Müller H P, Heinecke A, Borneff M
Department of Operative Dentistry and Periodontology, University of Heidelberg, Germany.
Eur J Oral Sci. 1998 Oct;106(5):945-52. doi: 10.1046/j.0909-8836.1998.eos106507.x.
Structured complexity may be a key feature of the microbiota residing in periodontal ecosystems. Recently, several attempts have been made to analyse the mutual interdependence of certain organisms in subgingival plaque and/or to identify clinical conditions which might influence presence or absence of these bacteria in subgingival plaque. The aim of the present analysis was to compare the results of different models derived from logistic regression of several clinical factors on the presence of Actinobacillus actinomycetemcomitans in subgingival plaque of adult periodontitis patients all harbouring this organism. Models assuming independence of observations or assuming independent observations with the level of response depending on the individual subject were compared to models considering the correlated structure of the acquired data by employing Generalized Estimating Equation (GEE) methods. Significant associations found when neglecting the correlated observations within a given subject as, e.g., between A. actinomycetemcomitans and amount of supragingival plaque, bleeding on probing, or attachment loss, became generally spurious in the GEE approach. Thus, presence of A. actinomycetemcomitans only depended on periodontal probing depth. It was concluded that the correlated structure of observations in an oral cavity should be carefully considered when associations between clinical factors are calculated.
结构复杂性可能是牙周生态系统中微生物群的一个关键特征。最近，人们进行了几次尝试，以分析龈下菌斑中某些微生物之间的相互依存关系，和/或确定可能影响龈下菌斑中这些细菌存在与否的临床状况。本分析的目的是比较不同模型的结果，这些模型来自对所有携带伴放线放线杆菌的成人牙周炎患者龈下菌斑中伴放线放线杆菌的存在情况进行的几种临床因素的逻辑回归分析。将假设观察值独立或假设观察值独立且反应水平取决于个体受试者的模型，与通过使用广义估计方程（GEE）方法考虑所获取数据的相关结构的模型进行比较。当忽略给定受试者内的相关观察值时，例如伴放线放线杆菌与龈上菌斑量、探诊出血或附着丧失之间发现的显著关联，在GEE方法中通常变得不可靠。因此，伴放线放线杆菌的存在仅取决于牙周探诊深度。得出的结论是，在计算临床因素之间的关联时，应仔细考虑口腔中观察值的相关结构。
