侵袭性牙周炎牙槽骨吸收状况及相关因素分析

Analysis of alveolar bone loss and related factors in patients with aggressive periodontitis

目的 评价未经治疗的侵袭性牙周炎（aggressive periodontitis,AgP）患者牙槽骨吸收状况并分析与牙槽骨吸收状况有关的因素,以期为临床提供参考.方法 对108例未经治疗的AgP患者[男45例,女63例;年龄≤25岁者34例（A组）,＞25岁者74例（B组）]进行吸烟状况和教育背景的问卷调查,并测量全口牙邻面位点探诊深度（probing depth,PD,浅袋：PD=3、4 mm,中袋：PD=5、6 mm,深袋：PD≥7 mm）;根据全口X线根尖片评价邻面牙槽骨吸收状况（轻、中、重度骨吸收）.结果 实际共测量了2841颗牙.浅袋与轻度骨吸收（r=0.518,P=0.000）、深袋与重度骨吸收（r=0.366,P=0.000）均呈正相关;AgP患者男性轻、中、重度骨吸收牙数（分别为7.1±6.2、12.5±4.7、5.1±0.6）与女性（分别为8.7±6.3、12.9±4.8、4.2±0.5）差异无统计学意义（P值分别为0.707、0.671和0.413）;B组中、重度骨吸收牙数（分别为13.6±4.2、5.2±3.7）显著多于A组（分别为11.0±5.5、3.6±3.5）,P＜0.01;受过高等教育和未受高等教育者轻、中、重度骨吸收牙数差异无统计学意义（P值为0.314、0.862和0.407）;吸烟是重度骨吸收AgP患者的危险因素之一（OR=1.961）.结论 AgP患者PD与牙槽骨吸收程度相关;年龄和吸烟是影响AgP患者牙槽骨吸收的重要因素.

Objective To evaluate the alveolar bone loss status and the related factors in aggressive periodontitis （AgP） patients. Methods A total of 108 untreated AgP patients were included. The patients averaged 27.7 years of age with 45 males and 63 females. Twenty males were current smokers and the smoking status was evaluated by cigarette/day and packyears. The educational condition of the patients was recorded. The proximal probing depth （PD） of each tooth in all patients was measured and assessed （shallow： PD =3,4 mm, moderate：PD =5,6 mm, deep：PD≥7 mm）. The alveolar bone loss was assessed on a full set of periapical radiographs. The number of teeth with bone loss was scored in three categories （ light bone loss, moderate bone loss and severe bone loss） for each patient. Based on the number of teeth （ ≥8 teeth）with severe alveolar bone loss and of the teeth lost, the patients （n = 108） were divided into severe AgP group （n =61 ）, and light-moderate group （n =47）. Results There were significantly positive correlations between shallow pocket and light bone loss （ r= 0. 518, P = 0. 000 ） or deep pocket and severe bone loss （ r = 0. 366, P = 0. 000） in proximal sites. The number of teeth with light bone loss, moderate bone loss and severe bone loss was not significantly different between male （ 7. 1 ± 6. 2,12. 5 ± 4. 7 and 5. 1 ± 0. 6）and female group（8.7 ± 6. 3,12. 9 ± 4. 8,4. 2 ± 0. 5, P values were 0. 707, 0. 671 and 0. 413 respectly）.There were more teeth with moderate bone loss and severe bone loss in the elderly than in the young （ 13.6 ±4. 2 vs 11.0 ± 5.5, 5. 2 ± 3.7 vs 3. 6 ± 3.5, P 〈 0. 01 ）. The difference of teeth number with light bone loss,moderate bone loss and severe bone was not found between higher education and non-higher education groups （P values were 0. 314, 0. 862 and 0. 407）. Smoking status had a significant positive correlation with the number of the teeth with severe bone loss （ r = 0. 575, P = 0. 032 ）. Conclusions The bone loss status is related to the pocket depth. Smoking and age are risk factors for alvelar bone loss in AgP patients.