今回はSPTを受けた患者が歯を喪失する原因
について10年以上に渡り後ろ向き研究している文献です。
50名の患者（喫煙者は内9名）はいずれも
初診時の検査、再評価、及び10年以上SPT経過後の再評価
が記録としてあり
6点法によるプラークスコア、PPD、BOP、抜歯の記録
が抽出されました。
To retrospectively assess tooth-survival rate and its association with patient and oral variables in periodontal office patients, followed up to 18 years.
Patients in a private periodontal office whose files included initial examination (T0 ), reevaluation (TRe ) and ≥ 10 years after T0 (TF ) chartings, and received periodontal therapy and supportive periodontal therapy (SPT) after TRe were included. General health, plaque scores (PI), probing depth (PPD), bleeding on probing (BOP) at six points/tooth, tooth extractions, and SPT visits were extracted from patient files at T0 , TRe , and TF . Descriptive statistics and Cox regression analysis were performed.
Fifty patients (mean 26 ± 4 teeth/patient, 1301 teeth) fulfilled inclusion criteria. About 20 and 129 teeth respectively were extracted before/after TRe , 96 of them for periodontal causes. PPD>7 mm at TRe (HR = 17.7, 95%CI 8.6, 36.6), age above 60 years (HR = 3.3, 95%CI 1.5, 7.2), multi-rooted teeth (HR = 1.9, 95%CI 1.2, 3.1) and SPT<3 times/year (HR = 1.8, 95%CI 1.1, 2.9), were the best prognostic factors for tooth loss during follow-up. (p < 0.05, Cox regression analysis). A continuous, statistically significant reduction was observed in mean PPD among teeth that survived follow-up [4.3 ± 1.8 mm, 3.5 ± 1.4 mm, 3.2 ± 1.3 mm, at T0 , TRe , TF , respectively. (p < 0.001, Repeated-measures test)].
Regular SPT was associated with low tooth-loss rates and continuous reductions in probing depth. PPD after initial therapy, age above 60, multi-rooted teeth and infrequent SPT were strong negative prognostic factors for long-term tooth survival among periodontal patients.
結果は、再評価時において
7mmを超えるPPD、60歳以上の年齢、複根歯
SPTの受診が年3回未満の場合が
フォローアップ期間における歯の喪失の
予測因子として有効だった
ということです。
治療の質も大事ですが、特に最後の
SPTの受診回数、間隔の設定も重要であることが
分かりました。
引用文献
Saminsky M1, Halperin-Sternfeld M1, Machtei EE1, Horwitz J
Variables affecting tooth survival and changes in probing depth: a long-term follow-up of periodontitis patients.
J Clin Periodontol. 2015 Jun;42(6):513-9.