背景:最近,提出了一种复合结局指标(COM)来描述牙周再生治疗的短期结果.本回顾性研究旨在评估在4年的支持性牙周护理(SPC)期间,COM对临床依恋水平(CAL)变化的预后价值。
方法:在再生治疗后6个月和4年评估了59例患者的74例骨内缺损。基于6个月的CAL变化和探测深度(PD),缺陷分类为:COM1(CAL增益≥3mm,PD≤4mm);COM2(CAL增益<3mm,PD≤4mm);COM3(CAL增益≥3mm,PD>4毫米);或COM4(CAL增益<3毫米,PD>4mm)。比较COM组的“稳定性”(即,CAL增益,4年时无CAL变化或CAL损失<1mm)。此外,比较各组的PD和CAL的平均变化,需要手术治疗,和牙齿的生存。
结果:在4年,COM1、COM2、COM3和COM4组的稳定缺陷比例为69.2%,75%,50%,和28.6%,分别,与COM4相比,COM1,COM2和COM3的缺陷显示稳定性的可能性要高得多(比值比分别为4.6,9.1和2.4)。尽管在COM4中观察到手术再干预的患病率较高,牙齿存活率较低,但在COM组之间没有发现显着差异。
结论:COM可能在预测牙周再生手术后接受SPC的部位CAL变化方面有价值。对更大群体的研究,然而,需要证实目前的发现。
Recently, a composite outcome measure (COM) was proposed to describe the short-term results of periodontal regenerative treatment. The present retrospective study aimed at evaluating the prognostic value of COM on clinical attachment level (CAL) change over a 4-year period of supportive periodontal care (SPC).
Seventy-four intraosseous defects in 59 patients were evaluated at 6 months and 4 years following regenerative treatment. Based on 6-month CAL change and probing depth (PD), defects were classified as: COM1 (CAL gain ≥3 mm, PD ≤4 mm); COM2 (CAL gain <3 mm, PD ≤4 mm); COM3 (CAL gain ≥3 mm, PD >4 mm); or COM4 (CAL gain <3 mm, PD >4 mm). COM groups were compared for \"stability\" (i.e., CAL gain, no change in CAL or CAL loss <1 mm) at 4 years. Also, groups were compared for mean change in PD and CAL, need for surgical retreatment, and tooth survival.
At 4 years, the proportion of stable defects in COM1, COM2, COM3, and COM4 group was 69.2%, 75%, 50%, and 28.6%, respectively, with a substantially higher probability for a defect to show stability for COM1, COM2, and COM3 compared with COM4 (odds ratio 4.6, 9.1, and 2.4, respectively). Although higher prevalence of surgical reinterventions and lower tooth survival were observed in COM4, no significant differences were detected among COM groups.
COM may be of value in predicting CAL change at sites undergoing SPC following periodontal regenerative surgery. Studies on larger cohorts, however, are needed to substantiate the present findings.