A Randomized Controlled Intervention Trial for Periodontal Disease: Community-Based Screening for Periodontal Disease

• Main Authors: Hongmin Lai, 賴弘明
• Other Authors: Chen, HH
• Format: Others
• Language: en_US
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/99588540666292121420

碩士 === 國立臺灣大學 === 預防醫學研究所 === 91 === Abstract Background As periodontal disease (PD) is preponderant among people aged over 30 years, population-based screening for PD through epidemiological assessment and PD treatment regime is urgently needed. Aims The objectives of this study were (1) to develop a community-based PD screening model; (2) to estimate population-based prevalence and severity of PD; and (3) to assess the efficacy of PD treatment regime in improving PD conditions. Setting Four Community Screening Sessions in Keelung, Taiwan Outcome Measurement Community Periodontal Index (CPI) and Loss of Attachment (LA) on individual (the severest index) and sextant basis Methods PD screening was integrated into a community-based integrated screening program in Keelung, Taiwan. A total of 141 patients with various degree of PD were ascertained and eligible for intervention study. After informed consent, 109 subjects were randomly allocated to two arms, 60 in the intervention group (PD treatment regime) and 49 in the control group (routine dental care). After one month of follow-up, 34 participants in the intervention group and 23 in the control group received reevaluation of CPI and LA. Analysis was attempted by subject level and sextant level. Main Findings For subject level, prevalence rates of CPI were 0.7%, 0.7%, 58.2%, 33.3%, and 7% for healthy, bleeding, calculus, shallow pocket, and deep pocket. If sextant was used as unit the average sextants involved with PD in terms of CPI were 0.1, 0.1, 5.1, 0.6, and 0.1 for healthy, bleeding, calculus, shallow pocket, and deep pocket. The difference in CPI before and after intervention was statistically significant (P=0.01), but the difference in LA was not significant (P=0.06). After adjustment for baseline periodontal assessment by mixed model, the efficacy of PD treatment regime was statistically significant (P < 0.001) in improving CPI score but not statistically significant (P =0.53) in improving LA score. By location, the improvement of CPI due to PD treatment regime was statistically significant for both posterior sextants (P=0.03) and anterior sextants (P < 0.001). However, no significant improvement in LA was observed for both posterior sextants (P=0.39) and anterior sextants (P=0.14). Intention-to-treat analysis found the efficacy of PD treatment regime significantly improved CPI (P < 0.001) and LA (P=0.04). Conclusions A community-based screening model for PD was successfully developed to estimate prevalence and severity of PD using CPI and LA. The efficacy of PD treatment regime in the improvement of PD conditions was demonstrated in a randomized controlled trial. Key Words Periodontal Disease, CPI, LA, Randomized Controlled Trial,