Kaye E, McDonough R, Singhal A, Garcia R I, Jurasic M
Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, Gainesville, FL, USA.
JDR Clin Trans Res. 2025 Jul;10(3):324-332. doi: 10.1177/23800844241276863. Epub 2024 Oct 9.
Obesity is associated with increased periodontal disease prevalence and incidence. This retrospective cohort study examined whether body mass index (BMI) is an effect modifier of periodontal treatment outcomes in patients attending an urban dental school clinic.
Data were extracted from electronic health records of 344 patients at a large urban dental school clinic who had at least 1 tooth with a probing pocket depth (PD) ≥5 mm at baseline and who subsequently received nonsurgical periodontal treatment. BMI was computed from self-reported weight and height and categorized as obese (≥30 kg/m), overweight (25-29.9 kg/m), or healthy (18-24.9 kg/m). The primary treatment outcome of interest was defined as having no teeth with PD ≥5 mm in a quadrant on follow-up after nonsurgical periodontal therapy. That outcome was considered to represent treatment success in this study. Secondary outcomes included changes in mean PD and clinical attachment loss (CAL). Analyses included 879 treated quadrants among 344 patients (185 males, 159 females; mean age 49 ± 12 y at baseline; mean posttreatment follow-up of 6 ± 2 mo). Clinical outcomes in patients who were overweight or obese were compared to healthy-weight patients using generalized linear models for binary or continuous outcomes, accounting for clustering within patients. Covariates were age, gender, tobacco use, history of diabetes, insurance type, and number of baseline sites ≥5 mm.
Obesity was associated with a significantly lower likelihood of successful nonsurgical treatment (odds ratio = 0.47; 95% confidence interval, 0.25-0.88) than healthy weight. Being overweight was not associated with treatment success. Posttreatment reductions in the percentage of sites with pockets ≥5 mm and CAL ≥5 mm were greater in patients with healthy weight as compared to those either overweight or obese. However, posttreatment changes in mean PD and CAL did not differ among the BMI groups.
Obesity adversely modifies the effectiveness of nonsurgical periodontal treatment among dental school clinic patients.Knowledge Transfer Statement:The results of this study may be used by dental providers to better understand and manage periodontal therapy in patients with obesity. Furthermore, patients will be better informed about their therapeutic options and outcome success.
肥胖与牙周病患病率和发病率的增加相关。这项回顾性队列研究调查了体重指数（BMI）是否是城市牙科学校诊所患者牙周治疗结果的效应修饰因素。
从一所大型城市牙科学校诊所的344例患者的电子健康记录中提取数据，这些患者在基线时至少有一颗牙齿的探诊深度（PD）≥5mm，随后接受了非手术牙周治疗。根据自我报告的体重和身高计算BMI，并分为肥胖（≥30kg/m²）、超重（25-29.9kg/m²）或健康（18-24.9kg/m²）。感兴趣的主要治疗结果定义为在非手术牙周治疗后的随访中，一个象限内没有PD≥5mm的牙齿。在本研究中，该结果被视为代表治疗成功。次要结果包括平均PD和临床附着丧失（CAL）的变化。分析包括344例患者（185例男性，159例女性；基线时平均年龄49±12岁；治疗后平均随访6±2个月）的879个治疗象限。使用广义线性模型对超重或肥胖患者与健康体重患者的二元或连续结果进行比较，并考虑患者内部的聚类情况。协变量包括年龄、性别、吸烟情况、糖尿病史﹑保险类型以及基线时≥5mm的部位数量。
与健康体重相比，肥胖与非手术治疗成功的可能性显著降低相关（比值比=0.47；95%置信区间，0.25-0.88）。超重与治疗成功无关。与超重或肥胖患者相比，健康体重患者治疗后牙周袋≥5mm和CAL≥5mm部位的百分比降低更大。然而，BMI组之间治疗后平均PD和CAL的变化没有差异。
肥胖对牙科学校诊所患者非手术牙周治疗的效果具有不利的修饰作用。知识转移声明：本研究结果可供牙科医疗人员用于更好地理解和管理肥胖患者的牙周治疗。此外,患者将能更好地了解他们的治疗选择和治疗成功的结果。
