Probing depth, attachment loss and gingival recession

The present investigation describes probing pocket depth, probing attachment level and recession data from 319 randomly selected subjects, aged 20-79 years, from Ushiku, Japan. The findings are reported as mean values, frequency distributions and percentile plots of the 3 parameters at buccal, interproximal and lingual surfaces of single rooted (incisors, canines, premolars) and molar teeth. Inter-as well as intra-examiner errors for probing pocket depth and probing attachment levels were assessed and found to be small. The data reported revealed that practically all subjects studied had one or more sites in the dentition affected by destructive periodontal disease and that the severity of disease increased with age. It was further observed that in each age group, molars had suffered more attachment loss than single rooted teeth and that the interproximal surfaces as a rule had lost more periodontal tissue support than corresponding buccal and lingual surfaces. The attachment loss difference observed between different surfaces of a given tooth or a group of teeth, however, was comparatively small. In the age groups between 20-59 years, advanced destructive periodontal disease was found in a small subgroup of the subject sample, while after the age of 60 years, widespread destructive periodontitis was common. An attempt was made to examine the progression of destructive disease with age by comparing the frequency distributions of sites with attachment loss of greater than or equal to 3 mm in subjects of different age groups. The data suggested that in younger subject groups, progression was confined to a subset of individuals, while in older age groups, more subjects and sites became involved. A major feature of destructive periodontal disease in older individuals was the accompaniment of attachment loss with recession at the gingival margin. Deep pockets were relatively infrequently detected, while advanced loss of attachment (with recession) occurred at many sites.     

Methods of evaluating periodontal disease data in epidemiological research

The purpose of the present investigation was to examine the use of different methods of data analysis to examine the pattern of periodontal tissue destruction in a group of adults. A clinical examination was carried out on 319 subjects, 20-79 years of age, randomly selected from the population of the city of Ushiku, Japan. The following parameters were studied: missing teeth, plaque, gingivitis, probing pocket depth and probing attachment level. All surfaces of all teeth were examined. The data obtained were evaluated in 3 ways: (i) mean values for each of the clinical parameters were computed for each subject and age group, (ii) the frequency of subjects with one or more sites of attachment loss above certain thresholds was assessed, (iii) percentile plots were generated in such a way that for each age group the percent of sites in subjects with varying attachment levels could be determined. The results revealed that the subjects included in the study had poor oral hygiene, high frequency of gingivitis and loss of probing attachment which increased with age. The mean annual attachment loss for all tooth surfaces was calculated to be less than 0.1 mm. Severe periodontal tissue breakdown was not as common as might have been expected. Hence, the majority of the subjects in the 20-59 year age group had very little evidence of destructive periodontal disease. In these age groups, a comparatively small subfraction accounted for most of the disease detected. After the age of 60, periodontal disease appeared to be more widespread among the subjects examined.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of nonsurgical periodontal therapy

Abstract Healing events following nonsurgical periodontal therapy in patients with periodontal pockets up to 12 mm deep were investigated. Incisors, cuspids and premolars in 16 patients were treated by plaque control and supra- and subgingival debridement using hand or ultrasonic instruments in a split mouth approach. The results were evaluated by recording of plaque scores, bleeding on probing, probing pocket depths and probing attachment levels. Minimal change in gingival conditions occurred during the initial 3 months of experimentation, which were utilized for plaque control measures alone. Subsequent to instrumentation and during the following 9-month period, a gradual and marked improvement of periodontal conditions took place. During the remaining 12 months of the 24-month experimental period no further changes of the recorded parameters were noted. No differences in results could be observed when comparing hand versus ultrasonic instrumentation, or when comparing the results of 2 different operators. Initially, a total of 305 sites demonstrated probing pocket depths 7 mm. At the 24-month examination 43 such sites remained. The results indicate that there is no certain magnitude of initial probing pocket depth where nonsurgical periodontal therapy is no longer effective.     

