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口腔健康相关生活质量和经过 10 年牙周支持治疗后的患者报告结局测量。

Oral health-related quality of life and patient-reported outcome measures after 10 years of supportive periodontal care.

机构信息

Private practice, Hundemstraße 4, 57368, Lennestadt, Germany.

Dental Academy, Lorenzstraße 7, 76135, Karlsruhe, Germany.

出版信息

Clin Oral Investig. 2023 Jun;27(6):2851-2864. doi: 10.1007/s00784-023-04876-9. Epub 2023 Feb 1.

Abstract

OBJECTIVE

The aim of this retrospective study was to evaluate the oral health-related quality of life (oHRQoL) and patient-reported outcome measures (PROMs) after 10 years of supportive periodontal care (SPC).

MATERIAL AND METHODS

Patients were re-examined 120±12 months after active periodontal therapy. Dental and periodontal status and oHRQoL by completing Oral Health Impact Profile-G49 (OHIP-G49) and PROMs by marking a visual analogue scale (VAS) for self-perceived esthetics (VASe), chewing function (VASc), and hygiene ability (VASh) were assessed. Patient- and tooth-related factors (age, insurance status, number of SPC, compliance, change of therapist, smoking, tooth loss, need for surgery or antibiotic intake, bleeding on probing (BOP), periodontal inflamed surface area) influencing oHRQoL and PROMs were evaluated.

RESULTS

One hundred eight periodontally compromised patients (59 female, mean age 65.4±10.7 years) lost 135 teeth during 10 years of SPC. At re-examination, 1.8% of all sites showed PPD ≥6mm. The mean OHIP-G49 sum score was 17.6±18.5, and VAS resulted in 76.0±22.5 (VASe), 86.3±16.3 (VASc), and 79.8±15.8 (VASh). Linear regression analyses identified a positive correlation with oHRQoL and/or PROMs for private insurance status (OHIP-G49, p=0.015, R=0.204; VASc, p=0.005, R=0.084; VASh, p=0.012, R=0.222) and compliance to SPC (VASe, p=0.032; R=0.204), as well as a negative correlation for active smoking (VASc, p=0.012, R=0.084), increased BOP (VASh, p=0.029, R=0.222) at the start of SPC, and number of lost molars (VASh, p=0.008, R=0.222).

CONCLUSION

It is realistic to obtain satisfactory oHRQoL and PROM values in most of the patients after 10 years of SPC. The identified factors may help to predict patient satisfaction in the long-term course of therapy.

CLINICAL RELEVANCE

Systematic therapy of periodontally compromised patients provides values for oHRQoL and PROMs in a favorable range 10 years after therapy. This should encourage dentists to implement SPC in their daily routine.

CLINICAL TRIAL NUMBER

NCT03048045.

摘要

目的

本回顾性研究旨在评估经过 10 年牙周支持性治疗(SPC)后患者的口腔健康相关生活质量(oHRQoL)和患者报告的结局测量(PROMs)。

材料和方法

在积极牙周治疗后 120±12 个月对患者进行重新检查。通过完成口腔健康影响量表-49 项(OHIP-G49)评估口腔健康状况和牙周状况,以及通过标记视觉模拟量表(VAS)评估自我感知美观(VASe)、咀嚼功能(VASc)和清洁能力(VASh)来评估 oHRQoL 和 PROMs。评估影响 oHRQoL 和 PROMs 的患者和牙齿相关因素(年龄、保险状况、SPC 次数、依从性、治疗师变更、吸烟、牙齿缺失、需要手术或抗生素摄入、探诊出血(BOP)、牙周炎表面面积)。

结果

10 年 SPC 期间,108 名牙周病患者(59 名女性,平均年龄 65.4±10.7 岁)共丧失 135 颗牙齿。在重新检查时,所有位点中仅有 1.8%的位点探诊深度(PPD)≥6mm。OHIP-G49 总分平均值为 17.6±18.5,VAS 结果分别为 76.0±22.5(VASe)、86.3±16.3(VASc)和 79.8±15.8(VASh)。线性回归分析表明,私人保险状况与 oHRQoL 和/或 PROMs 呈正相关(OHIP-G49,p=0.015,R=0.204;VASc,p=0.005,R=0.084;VASh,p=0.012,R=0.222),SPC 依从性与 oHRQoL 和/或 PROMs 呈正相关(VASe,p=0.032;R=0.204),而主动吸烟与 VASc 呈负相关(p=0.012,R=0.084),SPC 开始时探诊出血(BOP)增加与 VASh 呈负相关(p=0.029,R=0.222),以及磨牙缺失数与 VASh 呈负相关(p=0.008,R=0.222)。

结论

经过 10 年 SPC,大多数患者获得令人满意的 oHRQoL 和 PROM 值是现实的。确定的因素可能有助于预测治疗长期过程中的患者满意度。

临床意义

对牙周病患者进行系统治疗可在治疗后 10 年内为 oHRQoL 和 PROMs 提供有利范围的值。这应该鼓励牙医在日常工作中实施 SPC。

临床试验注册号

NCT03048045。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7233/10264521/9c75d1e95160/784_2023_4876_Fig1_HTML.jpg

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