Disease progression in periodontally healthy and maintenance subjects.
Disease progression in periodontally healthy and maintenance subjects.
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DOI：
10.1902/jop.2008.070485
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发表时间：
2008-05
影响因子：
4.3
通讯作者：
Ricardo Teles;Mitesh Patel;S. Socransky;A. Haffajee
中科院分区：
文献类型：
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作者：
Ricardo Teles;Mitesh Patel;S. Socransky;A. Haffajee
背景本研究的目的是确定预防方案中牙周健康受试者的附着丧失率是否与参加维持计划的牙周炎受试者的疾病进展率不同。方法对55名牙周健康者和57名牙周炎者进行基线和1年、2年和3年的临床和微生物监测。在每颗牙齿的六个部位测量的临床参数包括探诊出血、可见菌斑、探诊深度和附着水平。龈下菌斑样本取自每颗牙齿的近中颊面，并使用棋盘DNA-DNA杂交分析40种细菌的水平。使用重复测量方差分析确定临床参数随时间的差异的显著性，而使用非配对t检验确定组间差异的显著性。使用Mann-Whitney检验进行微生物分析，并调整P值进行多重比较。结果：两组的平均临床参数均随时间推移而改善。到研究结束时，维持组受试者中有4%的位点失去≥ 2 mm的附着，而在预防组受试者中只有1%的位点失去≥ 2 mm的附着。维持受试者主要在浅颊和舌部位丧失附着。在整个研究期间，维持组受试者的大多数试验种属水平显著较高。维持计划没有将红色复合物的水平降低到健康受试者的典型水平。结论：在预防性治疗方案中，牙周炎患者在维持治疗时比牙周健康者显示出更快的附着丧失。更大的疾病进展倾向可能与牙周病原体的暴露增加有关。
BACKGROUND The aim of this study was to determine whether the rate of attachment loss in periodontally healthy subjects in a prevention regimen would differ from the rate of disease progression in periodontitis subjects enrolled in a maintenance program. METHODS Fifty-five periodontally healthy subjects and 57 periodontitis subjects were clinically and microbiologically monitored at baseline and at 1, 2, and 3 years. Clinical parameters measured at six sites per tooth included bleeding on probing, visible plaque, probing depth, and attachment level. Subgingival plaque samples were taken from the mesio-buccal aspect of every tooth and were analyzed for the levels of 40 bacterial species using checkerboard DNA-DNA hybridization. The significance of differences over time in the clinical parameters was determined using repeated-measures analysis of variance, whereas the significance of differences between groups was determined using the unpaired t test. The Mann-Whitney test was used for microbial analyses, and P values were adjusted for multiple comparisons. RESULTS Mean clinical parameters improved for both groups over time. By the end of the study, 4% of the sites in maintenance subjects lost > or =2 mm of attachment, whereas in the prophylaxis subjects only 1% of the sites lost > or =2 mm of attachment. Maintenance subjects lost attachment primarily at shallow buccal and lingual sites. The maintenance subjects harbored significantly higher levels of most test species throughout the study. The maintenance program did not reduce the levels of red complex species to those typical of healthy subjects. CONCLUSIONS Treated periodontitis subjects under maintenance displayed more rapid attachment loss than periodontally healthy subjects in a preventive regimen. The greater propensity to disease progression may be related to an elevated exposure to periodontal pathogens.