Scaling and granulation tissue removal in periodontal therapy

The present clinical trial was performed to study whether subgingival scaling is a method of therapy which is equally effective as "access" flaps in reducing gingivitis and probing depths and in improving probing attachment levels. The study was also designed to assess whether granulation tissue removal is a determining factor for proper healing in the treatment of periodontal disease. 15 patients with advanced periodontal disease were included in the study. Each patient had at least 4 sites in each quadrant of the jaws with probing depths exceeding 6 mm. A baseline examination was performed to assess the following parameters: the oral hygiene status, the gingival conditions, the probing pocket depths and the probing attachment levels. In addition, in each quadrant, 3 approximal sites were selected for analysis of the subgingival microbiota. All of these sites showed signs of gingivitis. One site had a probing depth of less than 4 mm, another a probing depth between 4 and 6 mm and the third site had a probing depth exceeding 6 mm. The subgingival bacterial samples were studied by dark-field microscopy and the % of spirochetes and motile rods was assessed. By random selection the 4 jaw quadrants in each patient were treated for periodontal disease by the use of (1) the modified Widman flap procedure, (2) the modified Kirkland flap procedure or by (3) nonsurgical scaling and root planing. In all, 20 quadrants were treated with each of the 3 procedures. After the termination of active periodontal treatment, all patients were recalled for professional tooth cleaning once every 2 weeks during a 12-week period. Subsequently, they were recalled for prophylaxis every 3 months. The patients were examined 6 and 12 months after treatment using the same parameters as used at baseline. The data from the examinations demonstrated that subgingival scaling is an effective measure in the treatment of periodontal disease. Both in terms of average gingivitis resolution and average probing depth reduction, non-surgical therapy appeared to be equally effective as a surgical approach to treatment. It was also observed, however, that following non-surgical treatment, a larger number of sites with pockets exceeding 6 mm remained than following surgical therapy. Most of these deep pockets in non-surgically treated quadrants bled on probing to the base of the pocket. In addition, the subgingival microbiota of such sites were found to harbor more than 20% spirochetes and motile rods.(ABSTRACT TRUNCATED AT 400 WORDS)     

Improved periodontal conditions following therapy

The aim of the present clinical trial was to evaluate the effect of different modes of periodontal therapy on patients with moderately advanced periodontal disease and to express the findings in terms of probing pocket depth and attachment level alterations at periodontal sites with different initial probing depths. The material consisted of 16 patients, 35-65 years of age. Following a Baseline examination including assessments of oral hygiene status, gingival conditions, probing pocket depths and probing attachment levels, the patients were subjected to periodontal treatment. A "split-mouth" design approach of therapy was used and the jaw quadrants were randomly selected for the following different treatment procedures: (1) scaling and root planning, (2) scaling and root planing in conjunction with a gingivectomy procedure, (3) scaling and root planing in conjunction with an apically repositioned flap procedure without bone recontouring, (4) scaling and root planing in conjunction with an apically repositioned flap procedure including bone recontouring, (5) scaling and root planing in conjunction with a modified Widman flap procedure without bone recontouring and (6) scaling and root planing in conjunction with a modified Widman flap procedure including bone recontouring. The patients were following active treatment enrolled in a supervised maintenance care program including "professional tooth cleaning" once every 2 weeks during a 6-month period of healing, after which a final examination was performed. The investigation demonstrated that active therapy including meticulous subgingival debridement resulted in a low frequency of gingival sites which bled on probing, a high frequency of sites with shallow pockets (less than 4 mm) and the disappearance of pockets with a probing depth of greater than 6 mm. Between the Baseline examination and the 6-month re-examination, the probing attachment level for initially shallow pockets remained basically unaltered, but with a tendency of a minor apical shift. This occurred in all 6 treatment groups. For sites with initial probing depths of 4-6 mm and greater than 6 mm, there was in all groups some gain of probing attachment. This gain was most pronounced in the initially deeper (greater than 6 mm) pockets. With the use of regression analysis, the "critical probing depth" (CPD) value (i.e. the initial probing depth value below which loss of attachment occurred as a result of treatment and above which gain of probing attachment level resulted) was calculated for each of the 6 methods of treatment used. A comparison of the CPD-values between the 6 treatment groups did not reveal any major differences.     

