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III 度牙周袋累及牙的长期预后。

Long-term prognosis of teeth with class III furcation involvement.

机构信息

Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Germany.

Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Heidelberg, Germany.

出版信息

J Clin Periodontol. 2021 Dec;48(12):1528-1536. doi: 10.1111/jcpe.13551. Epub 2021 Sep 29.

Abstract

OBJECTIVE

Evaluation of survival of teeth with class III furcation involvement (FI) ≥5 years after active periodontal treatment (APT) and identification of prognostic factors.

METHODS

All charts of patients who completed APT at the Department of Periodontology of Goethe-University Frankfurt, Germany, beginning October 2004 were screened for teeth with class III FI. APT had to be accomplished for ≥5 years. Charts were analysed for data of class III FI teeth at baseline (T0), at accomplishment of APT (T1), and at the last supportive periodontal care (T2). Baseline radiographic bone loss (RBL) and treatment were assessed.

RESULTS

One-hundred and sixty patients (age: 54.4 ± 9.8 years; 82 females; 39 active smokers; 9 diabetics, 85 stage III, 75 stage IV, 59 grade B, 101 grade C) presented 265 teeth with class III FI. Ninety-eight teeth (37%) were lost during 110, 78/137 (median, lower/upper quartile) months. Logistic mixed-model regression and mixed Cox proportional hazard model associated adjunctive systemic antibiotics with fewer tooth loss (26% vs. 42%; p = .019/.004) and RBL (p = .014/.024) and mean probing pocket depth (PPD) at T1 (p < .001) with more tooth loss.

CONCLUSIONS

Subgingival instrumentation with adjunctive systemic antibiotics favours retention of class III furcation-involved teeth. Baseline RBL and PPD at T1 deteriorate long-term prognosis.

摘要

目的

评估牙周治疗(APT)后 5 年以上伴有 III 类分叉受累(FI)的牙齿的存活率,并确定预后因素。

方法

筛选 2004 年 10 月起在德国法兰克福歌德大学牙周科接受 APT 的所有患者的图表,以寻找 III 类 FI 牙齿。APT 必须完成至少 5 年。分析图表以获取 III 类 FI 牙齿的基线(T0)、APT 完成时(T1)和最后支持性牙周护理时(T2)的数据。评估基线放射状骨损失(RBL)和治疗情况。

结果

160 名患者(年龄:54.4±9.8 岁;82 名女性;39 名主动吸烟者;9 名糖尿病患者,85 例 III 期,75 例 IV 期,59 例 B 级,101 例 C 级)有 265 颗 III 类 FI 牙齿。110 至 78/137 个月(中位数,下四分位数/上四分位数)期间,98 颗牙齿(37%)丢失。逻辑混合模型回归和混合 Cox 比例风险模型将辅助全身抗生素与较少的牙齿丢失(26%对 42%;p=0.019/0.004)和 RBL(p=0.014/0.024)以及 T1 时的平均探诊袋深度(PPD)相关,与更多的牙齿丢失相关。

结论

使用辅助全身抗生素进行龈下器械治疗有利于保留 III 类分叉受累的牙齿。基线 RBL 和 T1 时的 PPD 会恶化长期预后。

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