Graduate Program in Dentistry, Federal University of Maranhão, São Luís 65080-805, Brazil.
Department of Dentistry II, Federal University of Maranhão, São Luís 65080-805, Brazil.
Int J Environ Res Public Health. 2024 Jan 30;21(2):156. doi: 10.3390/ijerph21020156.
To compare different criteria for the diagnosis of periodontitis and to evaluate the association of this condition with prematurity, this case-control study was conducted on 283 mothers of infants, divided into two groups based on gestational age (cases: <37 weeks, controls: ≥37 weeks), with 71 cases and 212 controls. The periodontal evaluation included probing depth (PD), clinical attachment level (CAL), plaque index, and bleeding on probing (BOP). Participants were classified regarding periodontitis per 14 criteria based on different periodontal parameters. The criterion selected as the gold standard was the presence of at least four teeth with one or more sites with a PD ≥ 4 mm, CAL ≥ 3 mm, and BOP at the same site. The prevalence of periodontal disease ranged from 8.1% to 55.1%. Moreover, compared to the gold standard, the sensitivities of the other criteria were 100%, while specificity ranged from 50.4% to 96.4%. Periodontitis, defined by six of the selected criteria, was associated with prematurity after multivariate adjustment, with OR ranging from 1.85 to 2.69 and 95% CI from 1.01 to 5.56; one of them was the gold standard mentioned above. Measurements using the clinical parameters of PD, CAL, and bleeding at the same site (criteria 5, 6, 7, 8), CPI (criterion 10), and at least four teeth with a PD ≥ 4 mm and CAL ≥ 3 mm (criterion 11) to define periodontitis showed a statistically significant association ( < 0.05). Given this study's limitations, we can conclude that the diagnostic criteria for a periodontitis definition using a PD ≥ 4 mm and CAL ≥ 3 mm in two or more teeth, with BOP at the same site, seem stronger when detecting an association between periodontitis and prematurity.
为了比较不同的牙周炎诊断标准，并评估该疾病与早产之间的关系，本病例对照研究纳入了 283 名婴儿的母亲，根据胎龄（病例组：<37 周，对照组：≥37 周）将其分为两组，其中病例组有 71 例，对照组有 212 例。牙周评估包括探诊深度（PD）、临床附着水平（CAL）、菌斑指数和探诊出血（BOP）。根据不同牙周参数的 14 项标准，将参与者分为牙周炎组。选择的金标准是至少有四颗牙齿在同一个部位有一个或多个位点的 PD≥4mm、CAL≥3mm 和 BOP。牙周病的患病率为 8.1%至 55.1%。此外，与金标准相比，其他标准的敏感性为 100%，而特异性为 50.4%至 96.4%。在多变量调整后，根据六个选定标准定义的牙周炎与早产有关，比值比（OR）范围为 1.85 至 2.69，95%置信区间（CI）为 1.01 至 5.56；其中一个是上文提到的金标准。使用 PD、CAL 和同一部位出血的临床参数（标准 5、6、7、8）、CPI（标准 10）和至少四颗 PD≥4mm 和 CAL≥3mm 的牙齿来定义牙周炎的测量（标准 11）显示出统计学上的显著相关性（<0.05）。鉴于本研究的局限性，我们可以得出结论，使用 PD≥4mm 和 CAL≥3mm 在两颗或更多牙齿上，并在同一部位出现 BOP 来定义牙周炎的诊断标准，在检测牙周炎与早产之间的关系时似乎更强。
