Brown L J, Albandar J M, Brunelle J A, Löe H
Division of Epidemiology and Oral Disease Prevention, National Institute of Dental Research, Bethesda, MD, USA.
J Periodontol. 1996 Oct;67(10):968-75. doi: 10.1902/jop.1996.67.10.968.
We studied the pattern of progression of early-onset periodontitis and the change in the extent and severity of the periodontal condition in adolescents who were followed for 6 years. In a national survey of the oral health of U.S. children, 14,013 adolescents were examined clinically in 1986/1987 to assess the periodontal attachment loss of teeth. Individuals with early-onset periodontitis within this population were identified and classified into localized juvenile periodontitis (LJP), generalized juvenile periodontitis (GJP), and incidental attachment loss (IAL) groups. Ninety-one subjects, 13 to 20 years old at baseline, were examined 6 years later. They included 51 males and 40 females; and 72 Blacks, 6 Hispanics, and 13 Whites. They were clinically re-examined and then reclassified according to their periodontal status at follow-up. The severity and extent of these diseases continued to increase during the study period. In teeth that were affected at baseline, the lesions had progressed to include deeper portions of the periodontium, and more of the teeth unaffected at baseline exhibited periodontal attachment loss at follow-up, thus changing the disease characteristics and the basis for the clinical classification. Of the individuals classified with LJP at baseline, 62% continued to have LJP 6 years later and 35% developed GJP. Of those classified with GJP initially, all but two (82%) continued to have GJP at follow-up. Among the IAL group, 28% of subjects developed LJP or GJP, and 30% were reclassified in the no attachment loss group. Molars and incisors were the teeth most often affected in all three groups. The mean change in attachment loss over 6 years in the LJP, GJP, and IAL groups was 0.45, 1.12, and 0.13 mm, respectively. The present findings demonstrate the limitations of the currently used morphological criteria in the classification of early-onset periodontitis. The findings also suggest that the difference between LJP and GJP is in the number and type of teeth involved, and that the two classifications progress similarly, with some cases of LJP developing into GJP.
我们研究了早发性牙周炎的进展模式以及对青少年牙周状况进行为期6年随访期间牙周状况在范围和严重程度上的变化。在美国儿童口腔健康的一项全国性调查中，1986/1987年对14,013名青少年进行了临床检查，以评估牙齿的牙周附着丧失情况。在该人群中确定了早发性牙周炎患者，并将其分为局限性青少年牙周炎（LJP）、广泛性青少年牙周炎（GJP）和偶然性附着丧失（IAL）组。91名基线年龄为13至20岁的受试者在6年后接受了检查。其中包括51名男性和40名女性；72名黑人、6名西班牙裔和13名白人。对他们进行了临床复查，然后根据随访时的牙周状况重新分类。在研究期间，这些疾病的严重程度和范围持续增加。在基线时受影响的牙齿中，病变已发展至累及牙周更深的部分，并且更多在基线时未受影响的牙齿在随访时出现了牙周附着丧失，从而改变了疾病特征及临床分类的依据。在基线时被分类为LJP的个体中，62%在6年后仍为LJP，35%发展为GJP。在最初被分类为GJP的个体中，除两名外（82%）在随访时仍为GJP。在IAL组中，28%的受试者发展为LJP或GJP，30%被重新分类到无附着丧失组。磨牙和切牙是所有三组中最常受影响的牙齿。LJP、GJP和IAL组在6年期间附着丧失的平均变化分别为0.45、1.12和0.13毫米。目前的研究结果表明了目前用于早发性牙周炎分类的形态学标准的局限性。研究结果还表明，LJP和GJP之间的差异在于受累牙齿的数量和类型，并且这两种分类的进展相似，一些LJP病例会发展为GJP。
