The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults -: Results after 30 years of maintenance
The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults -: Results after 30 years of maintenance
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DOI：
10.1111/j.1600-051x.2004.00563.x
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发表时间：
2004-09-01
影响因子：
6.7
通讯作者：
Lindhe, J
中科院分区：
文献类型：
--
作者：
Axelsson, P;Nyström, B;Lindhe, J
背景：牙面生物膜的形成和残留是龋病和牙周病的主要致病因素。龋齿和牙周病的预防必须基于对抗这种细菌菌斑的方法。目的：监测一组保持精心管理的菌斑控制计划的成年人在30年期间的牙齿脱落、龋病和附着丧失的发生率。此外，还比较了1972年和2002年51-65岁人群的口腔健康状况。材料和方法：1971年和1972年，共招募了550多名受试者。375名受试者组成试验组，180名受试者组成对照组。经过6年的监测，对照组停止，而试验组的参与者继续接受预防计划，并在30年后进行复查。在基线和3、6、15、30年后对以下变量进行研究：菌斑、龋齿、探诊袋深度、探诊附着水平和CPITN。每个患者都接受了详细的病例介绍和自我诊断教育。在头两年中每两个月一次，在3-30岁期间每3-12个月一次，参与者根据个人需要接受自我诊断和自我护理的额外教育，重点是适当的菌斑控制措施，包括使用牙刷和牙间清洁设备(刷子、牙带、牙签)。由牙科卫生员进行的预防活动还包括(I)菌斑揭示和(Ii)专业机械清洁牙齿，包括使用含氟牙膏/膏剂。结果：在维护的30年中，几乎没有牙齿脱落；不同年龄组的牙齿脱落0.4-1.8颗。牙齿脱落的主要原因是牙根折断，仅有21颗牙齿因进行性牙周炎或龋齿而脱落。三组平均新增龋损分别为1.2个、1.7个和2.1个。约80%的病变被归类为复发性龋病。大多数部位，口腔部位例外，没有表现出依恋丧失的迹象。此外，在1972-2002年间，所有年龄段的人在接近牙面上都有一定程度的附着性。结论：本研究报告了一组严密监测的受试者30年来预防性牙科治疗的结果，这些受试者定期受到鼓励，但也享受并认识到保持高标准的口腔卫生的好处。受试者的龋齿和牙周病的发生率以及牙齿死亡率都很低。由于30年来的所有预防和治疗工作都是在一家私人牙科诊所进行的，因此在与提供随机选择的受试者样本的口腔疾病数据的纵向研究进行比较时，必须谨慎行事。
Background: The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque.Objective: To monitor the incidence of tooth loss, caries and attachment loss during a 30-year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51-65 years old.Material and Methods: In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy-five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re-examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self-diagnosis. Once every 2 months during the first 2 years, once every 3-12 months during years 3-30, the participants received, on an individual need basis, additional education in self-diagnosis and self-care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride-containing dentifrice/paste.Results: Few teeth were lost during the 30 years of maintenance; 0.4-1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups.Conclusion: The present study reported on the 30-year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.