非外科牙周干预对口腔健康相关生活质量及牙周临床指标影响

Impact of non-surgical periodontal intervention on oral health-related quality of life and periodontal clinical indices

目的：探讨非外科牙周干预对口腔健康相关生活质量及牙周临床指标的影响。方法：91例重症慢性牙周炎患者分为治疗组（76例,给予非外科牙周干预）和对照组（15例,3%双氧水冲洗）,年龄35~76岁,在初诊（T0）时测定牙龈指数（GI）、菌斑指数（PLI）,探诊深度（PD）和附着丧失（AL）,行中国版口腔健康影响程度量表14（OHIP-14,OHIP）和牙周健康自我评价表调查。在治疗后1个月（T1）、12个月（T2）再次测定GI、PLI、PD和AL,调查OHIP和口腔健康自我评价表。结果：患者OHIP分值为26.7±3.2,与年龄,口腔卫生和吸烟习惯密切相关。治疗组在T1和T2期OHIP分值及GI、PLI、PD、AL显著低于对照组（P〈0.01）。治疗组OHIP分值在T1期（13.1±2.1）比T0期显著降低（P〈0.01）,OHIP分值在T2期（13.7±2.2）与T1期比无显著性差异;OHIP各条目分值及阳性反应患者比率在T1和T2期与T0期比较均明显降低,出现牙周健康有关症状患者比率在T1和T2期显著降低,GI、PLI、PD和AL与T0期比较有显著性差异（P〈0.01）。PD〉6 mm牙数所占比率在T2期（39.6%）明显低于T0期（65.5%）。结论：重症牙周炎与中国版OHIP显著相关,非外科牙周干预对口腔健康相关生活质量和牙周健康有关症状有明显改善作用。

Objective： To investigate the impact of non-surgical periodontal intervention on oral health-related quali- ty of life and periodontal clinical indices. Method： 91 cases with severe periodontitis divided into group therapy （76 cases treated with non-surgical procedure） and group control （15 cases treated with 3 % hydrogen peroxide rinsed）. All cases used the Chinses 14-item version of the oral health impact profile （OHIP）, as well as a demographic questionnaire. This was used to assess oral health-related quality of life （OHRQoL） issues. The questionnaire and clinical inspection were done be- fore therapy （TO） and 1 month （T1） and 12 monthes （T2） after treatment. The periodontal clinical parameters including gin- gival index （GI）, plaque index （PLI）, probing depth （PD）, attachment loss （AL） and periodontal health related symptoms of each group were measured at TO, T1 and T2. Result： Scores of OHIP were significantly associated with age, oral hygiene and smoking habits. There were significant difference of GI, PLI, PD, AL and OHIP score, and also the percentage Of periodontal health related symptom between group therapy and control at T1 and T2. The median score of OHIP reduced from 26.7±3.2 at TO to 13.1±2.1 at T1. Median OHIP scores reduced to 13.7±2.2 at T2 （P 〈0.01）. The rate of teeth with PD 〉6 mm could be reduced from 65.5 % at TO to 39.6 % at T2 （P 〈0.01）. There were significance difference of percentage of periodontal health related symptoms and the percentage of positive response of the patients on OHIP issue between T1 and TO or be- tween T2 and TO. The scores of GI, PLI, and PD, ALvalue decreased significantly at T1, T2 than that of TO. Conclusion： The severity of severe periodontitis are asociated with OHIP of Chinese version. Non-surgical periodontal intervention presented significantly improved effects on OHRQoL and periodontal clinical parameters, the effects maintained more than 1 year.