Costa Fernando Oliveira, Costa Adriana Moreira, Cortelli José Roberto, Cortelli Sheila Cavalca, Costa Amanda Almeida, Lima Rafael Paschoal Esteves, Pereira Gustavo Henrique Mattos, Oliveira Alcione Maria Soares Dutra, Oliveira Peterson Antônio Dutra, Cota Luís Otávio Miranda
School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
School of Dentistry, Newton Paiva Institute, Minas Gerais, Brazil.
J Periodontol. 2023 Jan;94(1):55-65. doi: 10.1002/JPER.22-0301. Epub 2022 Nov 8.
The aim of this study was to evaluate the effect of supragingival plaque control on the recurrence of periodontitis (RP) and the achievement of a stable periodontal clinical endpoint after 10 years of periodontal maintenance therapy (PMT).
The present retrospective cohort study included 225 individuals in continuous PMT. The plaque index (PI) determining the oral hygiene (OH) status, periodontal clinical parameters, and other variables of interest were collected at three time points: T1 (prior to active periodontal therapy [APT]), T2 (after APT), and T3 (10 years after T2). According to PI records at T3, participants were categorized into: (1) good OH (GOH; PI ≤ 30%, n = 63); (2) fair OH (FOH; PI > 30% and ≤40%, n = 73); and (3) poor OH (POH; PI > 40%, n = 88). Data were analyzed using the chi-square and Student t tests, analysis of variance (ANOVA), and mediation and regression analyses.
Significant differences in all periodontal clinical parameters between the GOH, FOH, and POH groups were observed at T3. The POH group exhibited higher mean bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL), as well as higher tooth loss (POH > FOH > GOH; P < .001). There was an increased risk for RP in the FOH (odds ratio [OR] 2.02; CI, 1.10-4.38) and POH (OR 4.33; CI, 2.17-8.65) groups. Moreover, the FOH and POH groups had an approximately 2.5 and 6.0 times greater chance of not achieving a stable periodontal clinical endpoint, respectively.
After 10 years of monitoring in PMT, individuals with higher PI scores (>30%) presented an unhealthier periodontal status, a higher risk for RP, and a lower chance of achieving ≤4 sites with PD ≥ 5 mm.
本研究旨在评估龈上菌斑控制对牙周炎复发(RP)的影响,以及在牙周维护治疗(PMT)10年后实现稳定的牙周临床终点的情况。
本回顾性队列研究纳入了225名接受持续PMT的个体。在三个时间点收集了确定口腔卫生(OH)状况的菌斑指数(PI)、牙周临床参数及其他相关变量:T1(积极牙周治疗[APT]前)、T2(APT后)和T3(T2后10年)。根据T3时的PI记录,参与者被分为:(1)良好口腔卫生(GOH;PI≤30%,n = 63);(2)一般口腔卫生(FOH;PI>30%且≤40%,n = 73);(3)差的口腔卫生(POH;PI>40%,n = 88)。使用卡方检验、学生t检验、方差分析(ANOVA)以及中介和回归分析对数据进行分析。
在T3时,观察到GOH、FOH和POH组之间所有牙周临床参数存在显著差异。POH组的平均探诊出血(BOP)、牙周探诊深度(PD)和临床附着水平(CAL)更高,牙齿缺失也更多(POH>FOH>GOH;P<.001)。FOH组(优势比[OR]2.02;CI,1.10 - 4.38)和POH组(OR 4.33;CI,2.17 - 8.65)发生RP的风险增加。此外,FOH组和POH组分别有大约2.5倍和6.0倍的可能性无法实现稳定的牙周临床终点。
在PMT监测10年后,PI评分较高(>30%)的个体牙周状况更不健康,RP风险更高,且实现PD≥5mm的位点≤4个的可能性更低。