单次全口非手术治疗和风险因素分析对长期牙周治疗结果的影响:一项后期研究
Obada Mandil1,2, Abdusalam Alrmali1,3, Khushboo Kalani1
1Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Clinical oral investigations
|June 4, 2025
概括
单次全口治疗有效地治疗牙周炎,牙损失较低. 频繁的支持性牙周治疗 (SPT) 访问显著降低了牙损失的风险,特别是对于糖尿病患者,吸烟者或晚期疾病患者.
科学领域:
- 牙周病学 牙周病学
- 牙科公共卫生 牙科公共卫生
- 临床牙周科 临床牙周科
背景情况:
- 支持性牙周治疗 (SPT) 通常涉及全口仪器用于持续的牙周口袋以控制疾病的进展.
- 单次访问全口腔仪器被探索为标准的SPT实践的替代方案,可能改善患者的坚持和减少治疗时间.
研究的目的:
- 评估一次性全口非手术治疗在SPT期间治疗牙周炎的长期有效性.
- 评估由于牙周炎 (TLP) 的牙损失作为主要结果,而探测深度 (PD) 的变化作为次要结果.
- 识别与TLP相关的风险因素.
主要方法:
- 在SPT (PiKS) 期间出现牙周衰竭的283名患者的回顾性分析,这些患者接受了一次性全口腔超声波仪器仪表.
- 主要结局:由于牙周炎 (TLP) 导致的牙损失,平均随访时间为19.4年.
- 二次结果:探测深度的变化 (PD ≥5mm和≥6mm) 和TLP风险因素的识别,使用多级逻辑回归和GEE.
主要成果:
- 平均TLP在19.4年内为每名患者0.9颗牙.
- 重要的TLP预测因素包括糖尿病 (OR=2.41),目前的吸烟 (OR=2.13),牙周炎等级B/C (OR=3.31),III-IV阶段 (OR=8.67) 和更深的基线PD (≥5mmOR=1.13;≥6mmOR=1.29).
- 每次额外的年度SPT访问将TLP风险减半 (OR=0.50);PD ≥6mm治疗后降低.
结论:
- 单次全口非手术疗法在治疗牙周炎方面表现出长期的有效性,导致牙损失率低.
- 糖尿病,吸烟,晚期牙周炎阶段/等级,以及更深的基线口袋是牙损失的关键预测因素.
- 频繁的SPT访问显著降低了牙损失的风险,强调了量身定制的,密集的维护计划的重要性.
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