Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.
AGENON, Gesellschaft für Forschung und Entwicklung im Gesundheitswesen, Berlin, Germany.
J Clin Periodontol. 2022 Aug;49(8):749-757. doi: 10.1111/jcpe.13668. Epub 2022 Jun 14.
According to retrospective clinical studies, periodontal treatment retains teeth. However, evidence on the effectivity of periodontal treatment stemming from the general population is lacking.
We analysed data of periodontally treated patients from routine data of a major German national health insurance (BARMER-MV; sub-sample of the Federal State of Mecklenburg-Vorpommern) and from a clinical cohort (Greifswald Approach to Individualized Medicine, GANI_MED), as well as periodontally untreated and treated participants of the Study of Health in Pomerania (SHIP-TREND) with either ≥2 or ≥4 teeth with pocket depths ≥4 mm. Yearly tooth loss (YTL) estimates and incidence rates were evaluated.
For moderately to severely affected groups, YTL and incidence rates were higher in BARMER-MV patients (0.35 and 0.18, respectively) than in untreated SHIP-TREND controls (0.19 and 0.08, respectively). In line, treated SHIP-TREND participants exhibited higher YTL rates than untreated SHIP-TREND controls (0.26 vs. 0.19). For severely affected groups, results with respect to tooth loss were inconclusive regarding the beneficial effects of periodontal treatment conducted either in the university (GANI_MED data) or in the general practice.
Until 2021, periodontal treatment performed in German general dental practices within the national health insurance system was probably not efficient in retaining more teeth in the short- to mid-term. Since reimbursement schemes were changed in 2021 and now cover periodontal treatment to a much larger extent, the future will show whether these new reimbursement codes will improve the quality of periodontal treatment and whether they will lead to more long-term tooth retainment.
根据回顾性临床研究，牙周治疗可保留牙齿。然而，缺乏来自普通人群的牙周治疗有效性的证据。
我们分析了来自德国主要国家健康保险（BARMER-MV；梅克伦堡-前波美拉尼亚州的子样本）常规数据以及临床队列（Greifswald 个体化医学方法，GANI_MED）中接受牙周治疗的患者的数据，以及接受牙周治疗和未接受治疗的波罗的海健康研究（SHIP-TREND）参与者的数据，这些参与者有≥2 颗或≥4 颗牙周袋深度≥4 mm 的牙齿。评估了每年牙齿缺失（YTL）估计值和发病率。
对于中度至重度牙周病患者，BARMER-MV 患者的 YTL 和发病率较高（分别为 0.35 和 0.18），而未接受治疗的 SHIP-TREND 对照组的 YTL 和发病率较低（分别为 0.19 和 0.08）。与之相似，接受治疗的 SHIP-TREND 参与者的 YTL 发生率高于未接受治疗的 SHIP-TREND 对照组（0.26 比 0.19）。对于重度牙周病患者，关于牙周治疗效果的研究结果对于大学（GANI_MED 数据）或普通实践中进行的牙周治疗的效果尚无定论。
直到 2021 年，德国国家健康保险系统下的普通牙科实践中进行的牙周治疗在短期内可能并没有有效地保留更多的牙齿。由于 2021 年报销计划发生了变化，现在更大程度地涵盖了牙周治疗，未来将表明这些新的报销代码是否会提高牙周治疗的质量，以及它们是否会导致更多的长期牙齿保留。
