Analytical epidemiology of periodontitis
Analytical epidemiology of periodontitis
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DOI：
10.1111/j.1600-051x.2005.00799.x
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发表时间：
2005-01-01
影响因子：
6.7
通讯作者：
Papapanou, PN
中科院分区：
文献类型：
--
作者：
Borrell, LN;Papapanou, PN
目的：回顾近十年来牙周炎分析流行病学的相关文献。本综述不涉及牙周炎的患病率、范围和严重程度的描述性流行病学研究，而是专门关注分析性流行病学问题，包括跨研究使用不同病例定义所带来的挑战、当前疾病进展的理论和模型，以及与牙周炎发病和进展相关的风险因素。方法：在英语中的相关出版物被确定后，Medline和PubMed数据库search.Findings和结论：有一个明显的缺乏统一的定义牙周炎流行病学研究中使用的，从不同的研究小组的结果是不容易解释。有一个缺乏研究，特别是解决牙周炎的发病与影响其进展的因素之间的区别负责。高水平特定细菌的定植、吸烟和糖尿病控制不佳已被确定为牙周炎的危险因素，而在相关研究中已确定了许多推定因素，包括特定的基因多态性。很明显，需要进行纵向前瞻性研究，以解决从横断面数据中出现的假设，并将既定的风险因素作为协变量沿着新的关注暴露。特别需要进行干预研究，以完成风险评估过程中的“确定目标”步骤。在这种情况下，明显的候选人是消除特定的细菌种类和戒烟干预作为替代传统的广泛的抗牙菌斑方法在预防和控制牙周炎的有效性的研究。理想情况下，此类研究应采用随机对照试验设计。
Aims: To review the literature related to the analytical epidemiology of periodontitis generated over the past decade. This review does not deal with descriptive epidemiologic studies of the prevalence, extent and severity of periodontitis with respect to global geography, but focuses exclusively on analytical epidemiology issues, including the challenges posed by the use of different case definitions across studies, current theories and models of disease progression, and risk factors associated with the onset and progression of periodontitis.Methods: Relevant publications in the English language were identified after Medline and PubMed database searches.Findings and conclusions: There is a conspicuous lack of uniformity in the definition of periodontitis used in epidemiologic studies, and findings from different research groups are not readily interpretable. There is a lack of studies that specifically address the distinction between factors responsible for the onset of periodontitis versus those affecting its progression. Colonization by specific bacteria at high levels, smoking, and poorly controlled diabetes have been established as risk factors for periodontitis, while a number of putative factors, including specific gene polymorphisms, have been identified in association studies. There is a clear need for longitudinal prospective studies that address hypotheses emerging from the cross-sectional data and include established risk factors as covariates along with new exposures of interest. Intervention studies, fulfilling the "targeting" step of the risk assessment process, are particularly warranted. Obvious candidates in this context are studies of the efficacy of elimination of specific bacterial species and of smoking cessation interventions as an alternative to the traditional broad anti-plaque approach in the prevention and control of periodontitis. Ideally, such studies should have a randomized-controlled trial design.