慢性牙周炎患者维护治疗的依从性对临床疗效影响的纵向观察  

Comparative analysis of the relationship between of chronic periodontitis patients＇compliance and clinical efficacy

作　　者：刘宗响 王鹏来 杜芳[3] 

机构地区：[1]徐州市口腔医院牙周科,江苏221002 [2]徐州市口腔医院口腔颌面外科 [3]徐州医学院口腔医学院口腔内科学教研室

出　　处：《中华口腔医学杂志》2013年第8期472-476,共5页Chinese Journal of Stomatology

摘　　要：目的评价慢性牙周炎患者牙周维护期间依从性不同对临床疗效的影响，以期为提高牙周治疗效果提供理论依据。方法对已完成牙周非手术治疗，且已进入牙周维护治疗（periodontal maintenance therapy，PMT）的慢性牙周炎患者进行3年的追踪观察，根据复诊次数，将患者分为3组：①完全依从组；②不稳定依从组；③不依从组。每3个月进行定期检查及牙周维护治疗，在基线和每次复查时记录牙齿数目并检查牙周探诊深度（probing depth，PD）、附着丧失（attachment loss，AL）和探诊出血（bleedingon probing，BOP）。3年后最终资料通过门诊随访和电话回访召回患者获取，并计算出人均临床指标百分比均数、人均失牙数和活动进展率。采用SPSS16．0软件，均数比较采用方差分析，活动进展率的比较采用）（。检验，以双侧P〈0．05为差异有统计学意义。结果完全依从组不同AL及BOP阳性位点百分比[AL4～5mm：（14．8±5．0）％，AL≥6mm：（9．3±3．1）％，BOP阳性：（22．8±4．2）％]与基线[AL4～5mm：（19．0±6．0）％，AL≥6mm：（10．6±3．1）％，BOP阳性：（30．3±5．6）％]相比均显著下降（P〈0．01），与不依从组[AL4～5mm：（43．3±1．3）％，AL≥6mill：（31．3±1．7）％，BOP阳性：（91．5±5．4）％]相比差异均有统计学意义（P〈0．01），与不稳定依从组[AL4—5mm：（18．9±6．7），AL≥6mm：（12．6±5．4）％，BOP阳性：（38．4±5．2）％]相比差异均有统计学意义（P〈0．05）。与不稳定依从组和不依从组相比，完全依从组牙周炎进展率[以个体为单位19．1％（4／21），以位点为单位0．7％（434／61362）]和人均失牙数（1．0）均较低。结论定期有效的牙周维护能使慢性牙周炎患者保持长期稳定的疗效。Objective To evaluate the effect of patients＇ compliance on clinical parameters in patients with chronic periodontitis during periodontal maintenance therapy period. Methods Chronic periodontitis patients who had completed non-surgical periodontal basic treatment were incorporated into the periodontal maintenance therapy（PMT）. Clinical examination was performed in the baseline and each quarterly recall, over 3-year period. Clinical parameters including number of teeth, probing depth （ PD ） , attachment loss（AL） level and bleeding on probing（BOP） , were recorded. According to the number of PMT visit, the patients were classified into three groups： regular eomplier （RC）; erratic complier （EC）; non-complier（NC）. The final parameters （three years later） were obtained by outpatient follow-up and telephone interviews. The data were calculated for the pecentage of sites with PD 4-5 mm, PD ≥6 mm, AL 4-5 mm, AL≥6 mm, BOP, and the number of tooth loss per patient and the rates of progression of periodontitis. Statistical analyses including ANOVA test and Chi-square test were performed by SPSS 16. 0 software package. Results The percentage of clinical parameters in RC [ AL 4-5 mm ： （ 14. 8± 5.0 ） % , AL≥6 mm： （ 9.3 ±3.1 ） % , BOP ： （ 22. 8 ± 4. 2 ） % ] were significantly decreased compared with that at baseline[AL4-5 mm：（19.0 ±6.0）%, AL≥6 mm：（10.6±3.1）%, BOP： （30.3 ±5.6）%] （P〈 0. 01 ）. There was significant difference between RC and NC E AL 4-Smm： （43.3 ± 1.3 ） % , AL ≥ 6 mm：（31.3±1.7）%, BOP（91.5 _±5.4）%]（P〈0.01）, and between RC and EC[AL4-5 mm：（18.9 ± 6.7）%, ALl〉6 ram：（12.6 ±5.4）%, BOP：（38.4 ± 5.2）%] （P〈0.05）.The progression rate of periodontitis [ 19. 1% （4/21） at subject level, 0. 7% （434/61 362） at site level] and tooth loss（1.0） was significantly lower in RC compared with EC and NC patients. Conclusions Regular periodontal maintenance enables the patients with c

关 键 词：慢性牙周炎 病人依从 纵向研究 影响因素 

分 类 号：R473.78[医药卫生—护理学]