目的:评估非手术牙周治疗后牙周袋深度(PPD)的位点相关变化,并在回顾性患者数据分析中确定PPD变化的预测因子。
方法:PPD,临床依恋水平,探查时出血,牙齿活动度(TM),分叉参与(FI),基台状态,对支持性牙周护理(SPC)的依从性和SPC随访是从牙周治疗前完全记录的患者数据中获得的(基线,T0),积极牙周治疗后(APT,T1)和SPC(T2)期间。PPD变化在现场水平分为恶化或不变/改善。采用多水平logistic回归分析确定SPC过程中PPD变化的影响因素。
结果:这项回顾性研究包括51名女性和65名男性(平均T0年龄:54.8±10.1岁,25名吸烟者12位糖尿病患者)患有III/IV期牙周炎。评估结果:T0/16,044个采样部位/2674颗牙齿;T1/15,636/2606;T2/14,754/2459。在9.0±2.3年期间,SPC,PPD减少(-1.33±0.70mm)21.8%的地点,保持41.4%不变,增加(1.40±0.78mm)36.8%。远视距FI(p<.001,比值比[OR]:0.252,OR的95%置信区间[CI]:0.118-0.540),残余口袋(p<.001,OR:0.503,95%CI:0.429-0.590)和TMI-III度(I度:p=.002,OR:0.765,95%CI:0.646-0.905;II度:p=.006,OR:0.658,95%CI:0.489-0.886;III度:p=.023,OR:0.398,95%CI
结论:超过75%的PPD在SPC期间保持不变或增加。远足区FI,TMI-III度和APT后残留的口袋会导致牙周袋恶化。
OBJECTIVE: To evaluate site-related changes in periodontal pocket depth (PPD) after non-surgical periodontal therapy and to identify predictors for PPD changes in a retrospective patient data analysis.
METHODS: PPD, clinical attachment level, bleeding on probing, tooth mobility (TM), furcation involvement (FI), abutment status, adherence to supportive periodontal care (SPC) and SPC follow-ups were obtained from fully documented patient data before periodontal therapy (baseline, T0), after active periodontal therapy (APT, T1) and during SPC (T2). PPD changes were classified into deteriorated or unchanged/improved at the site level. Multi-level logistic regression analysis was performed to identify factors influencing PPD changes during SPC.
RESULTS: This retrospective
study included 51 females and 65 males (mean T0 age: 54.8 ± 10.1 years, 25 smokers, 12 diabetics) suffering from Stage III/IV periodontitis. Evaluation outcome: T0/16,044 sampling sites/2674 teeth; T1/15,636/2606; T2/14,754/2459. During 9.0 ± 2.3 years SPC, PPD decreased (-1.33 ± 0.70 mm) by 21.8% of the sites, remained unchanged by 41.4% and increased (1.40 ± 0.78 mm) by 36.8%. Distopalatal FI (p < .001, odds ratio [OR]: 0.252, 95% confidence interval [CI] for OR: 0.118-0.540), residual pockets (p < .001, OR: 0.503, 95% CI: 0.429-0.590) and TM Degrees I-III (Degree I: p = .002, OR: 0.765, 95% CI: 0.646-0.905; Degree II: p = .006, OR: 0.658, 95% CI: 0.489-0.886; Degree III: p = .023, OR: 0.398, 95% CI: 0.180-0.879) correlated significantly with increasing PPD.
CONCLUSIONS: Over 75% of PPD remained unchanged or increased during SPC. Distopalatal FI, TM Degrees I-III and residual pockets after APT lead to worsening of periodontal pockets.