Rams T E, Oler J, Listgarten M A, Slots J
Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia.
J Clin Periodontol. 1993 Feb;20(2):147-50. doi: 10.1111/j.1600-051x.1993.tb00330.x.
The feasibility of using the Ramfjord index teeth to estimate whole-mouth periodontal disease activity was investigated. Whole-mouth examinations were carried out semi-annually over a 36-month period in 98 maintenance patients previously treated for adult periodontitis. Recurrent periodontitis was defined as either a 3-mm or greater probing depth increase from baseline, or a 2-mm or greater probing depth increase together with 2-mm or greater of relative attachment loss measured from a reference stent. Whole-mouth disease activity was compared to Ramfjord index teeth data, with and without adjustment. Adjustment was made by multiplying disease activity rates on Ramfjord index teeth by the ratio formed from the sum of all teeth present over the sum of all Ramfjord index teeth in the study population. Without adjustment, Ramfjord index teeth markedly underestimated subjects with recurrent disease activity when compared to whole-mouth findings. However, with adjustment, the hypothesis that upper and lower limits on whole-mouth incidence of recurrent periodontitis could be estimated from Ramfjord index teeth disease-activity rates were not rejected (P > 0.20, z-test) at any 6-month interval. At 5 of 6 examinations, the % of disease active subjects as determined from whole-mouth evaluations was below the upper limit for disease incidence calculated, with 95% confidence, from point estimates derived from adjusted Ramfjord index teeth data. Partial-mouth examinations with appropriate adjustment of Ramfjord index teeth data may be useful for assessing periodontal disease progression in longitudinal population studies of human periodontitis.
研究了使用Ramfjord指数牙来估计全口牙周疾病活动度的可行性。在98名曾接受成人牙周炎治疗的维持期患者中，每半年进行一次全口检查，为期36个月。复发性牙周炎定义为探诊深度较基线增加3毫米或更多，或探诊深度增加2毫米或更多，同时从参考支架测量的相对附着丧失为2毫米或更多。将全口疾病活动度与Ramfjord指数牙数据进行比较，比较时进行了调整和未调整两种情况。调整方法是将Ramfjord指数牙的疾病活动率乘以研究人群中所有现存牙齿总数与所有Ramfjord指数牙总数之比。未调整时，与全口检查结果相比，Ramfjord指数牙明显低估了患有复发性疾病活动的受试者。然而，经过调整后，在任何6个月间隔内，从Ramfjord指数牙疾病活动率估计复发性牙周炎全口发病率的上限和下限这一假设均未被拒绝（P>0.20，z检验）。在6次检查中的5次检查中，根据全口评估确定的疾病活跃受试者百分比低于根据调整后的Ramfjord指数牙数据点估计值以95%置信度计算出的疾病发病率上限。对Ramfjord指数牙数据进行适当调整的部分口腔检查可能有助于在人类牙周炎纵向人群研究中评估牙周疾病进展。
