[重度牙周炎患者4年自然病程中牙齿缺失的多变量分析]
[Multivariable analysis of tooth loss in subjects with severe periodontitis over 4-year natural progression].
作者信息
Wen J, Ouyang X Y, Pei X Y, Qiu S Y, Liu J R, Liu W Y, Cao C F
机构信息
Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China.
First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100034, China.
出版信息
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Feb 18;55(1):70-77. doi: 10.19723/j.issn.1671-167X.2023.01.010.
OBJECTIVE
To evaluate the characteristics of severe periodontitis with various number of tooth loss during 4-year natural progression, and to analyze the factors related to higher rate of tooth loss.
METHODS
A total of 217 patients aged 15 to 44 years with severe periodontitis were included, who participated in a 4-year natural progression research. Data obtained from questionnaire survey, clinical examination and radiographic measurement. Tooth loss during 4-year natural progression was evaluated. The baseline periodontal disease related and caries related factors were calculated, including number of teeth with bone loss > 50%, number of missing molars, number of teeth with widened periodontal ligament space (WPDL), number of teeth with periapical lesions and etc. Characteristics of populations with various number of tooth loss and the related factors that affected higher rate of tooth loss were analyzed.
RESULTS
In 4 years of natural progression, 103 teeth were lost, and annual tooth loss per person was 0.12±0.38. Nine patients lost 3 or more teeth. Thirty-four patients lost 1 or 2 teeth, and 174 patients were absent of tooth loss. Molars were mostly frequent to lose, and canines presented a minimum loss. The number of teeth with WPDL, with periapical lesions, with intrabony defects, with probing depth (PD)≥7 mm, with PD≥5 mm, with clinical attachment loss≥5 mm, with bone loss > 50% and with bone loss > 65% were positively correlated to number of tooth loss. Results from orderly multivariate Logistic regression showd that the number of teeth with bone loss > 50% =1.550), baseline number of molars lost (=1.774), number of teeth with WPDL (1 to 2: =1.415; ≥3: =13.105), number of teeth with periapical lesions (1 to 2: =4.393; ≥3: =9.526) and number of teeth with caries/residual roots (=3.028) were significant risk factors related to higher likelihood of tooth loss and multiple tooth loss.
CONCLUSION
In 4 years of natural progression, the number of teeth with bone loss > 50%, baseline number of missing molars, number of teeth with WPDL, baseline number of teeth with periapical lesions and number of teeth with caries/residual roots were significantly related to higher risk of tooth loss and multiple tooth loss among Chinese young and middle-aged patients with severe periodontitis in rural areas.
目的
评估重度牙周炎患者在4年自然进程中不同失牙数的特点，并分析与较高失牙率相关的因素。
方法
纳入217例年龄在15至44岁的重度牙周炎患者，他们参与了一项为期4年的自然进程研究。通过问卷调查、临床检查和影像学测量获取数据。评估4年自然进程中的失牙情况。计算基线牙周病相关和龋病相关因素，包括骨丧失>50%的牙数、缺失磨牙数、牙周膜间隙增宽（WPDL）的牙数、根尖周病变的牙数等。分析不同失牙数人群的特点以及影响较高失牙率的相关因素。
结果
在4年的自然进程中，共失牙103颗，人均年失牙数为0.12±0.38。9例患者失牙3颗或更多。34例患者失牙1颗或2颗，174例患者无失牙。磨牙最常失牙，尖牙失牙最少。有WPDL的牙数、有根尖周病变的牙数、有骨内缺损的牙数、探诊深度（PD）≥7mm的牙数、PD≥5mm的牙数、临床附着丧失≥5mm的牙数、骨丧失>50%的牙数和骨丧失>65%的牙数与失牙数呈正相关。有序多因素Logistic回归结果显示，骨丧失>50%的牙数（=1.550）、基线缺失磨牙数（=1.774）、有WPDL的牙数（1至2颗：=1.415；≥3颗：=13.105）、有根尖周病变的牙数（1至2颗：=4.393；≥3颗：=9.526）和有龋病/残根的牙数（=3.028）是与较高失牙可能性和多颗牙缺失相关的显著危险因素。
结论
在4年的自然进程中，骨丧失>50%的牙数、基线缺失磨牙数、有WPDL的牙数、基线有根尖周病变的牙数和有龋病/残根的牙数与中国农村地区年轻和中年重度牙周炎患者较高的失牙风险和多颗牙缺失显著相关。
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