Gram negative species associated with active destructive periodontal lesions

Apical subgingival plaque samples were taken from 19 subjects exhibiting active destructive periodontal disease. The predominant cultivable Gram negative species from 50 active sites were compared to 69 inactive sites of comparable pocket depth and attachment level loss. Active disease sites were chosen which showed a significant loss of attachment within a two-month interval. Proportions of Gram negative rods were higher in active periodontal disease sites than in inactive sites. Species which were found to be significantly elevated only in active sites were Bacteroides intermedius, "fusiform" Bacteroides, Actinobacillus actinomycetemcomitans and Wolinella recta. Fusobacterium nucleatum, Capnocytophaga gingivalis and Eikenella corrodens were found in significantly increased proportions in active sites of some subjects and inactive sites of others.     

Current interpretations of periodontal probing evaluations: diagnostic and therapeutic implications

Probing depth assessments are the backbone of a periodontal evaluation. However, they should be interpreted with respect to current information regarding their diagnostic and therapeutic implications. Controlled clinical trials and review papers that related probing depth determinations to diagnosing periodontal disease or assessments of therapy were selected for evaluation. The literature indicates that increased probing depths usually are related to loss of clinical attachment; however, they may not reflect periodontal disease or disease progression. When characteristics pertaining to deep and shallow sites are compared, deep sites have more bleeding on probing, elevated bacterial levels, reduced ability of oral hygiene to alter subgingival microflora, less effective root instrumentation, and a greater percentage of pockets that experience disease progression in treated and untreated sites. However, individual deep sites are not good predictors of disease progression. The preponderance of information indicates that it is preferable, but not always essential, to have shallow sites around teeth to attain and maintain periodontal health. Ultimately, therapeutic decisions based on probing depths are influenced by the medical and dental history of the patient, a practical interpretation of the literature, and clinical experience.     

Multifactorial assessment of predictors for prevention of periodontal disease progression

Univariate approaches have identified single factors influencing periodontal disease progression. The aim of this explorative approach was to assess the influence of various predictive factors responsible for the prevention of periodontal disease progression in the same patient sample. Patients with untreated chronic periodontitis underwent subgingival debridement alone or in combination with adjunctive antimicrobial therapy (systemic amoxicillin and metronidazole/7 days plus supragingival CHX irrigation). Supportive periodontal therapy was performed over a 24-month period. As predictors, clinical, microbial, immunological, and genetic parameters were assessed. The primary outcome variable was the percentage of teeth without attachment loss 2 mm over the study period (stability of attachment). At 24 months, multiple regression analysis identified adjunctive antimicrobial therapy for teeth with initially at least one site showing a pocket probing depth of 7 mm and IgG₄ reactivity against a 110-kDa protein of A. actinomycetemcomitans at teeth with initial pocket probing depths 6 mm as main predictors of long-term attachment stability (p<0.05). Other parameters failed to influence treatment outcome. Adjunctive antimicrobial therapy and antibody reactivity may be dominant factors influencing the prevention of attachment loss in patients receiving periodontal therapy.     

