口腔医学 ›› 2023, Vol. 43 ›› Issue (7): 633-637.doi: 10.13591/j.cnki.kqyx.2023.07.009

• 临床研究 • 上一篇    下一篇

Ⅳ期C级牙周炎患者预后无望牙疗效的影响因素研究

蒋立姗1,杨智宇1,史佳虹1,王金孟1,雷浪2,李厚轩1()   

  1. 1 南京大学医学院附属口腔医院,南京市口腔医院牙周科,江苏南京(210008)
    2 南京大学医学院附属口腔医院,南京市口腔医院正畸科,江苏南京(210008)
  • 修回日期:2023-04-14 出版日期:2023-07-28 发布日期:2023-07-28
  • 通讯作者: 李厚轩 Tel:(025)83620208 E-mail:lihouxuan3435_0@163.com
  • 基金资助:
    南京市医学科技发展资金(ZKX20047)

Therapeutic effect and influencing factors of hopeless teeth with Stage Ⅳ Grade C periodontitis: A retrospective study

JIANG Lishan1,YANG Zhiyu1,SHI Jiahong1,WANG Jinmeng1,LEI Lang2,LI Houxuan1()   

  1. Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
  • Revised:2023-04-14 Online:2023-07-28 Published:2023-07-28

摘要:

目的 探讨Ⅳ期C级牙周炎患者预后无望患牙经过完善牙周治疗后的效果及其影响因素。方法 本回顾性研究纳入63例Ⅳ期C级牙周炎患者,共307颗预后无望患牙,根据2年后患牙存留与否分为存留组和失牙组,存留组中根据临床检查和影像学骨吸收是否恢复至根中1/3分为预后好转组和预后不变组。根据临床资料分析年龄、性别、牙位、基础疾病、吸烟情况、家族遗传、牙列是否完整、牙周炎分型、治疗过程、初诊牙周临床指标对治疗效果的影响。结果 307颗患牙两年存留率为83.1%,预后明显好转占比46.2%。存留组和失牙组在家族遗传、初诊时牙列完整性、1个月复查是否按时、维护期治疗规律性、手术情况和患牙初诊临床指标上差异有统计学意义。回归分析显示,未进行翻瓣再生类手术、有家族遗传史、基线深附着丧失值、高松动度为主要风险因素。结论 对于Ⅳ期C级牙周炎患者预后无望患牙在短期内大多数可以保留,临床治疗中需要根据风险因素进行个性化的治疗以提高患牙存留率。

关键词: Ⅳ期C级牙周炎, 预后无望, 治疗效果

Abstract:

Objective To investigate the therapeutic effect and influencing factors of hopeless teeth with Stage Ⅳ Grade C periodontitis after complete periodontal treatment. Methods A total of 63 patients with Stage Ⅳ Grade C periodontitis were enrolled in this retrospective study. Their 307 hopeless teeth were divided into the retained group and the lost group according to the retention two years later. In the retained group,teeth were further divided into the improved group and the unchanged group considering whether bone resorption was restored to mid-third of root on the image and clinical examination. According to the clinical data, age, gender, dental position,underlying disease, smoking status, family genetics, dentition integrity, type of periodontitis, treatment process and baseline periodontal clinical indicators were measured and analyzed. Results The 2-year survival rate of 307 teeth was 83.1%, and the prognosis was significantly improved in 46.2% of the teeth. The family genetics, integrity of dentition,timeliness of one-month review, regularity of maintenance treatment, surgical conditions,and clinical indicators of affected teeth at the baseline were statistically different between the retained group and the lost group. Regression analysis showed that the main risk factors were no flap surgery, family history, baseline deep attachment loss value and high looseness. Conclusion For Stage Ⅳ Grade C periodontitis, most hopeless teeth can be preserved in the short term. In clinical treatment, personalized treatment plan should be carried out according to risk factors to improve the retention rate.

Key words: Stage Ⅳ Grade C periodontitis, hopeless teeth, therapeutic effect

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