Current view of risk factors for periodontal diseases
Current view of risk factors for periodontal diseases
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DOI：
10.1902/jop.1996.67.10s.1041
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发表时间：
1996-10-01
影响因子：
4.3
通讯作者：
Genco, RJ
中科院分区：
文献类型：
--
作者：
Genco, RJ
牙周病是一种感染性疾病，许多形式的疾病都与特定的病原菌有关，这些病原菌定植在龈下区域。这些微生物中至少有两种，牙龈卟啉单胞菌和伴放线放线杆菌，也侵入牙周组织，是有毒的生物。牙周感染的发生和发展明显受到称为风险因素的局部和全身条件的影响。局部因素包括预先存在的疾病，如深探诊深度和与有缺陷的牙菌斑相关的牙菌斑保留区域所证明的。系统性危险因素最近已经通过大规模流行病学研究确定，使用多因素统计分析来校正混杂或相关的共危险因素。我们今天知道的重要危险因素包括糖尿病，特别是在代谢控制不良的个体中，以及吸烟。这两个危险因素显着影响牙周炎的发生和进展，尝试管理这些因素现在是成人牙周炎预防和治疗的重要组成部分。与中性粒细胞数量或功能减少相关的全身性疾病也是儿童、青少年和年轻人的重要风险因素。发生中性粒细胞功能障碍的疾病包括与局限性青少年牙周炎相关的惰性白细胞综合征、周期性中性粒细胞减少症和先天性中性粒细胞减少症。最近的研究还指出了几个潜在的重要牙周风险指标。这些包括压力和应对行为，以及与雌激素缺乏相关的骨质减少。还有一些与牙周病相关的背景决定因素，包括性别（男性有更多的疾病），年龄（在老年人中看到更多的疾病）和遗传因素。牙周病风险的研究是一个迅速兴起的领域，还有很多东西有待了解。然而，至少有两个重要的危险因素吸烟和糖尿病，这需要注意在目前的牙周病管理。
PERIODONTAL DISEASES ARE INFECTIONS, and many forms of the disease are associated with specific pathogenic bacteria which colonize the subgingival area. At least two of these microorganisms, Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans, also invade the periodontal tissue and are virulent organisms. Initiation and progression of periodontal infections are clearly modified by local and systemic conditions called risk factors. The local factors include pre-existing disease as evidenced by deep probing depths and plaque retention areas associated with defective restorations. Systemic risk factors recently have been identified by large epidemiologic studies using multifactorial statistical analyses to correct for confounding or associated co-risk factors, Risk factors which we know today as important include diabetes mellitus, especially in individuals in whom metabolic control is poor, and cigarette smoking. These two risk factors markedly affect the initiation and progression of periodontitis, and attempts to manage these factors are now an important component of prevention and treatment of adult periodontitis. Systemic conditions associated with reduced neutrophil numbers or function are also important risk factors in children, juveniles, and young adults. Diseases in which neutrophil dysfunction occurs include the lazy leukocyte syndrome associated with localized juvenile periodontitis, cyclic neutropenia, and congenital neutropenia. Recent studies also point to several potentially important periodontal risk indicators. These include stress and coping behaviors, and osteopenia associated with estrogen deficiency. There are also background determinants associated with periodontal disease including gender (with males having more disease), age (with more disease seen in the elderly), and hereditary factors. The study of risk in periodontal disease is a rapidly emerging field and much is yet to be learned. However, there are at least two significant risk factors-smoking and diabetes-which demand attention in current management of periodontal disease.