New concepts of destructive periodontal disease

The most common forms of destructive periodontal disease have been thought to slowly and continuously progress until treatment or tooth loss. Recently, data have become available which are inconsistent with this "continuous disease" hypothesis. Data from longitudinal monitoring of periodontal attachment levels and alveolar bone in humans and in animals suggest that periodontal disease progresses by recurrent acute episodes. In addition, rates of attachment loss have been measured in individual sites which are faster than those consistent with the continuous disease hypothesis or slower than those expected from estimates of prior loss rates. To account for these observations, a model of destructive periodontal disease is described in which bursts of activity occur for short periods of time in individual sites. These bursts appear to occur randomly at periodontal sites throughout the mouth. Some sites demonstrate a brief active burst of destructive periodontal disease (which could take a few days to a few months) before going into a period of remission. Other sites appear to be free of destructive periodontal disease throughout the individual's life. The sites which demonstrate destructive periodontal activity may show no further activity or could be subject to one or more bursts of activity at later time periods. Comparison of monitored loss rates for a year with mean loss rates prior to monitoring suggested that there may be relatively short periods in an individual's life in which many sites undergo periodontal destruction followed by periods of extended remission. An extension of the random disease model is also suggested in which bursts of destructive periodontal disease activity occur with higher frequency during certain periods of an individual's life.     

Microbiological assays as predictors of the response to periodontal therapy

Thirty-four patients with periodontal disease each had subgingival plaque samples collected from four sites (one from each quadrant) in their mouths. The relative proportions of spirochaetes, motile rods and cocci were determined using dark field microscopy and the proportion of anaerobic to aerobic microorganisms was calculated after culture. In addition, clinical recordings were made at these sampled sites. The patients then underwent a course of periodontal treatment and were placed on a maintenance programme. The clinical recordings were repeated and the results examined to ascertain if the original microbiological or clinical measurements could have been used to predict the response to therapy.
Of the baseline recordings, the initial probing depth, the initial attachment level and the presence of suppuration all showed a positive correlation with the degree of pocket reduction or attachment gain produced by treatment. The percentage of cocci in the subgingival plaque correlated negatively with the treatment response. Suppuration seemed to be associated primarily with the original pocket depth while the percentage of cocci in subgingival plaque showed a true relationship with the amount of attachment gained after periodontal therapy. The significance of this finding is discussed.     

Periodontal loser sites in untreated adult subjects

Subjects in age groups between 20 and 79 years were recruited for a study on the effect of different modalities of periodontal therapy. A baseline examination included assessments of plaque, gingivitis, probing pocket depth and probing attachment level. The subjects received no periodontal therapy for 2 years but were recalled for re-examination after 1 and 2 years. The results from the baseline examination and the overall changes which occurred in the sample during the 2 years have been reported previously. The present study describes some characteristics of subjects and sites that lost probing attachment of 3 mm or more during the course of the 24 months of monitoring. 161 of the 265 subjects who returned for both re-examinations had no change of the attachment level at any site that amounted to 3 mm or more. Of the 104 subjects that showed deterioration, at or above this level, the majority exhibited disease activity either during the 1st or the 2nd year of monitoring. Only 20 subjects showed disease activity during both year 1 and year 2. In addition, 70% of the sites that deteriorated (loser sites) occurred in 12% of the subjects. Loser sites were most frequently detected in older subjects and at molar sites. Most of the loser sites occurred at interproximal surfaces and were most numerous at surfaces with initially advanced loss of attachment.     

Frequency distributions of periodontal attachment loss Clinical and microbiological features

