中位点的Δ PD 大于颊舌中央位点(P<0.001)。单根牙的Δ PD 大于多根牙(P<0.001)。基线 PD、牙齿动度(TM)、出血指数(BI)、临床附着丧失(CAL)与Δ PD 呈显著负相关(P<0.001)。
牙周炎Ⅱ-Ⅳ期非吸烟患者,依从性好,口腔健康意识强,基线 PD≥5mm的位点百分比低,单根牙动度低,临床附着丧失和出血指数低,近中或远中位点的患者,可获得理想的非手术治疗短期疗效。