Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral-, Dental- and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
Clin Oral Investig. 2022 Jan;26(1):921-930. doi: 10.1007/s00784-021-04075-4. Epub 2021 Jul 26.
To compare the outcome of periodontal parameters in mobile mandibular incisors which were splinted before or after full-mouth disinfection (FMD).
Thirty-four periodontitis patients with ≥ 1 mobile mandibular incisor (mobility degree II/III, clinical attachment loss (CAL) ≥ 5 mm, relative bone loss ≥ 50%) were randomly allocated to group A or B. Patients received periodontal treatment (PT) including splinting of teeth 33-43 before (A) or after FMD (B). Patient (age/sex/smoking status/systemic diseases/number of teeth) and tooth-related parameters (mean probing pocket depth (PPD)/CAL/oral hygiene indices; for the overall dentition and region 33-43) were assessed prior to PT and 12 months after FMD by a blinded examiner. Therapy-related information was added (group/antibiotic therapy/surgical intervention).
Twenty-six patients (A: 12; B:14) were re-examined. Two patients of group B did not need splinting after FMD because of reduction in mobility after FMD. Regression analysis revealed a positive association of antibiotic therapy with CAL_overall, PPD_overall, and PPD_33-43 (p ≤ 0.01). There is a trend toward a higher reduction of periodontal parameters at teeth 33-43 in group A (PPD_33-43: - 0.91 vs. - 0.27 mm; CAL_33-43: - 1.02 vs. - 0.47 mm).
Teeth splinted before or after FMD show a significant improvement in periodontal parameters 12 months after FMD. Splinting after FMD offered the option to detect reduction in mobility.
Despite a higher, but not statistically significant, improvement in periodontal parameters on teeth splinted before FMD, the results do not indicate which timepoint of splinting is more beneficial. The decision for the therapeutic procedure should therefore be made individually.
比较全口消毒（FMD）前后固定活动下颌切牙的牙周参数结果。
34 名患有≥1 颗活动下颌切牙（活动度 II/III 级，临床附着丧失（CAL）≥5mm，相对骨丧失≥50%）的牙周炎患者被随机分配到 A 组或 B 组。患者接受牙周治疗（PT），包括 33-43 颗牙齿的固定（A）或 FMD 后固定（B）。由盲法检查者在 PT 前和 FMD 后 12 个月评估患者（年龄/性别/吸烟状况/系统性疾病/牙齿数）和与牙齿相关的参数（总牙列和 33-43 区域的平均探诊袋深度（PPD）/CAL/口腔卫生指数）。添加治疗相关信息（组/抗生素治疗/手术干预）。
26 名患者（A 组 12 名，B 组 14 名）重新接受检查。B 组的 2 名患者由于 FMD 后活动度降低，不需要 FMD 后固定。回归分析显示，抗生素治疗与总 CAL、总 PPD 和 33-43 PPD 呈正相关（p≤0.01）。A 组 33-43 颗牙齿的牙周参数降低趋势更高（PPD_33-43：-0.91 比-0.27mm；CAL_33-43：-1.02 比-0.47mm）。
FMD 前后固定的牙齿在 FMD 后 12 个月时牙周参数有显著改善。FMD 后固定提供了检测活动度降低的机会。
尽管 FMD 前固定牙齿的牙周参数改善程度较高，但没有统计学意义，但结果并不表明哪个固定时间点更有益。因此，治疗程序的决策应因人而异。