The present investigation attempted to determine if the pattern of past periodontal destruction could be concisely summarized, and related to other clinical and microbiological parameters. 61 subjects between the ages of 12 and 61 years with destructive periodontal disease were evaluated at 6 sites per tooth for redness, plaque, suppuration, bleeding on probing, pocket depth, and attachment level. The frequency distribution of baseline attachment level measurements was computed for each individual. A curve fitting algorithm was used to fit the frequency distribution to 1-, 2-, and 3-term normal distributions. The parameters of the fit could be used to summarize concisely all of the frequency distributions. 3 major patterns of attachment loss could be distinguished. Pattern I required a two-term distribution with localized destruction at less than 34% of sites and was further divided into 3 groups, depending on average attachment loss at diseased sites. The means of the second peak for the subgroups were 2.7, 5.3, and 8.6 mm, respectively. Pattern II exhibited more widespread disease (greater than 33% of sites affected) with multiple peaks in the frequency distribution requiring a 3-term distribution for satisfactory fit. However, a significant proportion of sites was not affected. Pattern III exhibited a single-peaked normal distribution in which virtually all sites were affected. Mean attachment levels of the peaks in this group ranged from 2.7 to 8.4 mm. 23 of the 61 subjects showed significant attachment loss at 1 or more sites during the course of bi-monthly monitoring, as determined by the tolerance method of analysis. Subgingival plaque samples were taken from these active sites and matched with control sites prior to therapy. The proportions of Fusobacterium nucleatum, Streptococcus intermedius, and Eikenella corrodens were significantly elevated in active and control sites of subjects in groups II and III combined (the widespread disease groups), and proportions of Actinobacillus actinomycetemcomitans and Propionibacterium acnes were elevated in active and control sites of the more localized disease group I subjects. Group I subjects showed a 13- to 15-fold decrease in hazard rates of periodontal sites after Widman flap surgery and systemic tetracycline, whereas groups II and III subjects showed 2-to 6-fold decreases.     

Vector超声系统对牙周炎维护期患者的疗效观察和疼痛感受评价

目的本研究应用Vector超声系统、手工刮治和常规超声系统对慢性牙周炎患者维护期的牙周袋进行治疗,以比较不同治疗方法的临床疗效和患者的疼痛程度。方法选择26例慢性牙周炎维护期的患者,其全口四个象限每个象限至少各有2颗牙齿,其邻面至少有一位点探诊深度≥4mm,有探诊出血,根据随机表将四个象限随机分入手工刮治组、传统超声治疗组（赛特力组）、Vector摩擦剂组和Vector抛光剂组进行龈下刮治。记录基线和治疗后3个月时,入选位点的菌斑指数、牙周探诊深度、临床附着丧失、出血指数及刮治当时的疼痛程度VAS值。结果对于牙周炎维护期患者,Vector摩擦剂组、Vector抛光剂组的治疗效果和手工刮治组、赛特力组相同,牙周探诊深度、临床附着丧失和出血指数在治疗后都有明显改善,同时患者在治疗中的疼痛程度明显小于常规的手工刮治和超声刮治。结论Vector超声系统为牙周炎维护期患者的复查复治提供了一个新的有效手段,有利于增加患者的依从性。     

Short-term effects of initial periodontal therapy (hygienic phase)

Abstract The aim of the present study was to evaluate the effect of non-surgical periodontal therapy on probing pocket depths and probing attachment levels using a patient group with moderate to advanced periodontitis. 68 patients with moderate to advanced periodontitis underwent hygienic phase therapy including oral hygiene instructions, scaling and root planing and elimination of plaque retentive factors. Assessments of the plaque control record (PCR), bleeding on probing (BoP), probing depths and probing attachment levels were performed at baseline examination and 3 to 5 months following active treatment. The measurements were obtained at 4 interproximal aspects of each tooth with a thin calibrated probe. Mean BoP values decreased from 63.2±21.9% at baseline to 16.6±7.3% after therapy, and mean PCR decreased from 78.6±16.4% to 12.7±7.1%, respectively. A reduction in mean probing pocket depth from 3.96±1.39 mm at baseline to 3.30±1.16 mm after therapy was noted. Sites with initial probing depths of 1–3 mm showed no change, sites with initial values of 4–6 mm revealed a reduction of 1.03±1.04 mm, while initial pockets of 7–9 mm decreased in depth by 2.28±1.62 mm. A gain in the mean probing attachment level from 4.16±1.80 mm to 3.74±1.71 mm was observed as a result of treatment. The group with the shallow initial probing depths of 1–3 mm showed no alteration in probing attachment level. Pockets with baseline values of 4–6 mm showed gain of clinical attachment of 0.69±1.43 mm. The greatest gain in clinical attachment of 1.51±1.75 mm was obtained in sites with initially deep pockets of 7–9 mm. From the results of this study, it can be concluded that non–surgical periodontal therapy is an effective means to reduce probing pocket depths and to improve clinical attachment levels in patients with moderate to advanced periodontitis.     

