Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, 48109-1078, USA.
Department of Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery, University of Tripoli School of Dentistry, Tripoli, Libya.
Clin Oral Investig. 2024 Jul 25;28(8):446. doi: 10.1007/s00784-024-05849-2.
This study aimed to explore the relationship between Radiographic Residual Vertical Defects (RVDs) and the progression of periodontitis in patients undergoing periodontal maintenance therapy (PMT).
Teeth with RVDs were compared to the same contralateral teeth in the same patient. The study investigated the effect of smoking, diabetes, compliance, disease Stage, and Grade, baseline probing depth (PD), periodontal risk score (PRS), baseline pocket closure (PC) (≤ 4 mm), and tooth mobility on disease progression. We calculated the need for retreatment during PMT and its associated cost. Generalized estimation equations and linear and multilevel logistic regression analyses were employed for data analysis.
Each group had 139 teeth, accounting for 80 patients. Although the group with RVDs had similar PD reduction compared to the control teeth, the prevalence of PC at the last follow-up was reduced to half in the RVDs group (odds ratio OR = 0.5; p-value = 0.028), regardless of PC status at the baseline. RVDs were also significant predictors of tooth loss due to periodontitis (TLP), with an OR of 2.28 (p = 0.043). Patients with diabetes, Stage IV, higher mobility, and higher PRS scores had a higher risk of tooth loss due to periodontitis (OR = 4.71, 3.84, 3.64, and 5.97, respectively (P < 0.01). Incidences of sites requiring retreatment were similar in both groups, but the cost of treatment was 30% higher for teeth with RVDs. Grade C had the most significant influence on receiving retreatments (OR = 18.8, p = 0.005).
Teeth with RVDs represent a risk indicator for tooth loss compared to identical contralateral teeth with similar PD in the same patient. Teeth with RVD had more risk of pocket opening during follow-up.
While teeth with RVDs can be maintained long-term, they have twice the risk of pocket opening and tooth loss due to periodontitis during follow-up. Patients with systemic and local risk factors need to be monitored closely as they are at the highest risk of losing teeth with RVDs. The increased cost of retreatment for teeth with RVDs also has implications in terms of retention versus extraction and replacement.
本研究旨在探讨放射学残余垂直缺损（RVD）与牙周维护治疗（PMT）患者牙周炎进展之间的关系。
将 RVD 牙与同一患者的相同对侧牙进行比较。该研究调查了吸烟、糖尿病、依从性、疾病分期和分级、基线探诊深度（PD）、牙周风险评分（PRS）、基线袋闭合（PC）（≤4mm）和牙齿松动对疾病进展的影响。我们计算了 PMT 期间需要再治疗的次数及其相关费用。采用广义估计方程和线性及多级逻辑回归分析进行数据分析。
每组均有 139 颗牙，涉及 80 名患者。尽管 RVD 组的 PD 降低程度与对照牙相似，但在 RVD 组，最后一次随访时 PC 的发生率降低到一半（比值比 OR=0.5；p 值=0.028），而与基线时的 PC 状态无关。RVD 也是因牙周炎导致牙齿丧失（TLP）的显著预测因子，其比值比为 2.28（p=0.043）。患有糖尿病、IV 期、更高牙齿松动度和更高 PRS 评分的患者因牙周炎导致牙齿丧失的风险更高（OR=4.71、3.84、3.64 和 5.97，分别（P<0.01）。两组的再治疗部位发生率相似，但 RVD 牙的治疗费用高 30%。C 级对接受再治疗的影响最大（OR=18.8，p=0.005）。
与同一患者相同 PD 的相同对侧牙相比，RVD 牙是牙齿丧失的风险指标。在随访期间，RVD 牙的牙周袋开口风险更高。
尽管 RVD 牙可以长期维持，但在随访期间，由于牙周炎，RVD 牙的牙周袋开口和牙齿丧失的风险增加了一倍。患有系统性和局部危险因素的患者需要密切监测，因为他们是 RVD 牙最容易丧失的人群。RVD 牙再治疗的成本增加也会对保留还是拔牙和替换产生影响。
