不同程度慢性牙周炎患者病情的二年自然进展

目的　观察不同程度慢性牙周炎的自然进展规律。方法　纵向观察 16 9例轻、中、重度慢性牙周炎患者在 2年中的疾病自然进展 ,检查除第三磨牙外的全口牙 ,每颗牙 6个位点 ,以探诊深度、附着丧失为指标 ,两次检查之间附着丧失加重≥ 3mm的牙位定为活动性进展。结果　活动性发生率依基线时疾病的轻、中、重程度而逐渐增高 ,按位点活动性的发生率分别为 0 14 %、0 39%及0 73% ,按个体活动性的发生率分别为 15 5 6 %、2 9 89%及 4 3 2 4 % ,差异有统计学意义。结论　重度牙周炎患者是牙周破坏活动性进展的高危人群。

Two-year disease progression in mild,moderate and advanced chronic periodontitis patients

OBJECTIVE: To observe two-year natural progression of chronic periodontitis in mild, moderate and advanced periodontitis patients. METHODS: The periodontal status of 169 untreated chronic periodontitis patients aged from 22 to 64, were examined for two years. Periodontal measurements were performed on all teeth except the third molars and 6 sites examined for each tooth. Probing depth (PD), attachment loss (AL), and bleeding on probing (BOP) were measured at baseline, one year, and two year by a same experienced periodontist. Forty-five patients were diagnosed as having mild periodontitis, 87 with moderate, and 37 with advanced periodontitis. The changes of attachment level in these three group patients were analyzed. The site with change of AL greater than 3 mm (DeltaAL > or = 3 mm) were defined as periodontal disease activity (PDA) sites. The occurrence of PDA in three groups was compared. RESULTS: (1) The average AL levels at 1 year and at 2 year were greater than that at baseline in mild, moderate and advanced periodontitis. (2) The percentage of sites with AL > or = 1 mm in three groups all increased from baseline to 1 year and to 2 year. (3) The occurrence of periodontal disease activity increased significantly from mild (0.14% at site level, 15.56% at subject level), moderate (0.39%, 29.89%) to advanced (0.73%, 43.24%) periodontitis patients. (4) The mean baseline AL and PD levels in active sites were greater than that in inactive sites (PD: 3.03 +/- 0.45 vs. 2.87 +/- 0.38, P < 0.05; AL: 2.25 +/- 0.93 vs. 1.77 +/- 0.90, P < 0.01). CONCLUSION: Untreated advanced periodontitis patients were the risk population for further periodontal breakdown.