Considerations on the contribution of ageing to loss of periodontal tissue support

The present study is an attempt to assess if age-related changes, manifested as loss of probing attachment and alveolar bone, occur in humans. 511 subjects, in ages 20-24, 30-34, 40-44, 50-54 and 60-64 years, were included in the study. All subjects had undergone a comprehensive clinical examination, including recordings of probing pocket depth and probing attachment level. A subsample of subjects was selected, whose periodontal status indicated minimal experience of destructive periodontal disease. In these particular subjects, the height of the alveolar bone was also assessed. The results showed that in the subsample, (i) attachment loss increased with age, but (ii) a high proportion of tooth surfaces remained with no attachment or alveolar bone loss in ages between 20 and 64 years. There are reasons to suggest, therefore, that age-related alterations in the periodontium may not inevitably be manifested as loss of probing attachment or alveolar bone.     

Periodontal tissue alterations following Emdogain treatment of periodontal sites with angular bone defects. A series of case reports

The aim of the present study was to assess the predictability of probing attachment gain and probing pocket depth reduction following Emdogain treatment at sites with deep angular bone defects. MATERIAL AND METHODS: 108 consecutively-treated periodontal patients (mean age 55.8 years) were included. Each subject exhibited at least 1 deep interproximal intrabony defect that could be identified as an experimental site based on the inclusion criteria: (i) probing pocket depth > or = 5 mm, (ii) probing attachment loss > or = 6 mm, (iii) radiographic evidence of an interproximal bone defect with a > or = 3 mm intrabony component. A total of 145 defects met the criteria for inclusion. All subjects received non-surgical periodontal therapy. This included subgingival instrumentation in all parts of the dentition. At least 6 months after the completion of this treatment, a baseline examination was performed to characterise the experimental site. Reconstructive therapy was subsequently performed. Full-thickness periodontal flaps were elevated, and the root surface scaled and planed. No bone recontouring was performed. A gel containing 24% EDTA was applied on the exposed root and was kept in place for 2 min. A preparation of enamel matrix proteins was applied to the root surface and adjacent defect space. The flaps were replaced and closed with sutures. The experimental sites were re-examined 12 months after reconstructive surgery. RESULTS: The re-examination demonstrated that a treatment including the application of enamel matrix proteins at periodontal sites with angular defects resulted in a mean probing attachment level gain of 4.6 mm and a probing pocket depth reduction of 5.2 mm. 87% of all sites treated exhibited a probing attachment gain of > 2 mm. One site suffered probing attachment loss. The radiographic assessments revealed that the bone defect had been reduced in depth by 2.9 mm on average. The reduction in defect size corresponded to an average bone fill of 69% of the original defect. In 43% of the defects, the bone fill amounted to > or = 80%. CONCLUSION: The overall probing pocket depth reduction, probing attachment level gain, and soft tissue recession, that results following Emdogain therapy, is similar to the corresponding outcome variables following GTR.     

