Comparative longitudinal study of 2 methods of scheduling maintenance visits: 4-year data.
Comparative longitudinal study of 2 methods of scheduling maintenance visits: 4-year data.
复制标题
两种安排维护访问方法的纵向比较研究：4 年数据。
DOI：
10.1111/j.1600-051x.1989.tb01622.x
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发表时间：
1989
影响因子：
6.7
通讯作者：
Kramer,AA
中科院分区：
文献类型：
--
作者：
Listgarten,MA;Sullivan,P;George,C;Nitkin,L;Rosenberg,ES;Chilton,NW;Kramer,AA
116名受试者是从以前接受过成人牙周炎治疗并通过每3-6个月进行一次定期牙周松弛来保持牙周健康的患者中招募的。受试者被分为对照组（C）和试验组（T）。T组共有33例患者，C组共有47例患者完成了4年研究。C组受试者每6个月检查一次，每3个月给予一次预防性治疗。T组的患者以相似的时间间隔进行检查，但根据Listgarten和Shiffter的个体化方案，根据龈下细菌形态型的显微镜差异计数，给予泻药。复发性牙周炎被定义为从基线测量值增加3 mm或更多的探测深度。当诊断出复发性疾病并从研究中“退出”进行治疗时，对受影响的牙齿进行微生物取样。同时从先前定义的未受影响表面的合并样本中采集对照微生物样本，该样本具有相对较高但稳定的探测深度。在4年期间，超过一半的受试者至少发生一次疾病复发，三分之一的受试者有2次或2次以上的牙周炎复发。81%的病例在近端表面复发，19%的病例在口前庭表面复发。C组和T组之间的疾病复发率没有显著差异，尽管T组在4年检查时的回忆间隔平均为19.4个月，自上次预防以来平均已经过去了30.6个月。在4年的研究中，两组表现出相似的菌斑指数和牙龈指数评分、相似的探诊深度和附着水平测量值以及相似的不同细菌形态类型比例。然而，在这些标准中的大多数方面，两组的检查之间存在差异。本研究提供了一组成年患者的4年纵向数据，这些患者既往接受过中晚期牙周炎治疗，随后接受牙周维护。结果表明，尽管缺乏定期的每三个月一次的回顾访问，但其中一些患者可能保持良好的牙周健康，并且龈下微生物群的显微镜监测可能对识别这些个体具有价值。我们的研究结果还表明，龈下微生物群的显微镜监测可能无法提供足够的好处，以证明将这种技术纳入牙周预防性维护的标准方案所需的额外时间和劳动力。
116 subjects were recruited from a population of patients previously treated for adult periodontitis and maintained in periodontal health by means of periodic prophylaxes every 3–6 months. The subjects were divided into a control (C) and a test (T) group. A total of 33 patients in the T group and 47 in the C group completed the 4‐year study. The C subjects were examined every 6 months and given a prophylaxis every 3 months. The patients in the T group were examined at similar intervals, but prophylaxes were administered according to the individualized scheme of Listgarten and Shiffter, on the basis of a differential microscopic count of subgingival bacterial morphotypes. Recurrent periodontitis was defined as an increase in probing depth of 3 mm or more from baseline measurements. Teeth so affected were sampled microbiologically when the diagnosis of recurrent disease was made and “exited” from the study for treatment. A control microbial sample was taken at the same time from a previously‐defined pooled sample of non‐affected surfaces with comparatively high, but stable probing depths. During a 4‐year period, more than half of the subjects developed at least one recurrence of disease, and one‐third of the subjects had 2 or more recurrences of periodontitis. Disease recurred on approximal surfaces 81% and on oro‐vestibular surfaces 19% of the time. There were no significant differences in the rate of disease recurrence between the C and the T group, even though recall intervals in the T group at the 4‐year examination averaged 19.4 months and an average of 30.6 months had elapsed since the previous prophylaxis. Both groups exhibited similar plaque index and gingival index scores, similar probing depth and attachment level measurements, and similar proportions of different bacterial morphotypes during the 4‐year study. However, differences were noted between examinations for both groups with respect to most of these criteria. This study provides 4‐year longitudinal data on the clinical and certain microbiological characteristics of a population of adult patients previously treated for moderate to advanced periodontitis, and subsequently placed on periodontal maintenance. The results indicate that some of these patients may remain in good periodontal health despite the lack of regular tri‐monthly recall visits, and that microscopic monitoring of the subgingival microbiota may be of value in identifying these individuals. Our findings also indicate that microscopic monitoring of the subgingival microbiota may not provide sufficient benefits to justify the additional time and labor required to incorporate this technique into a standard regimen of periodontal preventive maintenance.