Ma Kevin Sheng-Kai, Wu Meng-Che, Thota Eshwar, Wang Yu-Hsun, Alqaderi Hend E, Wei James Cheng-Chung
Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan.
J Periodontol. 2022 May;93(5):721-731. doi: 10.1002/JPER.21-0215. Epub 2022 Jan 19.
To determine whether patients who had undergone tonsillectomy would have higher risks of postoperative periodontitis.
Data were collected from the Taiwan Longitudinal Health Insurance Dataset from 1999 to 2013, a population-based cohort study consisting of cases of newly-onset sleep apnoea, chronic diseases of tonsils and adenoids, peritonsillar abscess, and periodontal diseases. A total of 1482 tonsillectomy cases and 14,796 non-tonsillectomy controls were selected. Propensity score matching between the tonsillectomy group and the non-tonsillectomy group was conducted to exclude the confounding effect resulting from indications of tonsillectomy. Cox proportional hazard model and subgroup analyses were conducted to identify subpopulations at risk of tonsillectomy-associated periodontitis, and a sub-outcome analysis was applied to identify the subtype of tonsillectomy-associated periodontitis.
A total of 648 patients who had undergone tonsillectomy and 648 out of 6509 propensity score-matched controls were retrieved, among which 230 cases in the tonsillectomy group were associated with post-surgical periodontitis (adjusted HR = 1.31, 95% CI = 1.08 to 1.59). The association persisted in a subpopulation of patients with periodontitis who received mechanical and surgical treatments for periodontitis (adjusted HR = 1.33, 95% CI = 1.09 to 1.63). The incidence of periodontitis was significantly high in the individuals who underwent tonsillectomy and was particularly high in those that were below 12 years of age (HR = 1.58, 95% CI = 1.10 to 2.27). The risk of periodontitis increased 4 years after tonsillectomy (HR = 1.82; 95% CI = 1.29 to 2.59). The majority of post-tonsillectomy periodontitis was aggressive and acute periodontitis (HR = 1.37; 95% CI = 1.10 to 1.71).
Tonsillectomy performed in pediatric patients of < 12 years old, increased the risk of developing periodontitis. Aggressive and acute periodontitis as a long-term, postoperative adverse event took place at 4 years or longer after tonsillectomy.
确定接受扁桃体切除术后的患者是否有更高的术后牙周炎风险。
数据来自1999年至2013年的台湾纵向健康保险数据集，这是一项基于人群的队列研究，包括新发睡眠呼吸暂停、扁桃体和腺样体慢性疾病、扁桃体周围脓肿以及牙周疾病病例。共选取1482例扁桃体切除术病例和14796例非扁桃体切除术对照。对扁桃体切除术组和非扁桃体切除术组进行倾向评分匹配，以排除扁桃体切除术指征导致的混杂效应。采用Cox比例风险模型和亚组分析来确定有扁桃体切除术后牙周炎风险的亚人群，并应用亚结果分析来确定扁桃体切除术后牙周炎的亚型。
共检索到648例接受扁桃体切除术的患者以及6509例倾向评分匹配对照中的648例，其中扁桃体切除术组有230例与术后牙周炎相关（调整后风险比=1.31，95%置信区间=1.08至1.59）。在接受牙周炎机械和手术治疗的牙周炎患者亚组中，这种关联仍然存在（调整后风险比=1.33，95%置信区间=1.09至1.63）。接受扁桃体切除术的个体中牙周炎发病率显著较高，12岁以下者尤其高（风险比=1.58，95%置信区间=1.10至2.27）。扁桃体切除术后4年牙周炎风险增加（风险比=1.82；95%置信区间=1.29至2.59）。大多数扁桃体切除术后牙周炎为侵袭性和急性牙周炎（风险比=1.37；95%置信区间=1.10至1.71）。
12岁以下儿童患者进行扁桃体切除术会增加患牙周炎的风险。侵袭性和急性牙周炎作为一种长期的术后不良事件发生在扁桃体切除术后4年或更长时间。
