Cohort Study on Management System for Periodontal Maintenance Patients.

[牙周治疗后远期疗效评价]铃木观察了68例牙周病患者在维持期内的治疗后变化，结果表明，牙周病维持良好组牙周袋深度基本保持不变，而下坡组牙周病复发，治疗后32个月再次拔牙。KUMAGAYA调查了208例患者的治疗后变化。初始菌斑积分与治疗后结果之间未发现相关性，这意味着在维持患者中宿主因素可能比寄生虫因素更重要。[宿主因素分析]石川报道，放线菌共生放线杆菌和牙龈卟啉单胞菌抗体均较高的患者，治疗后结果较差。Murayama证实石川的观察，并进一步建议将趋化和吞噬活性、总T细胞数、Th/I比值作为牙周病进一步进展的危险指标。MURAKAMI从维持治疗患者中提取5年内X线片显示牙槽骨进一步吸收至少4%的高危组。高危患者龈沟液中IL-1浓度、龈下菌斑中牙龈卟啉单胞菌浓度、抗牙龈卟啉单胞菌抗体滴度均显著高于对照组。[Risk积极牙周治疗后的指标]长谷川使用细菌监测试剂盒检测牙周炎细菌如P.g.和齿垢密螺旋体的特定酶，并得出结论，该系统在监测治疗后的效果方面非常有用。这个结果与村上的发现一致。WATANABE建议在风险指标中采用阶段标志和状态标志两种不同的概念。应将附着水平视为阶段标记，并将探测囊袋深度视为状态标记。

[Assessment of long term results after periodontal treatment]SUZUKI observed post treatment changes during maintenance period in 68 periodontal patients, and indicated that periodontal pocket keep their original depth in well maintenained group, however in down hill group recurrence of periodontal pathosis resulting in retreatment of tooth extraction occurred 32 months after treatment. KUMAGAYA surveyed post treatment changes in 208 patients. The relationships were not found between initial plaque score and post treatment results, which means host factor might be more important than parasite factor in maintenance patients.[Analysis of host factor]ISHIKAWA reported that patients who have higher antibodies to both Actinobacillus actinomycetemcomitance and porphylomonas gingivalis showed poorer post treatment results than others. MURAYAMA confirmed ISHIKAWA's observation, and suggested further that chemotactic and phagocytotic activities, total T cell number, Th/I ratio would be regarded as risk indicators for the further progression of periodontal diseases. MURAKAMI extracted high risk group which showed at least 4% further alveolar bone resorption on the X-ray pictures during 5 years from maintenance patiehts. The high risk patients exhibited significantly higher IL-l concentration in Gingival Crevicular Fluid, higher concentration of P.gingivalis in the subgingival plaque, and higher antibody titer to P.g.[Risk indicator after active periodontal treatment]HASEGAWA used a bacterial monitoring kit to detect specific enzyme for periodontopahtic bacteria such as P.g.and Treponema denticola, and concluded that this system was extremely useful in monitoring post-treatment effect. This result coincide to MURAKAMI's finding. WATANABE suggested to employ tow defferent concept in risk indicator, stage marker and state marker. Attachment level should be regarded as a stage marker and probing pocket depth as a state marker.