Attachment level changes in destructive periodontal diseases

The present communication attempts to summarize some of the features of attachment loss which are of interest to the clinician and the statistician analyzing data from clinical trials. These include the measurements employed to detect changes in attachment level, the nature of the destructive disease process and the effects of therapy on the attachment level measurements. Although there are several difficulties associated with the attachment level measurement, at the present time it appears to be the best estimator of periodontal attachment available. The overall standard deviation of this measurement in greater than 46,000 replicate measurements at periodontal sites in 58 subjects was 0.78 mm (range 0.4 to 1.2 mm). In the periodontally healthy subject, the length of the attachment measured around 28 teeth is approximately 700 mm. Therefore, there are approximately 1400 adjacent points along the periodontal attachment where a measurement could be made using a periodontal probe with a 0.5 mm diameter tip. If 6 measurements were recorded per tooth, then approximately 12% of the possible probable points would be evaluated. Recent data indicate that destructive periodontal diseases progress with acute bursts of activity rather than as slowly progressive, continual processes. Such findings suggest new models of attachment loss progression. In one likely model, destructive periodontal diseases would progress by asynchronous bursts of activity at individual sites which occur with greater frequency during a finite period of time in an individual's life. 3 major patterns of attachment loss could be distinguished when frequency distributions of attachment level measurements were constructed for 61 destructive periodontal disease subjects. Pattern I (30 subjects) exhibited a bimodal distribution with localized destruction occurring at less than 34% of sites. Pattern II (14 subjects) exhibited more widespread disease (greater than 33% of sites affected) with a trimodal frequency distribution. Pattern III (17 subjects) exhibited a unimodal distribution in which virtually all sites were affected. The proportions of Fusobacterium nucleatum, Streptococcus intermedius and Eikenella corrodens in subgingival plaque samples were significantly elevated in sites of subjects with patterns II and III (the widespread disease groups). Bacteroides intermedius, Streptococcus uberis and Actinobacillus actinomycetemcomitans were elevated in sampled sites of localized disease subjects (pattern I). The effects of therapy by Widman flap surgery and systemic tetracycline were examined by several statistical analyses.(ABSTRACT TRUNCATED AT 400 WORDS)     

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??Treatment and diagnosis of periodontal disease should be based on the correct periodontal examination??and the periodontal probing is one of the most important periodontal examination. The periodontal probing not only reveals bleeding on probing??periodontal pocket depth??and periodontal attachment level??but also shows subgingival calculus and furcation involvement. This article attempts to make a brief  summary on the development of the periodontal probing technique and its clinical significance??in order for it to play a greater role in periodontal clinical diagnosis and therapy.     

牙周探针及探诊技术的进展及临床应用

牙周病的正确诊断和治疗依赖规范化的牙周检查,在诸多的牙周检查中牙周探诊是最重要的检查方法之一。牙周探诊不仅可以探测牙龈出血、牙周袋深度、牙周附着水平,还可以探查袋内是否有牙石、是否出现根分叉病变等情况。文章就目前牙周探针及探诊技术的进展及临床应用做一介绍,以期牙周探诊技术在临床诊疗中发挥更大的作用。     

A 10-year retrospective study of periodontal disease progression Clinical characteristics of subjects with pronounced and minimal disease development

The present study reports on some characteristics of 2 groups of subjects, chosen from a sample of 191 dentate individuals who had been exposed to full-mouth intraoral radiographic examinations in 1975 and 1985. The 1st group, which comprised 14 subjects, had experienced pronounced loss of periodontal bone support during a 10-year period (mean longitudinal bone loss of 4.13 mm (S.D. 1.4]. The 2nd group of 14 subjects had suffered no or minimal periodontal disease progression (mean longitudinal bone gain of 0.35 mm (S.D. 0.7]. A clinical examination was performed in conjunction with the radiographic examination in 1985 and included assessment of plaque, gingivitis, bleeding on probing from the base of the pocket, probing depth and probing attachment loss. Information regarding the oral hygiene habits of the subjects as well as the amount of dental and periodontal therapy received between 1975 and 1985 was obtained through a questionnaire. The results revealed that the 14 subjects who had experienced pronounced progression of periodontal disease had more plaque and gingivitis, deeper pockets and more attachment loss than the 14 subjects with minimal periodontal disease progression. Over the 10-year period, subjects in the "high rate" group had lost a mean of 6.8 teeth (S.D. 5.0) as compared to 4.1 teeth (S.D. 4.4) in the "low rate" group. The radiographic assessments of alveolar bone loss were strongly correlated with the assessments of probing attachment loss (r = 0.80, p = 0.0001). In 92% of the tooth sites examined, the difference between the radiographic and the clinical assessment was within 2 mm.(ABSTRACT TRUNCATED AT 250 WORDS)