Clinic for Conservative Dentistry and Periodontology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
Department of Psychology, University of Cologne, Cologne, Germany.
BMC Oral Health. 2022 Dec 15;22(1):610. doi: 10.1186/s12903-022-02655-8.
There is a lack of data on long-term impact of different psychological variables on periodontitis. Aim of the current study was to investigate the impact of psychological factors in patients with chronic periodontitis (CP; according to the 1999 Classification of Periodontal Diseases) to explain adherence to or discontinuation of supportive periodontal therapy (SPT) in a university setting.
A sample of n = 119 patients were examined in a questionnaire-based, cross-sectional survey. All patients had received active periodontal treatment (APT) and were reevaluated in a university setting (Kiel) before 2016 [T1: start SPT]. Patients who showed sufficient adherence to SPT of ≥ 2 years (maximum ± 6 months of deviation between SPT intervals, last visit and questionnaire at T2) were assigned to the adherence group (AG: n = 58), or, if they interrupted SPT or stopped treatment altogether, to the non-adherence group (NAG: n = 61). In addition to dental parameters, we assessed socio-demographic, treatment-related (critical attitudes/complaints), dental as well as psychological variables (especially psychological attachment, but also dental fear, patient participation style, personality functioning) and examined between-group differences as well as possible mediating factors of non-adherence to treatment continuation.
For both groups we found similar average observation time (NAG/AG: 15.9(8.9)/14.9(10.6)years). There were significant differences in age, critical attitudes, dental fear, and patient participation style between the groups. With the help of exploratory sequential mediation models, we found a significant indirect pathway of the impact of attachment anxiety on discontinuation of treatment mediated through dental fear and number of critical attitudes/complaints.
Considering the limitations, dentists should be aware of personality-related risk-factors such as attachment anxiety as well as their interplay with levels of dental fear and critical attitudes which may influence adherence to SPT.
The clinical trial was retrospectively registered in the DRKS-German Clinical Trials Register ( https://www.drks.de ) with registration DRKS00030092 (26/08/2022).
目前关于不同心理变量对牙周炎的长期影响的数据还很缺乏。本研究的目的是在大学环境中调查慢性牙周炎（CP；根据 1999 年牙周病分类）患者的心理因素对坚持或停止牙周支持治疗（SPT）的影响。
采用基于问卷调查的横断面研究，对 n=119 例患者进行了调查。所有患者均接受过积极的牙周治疗（APT），并于 2016 年之前在大学环境（基尔）重新评估[T1：开始 SPT]。如果患者对 SPT 的依从性足够（≥2 年；SPT 间隔、最后一次就诊和 T2 时的问卷之间的最大偏差±6 个月），则将其分配到依从组（AG：n=58），否则，如果中断 SPT 或完全停止治疗，则将其分配到不依从组（NAG：n=61）。除了牙齿参数外，我们还评估了社会人口统计学、治疗相关（关键态度/抱怨）、牙齿以及心理变量（特别是心理依恋，但也包括牙齿恐惧、患者参与风格、人格功能），并检查了组间差异以及治疗连续性不依从的可能中介因素。
对于两组，我们发现平均观察时间相似（NAG/AG：15.9（8.9）/14.9（10.6）年）。两组间在年龄、关键态度、牙齿恐惧和患者参与风格方面存在显著差异。通过探索性序贯中介模型，我们发现依恋焦虑对治疗中断的影响通过牙齿恐惧和关键态度/抱怨的数量对治疗中断的间接途径具有统计学意义。
考虑到局限性，牙医应该意识到与个性相关的风险因素，如依恋焦虑，以及它们与牙齿恐惧和关键态度的相互作用，这些因素可能会影响 SPT 的依从性。
该临床试验在 DRKS-德国临床试验注册中心（https://www.drks.de）进行了回顾性注册（DRKS00030092，2022 年 8 月 26 日）。
