Summary: | 碩士 === 高雄醫學大學 === 口腔衛生學系碩士在職專班 === 104 === Background:
Periodontitis is an inflammatory disease caused by the infection of periodontal pathogens. Long-term effects of severe periodontitis may lead to the tooth loss. After periodontal treatment, scheduled dental check-up and supportive periodontal treatment (SPT) could improve the tooth health and increase the life expectancy of damage tooth. However, the change of periodontal index and life expectancy of damage tooth after the treatment of periodontitis were rare found in the long-term follow-up study.
Aim:
Our aims were to investigate 1) the difference in periodontal index and dempgraphics between periodontitis patients with and without dental check-up after the treatment; 2) the risk factors associated with the reduction of tooth life expectancy after the treatment in the long-term follow-up.
Materials and method:
Clinical records and demographics were collected from patients treated by the same visiting staff of the periodontal division, dental department at Kaohsiung Medical University Hospital. Average time period of recall in dental clinic was 3-6 month. The charting data of each dental check-up and before treatment were collected to compare the changes in periodontal index. Periodontal index included pocket depth (PD), bleeding on probing (BOP), clinical attachment loss (CAL), plaque accumulation on tooth surface (PAOTS), and mobility. The software of Access 2013 was used to key in clinical data and demographics. Statistical analysis was used to analyze the association.
Result:
A total of 280 patients with periodontitis were collected in the initial stage. The longest follow-up period was eleven years (2003-2014). No differences in the frequencies of demographic variables, BOP, and different levels of PD, CAL (p-value =0.561), and tooth mobility were found between periodontits patients with and without dental check-up. However, the frequencies of PAOTS were significantly higher in periodontits patients with dental check-up (X2= 9.088, p-value = 0.011).
A total of 3258 teeth were selected into the analysis. The frequencies of tooth with BOP (X2 = 170.184 , p-value <0.001) and PATOS (X2= 140.619, p-value <0.001), and the worsest of PD (X2=1253.475, P-value <0.001), CAL (X2 = 1678.564, P-value <0.001), and tooth mobility (X2= 140.619, P-value <0.001) were significantly reduced in patients with periodontitis and dental check-up, especially in the last recall compared with their periodontal index before treatment. Survival curve and log-rank test showed that patients with the habit of cigarette smoking (log-rank test=3.960,p-value=0.047), self-reported heart diseas (log-rank test=6.405,p-value=0.011), diabetics (log-rank test=6.666,p-value=0.010), and the worsest of CAL (log-rank test=139.888,p-value <0.001), PD (log-rank test=200.099,p-value <0.001), and tooth mobility (log-rank test =161.689,p-value <0.001) were all significantly correlated with a lower teeth accumulated survival rate compared with their control group. However, no such result was found in the variables of gender, hypertention, hepatitis infection, and the habits of drinking and betel quid chewing. Multivariate cox proportional hazards model analysis indicated that smokers (AHR = 4.46, 95% CI = 0.96-20.60), diabetes (AHR = 0.18, 95% CI = 0.09-0.95), heart disease (AHR = 4.81, 95% CI = 1.73-13.41) were risk factors to decrease the tooth survival time after the treatment.
Conclusion:
Our reults showed that patients with periodontitis and scheduled dental check-up could significantly improve their periodontal health and accumulated teeth survival rate after the treatment. However, the more intensive care were needed to treat those teeth with high severity of damage in periodontal health, especially in damage teeth without improvement after the treatment.
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