Analysis of factors affecting oral health after non-surgical periodontal therapy
비외과적 치주치료 이후 구강건강에 영향을 미치는 요인 분석
- 주제(키워드) Periodontal debridement , Tooth loss , Oral health , Patient compliance , Patient reported outcome measures
- 주제(DDC) 617.6
- 발행기관 아주대학교 임상치의학대학원
- 지도교수 정재숙
- 발행년도 2025
- 학위수여년월 2025. 8
- 학위명 석사
- 학과 및 전공 임상치의학대학원 임상치의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000035048
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Supportive periodontal therapy (SPT) following non-surgical periodontal therapy is effective in maintaining periodontal health and preventing tooth loss in patients with periodontitis. However, even in patients with regular maintenance, the likelihood of disease recurrence increases with longer maintenance period. The purpose of this study was to analyze the factors influencing oral health during long-term SPT following non-surgical periodontal treatment. Materials and Methods: Patients with chronic periodontitis who underwent non-surgical periodontal therapy at Ajou university medical center since 2016 and received SPT for over one year were included. At baseline (T1), panoramic radiographs and full-mouth probing depths were obtained. Between March and June 2024 (T2), full-mouth clinical measurements and a questionnaire were conducted. The clinical parameters included probing pocket depth (PPD), bleeding on probing (BOP), modified sulcus bleeding index (mSBI), and clinical attachment loss (CAL). A questionnaire was administered to gather information on demographic and medical information, compliance, oral hygiene habits, perception of dental care, lifestyle and personal characteristics, and socioeconomic status. Statistical analyses included Poisson regression to assess factors associated with pocket closure, Mann–Whitney U test or paired t-test for comparison of clinical parameters before and after treatment, and chi-squared or Fisher’s exact tests for group comparisons. Propensity score matching (PSM) was performed with conditional logistic regression used for post-matching analysis. Results: A total of 100 patients (mean age: 59.1 years) were followed for an average of 4.5 years. Clinical parameters significantly improved after non-surgical periodontal therapy, with mean PPD decreasing from 3.3±0.5mm to 2.8±0.4mm (P<0.001) and number of sites with PPD≥5mm reducing from 20.6 to 6.3 per patient(P<0.001). The likelihood of pocket closure decreased as the initial PPD increased and was observed more frequently in single-root teeth than in multi-root teeth. Multivariable analysis identified older age, non-compliance, longer brushing time, and lack of sensitivity during scaling as negatively associated with pocket closure, while sufficient sleep and economic satisfaction were positive predictors. Only 12 patients (12%) achieved the defined clinical endpoint (≤4 sites with PPD≥5mm and BOP≤20%). After PSM, daily use of interdental brushes and lower economic satisfaction were significantly associated with endpoint achievement. Of 2,486 teeth, excluding third molars, 68 were extracted during SPT from 45 patients, with periodontitis being the main cause (78%). Tooth loss due to periodontitis was significantly associated with lower compliance. Conclusion: Various factors may influence SPT outcomes after non-surgical periodontal therapy. Especially, the use of interdental brushes and improvement in patient compliance are key factors for the success of SPT. Developing strategies to prevent missed appointments and enhance patient compliance will help increase the success rate of SPT. Further studies with larger sample sizes and consistent SPT durations are recommended.
more초록/요약
이 연구의 목적은 비외과적 치주치료 후 정기적으로 내원한 환자를 대상으로 성공적인 유지치주치료에 영향을 미치는 요인을 알아보기 위함이다. 2016 년 이후 아주대학교병원에서 만성 치주염으로 비외과적 치주치료를 받고 1 년 이상 유지치주치료를 받은 20 세 이상 환자 100 명의 동의를 얻어 임상검사기록 및 설문조사 자료를 분석하였다. 비외과적 치주치료 후, 치주낭 폐쇄의 성공에는 고령, 내원 불이행, 긴 양치 시간, 스케일링 시 민감도 없음이 부정적 요인으로, 충분한 수면과 경제적 만족도가 긍정적 요인으로 나타났다. 성공 기준을 달성한 환자 비율은 12%였으며, 일일 치간칫솔 사용과 높은 경제적 만족도와 유의한 관련이 있었다. 치주염으로 인한 발치는 낮은 순응도와 관련이 있었다. 이 연구의 결과에 따르면 특히 치간칫솔 사용과 순응도 향상은 유지치주치료 성공을 위한 핵심적인 요소로 작용한다. 내원 불이행을 방지하고, 환자의 순응도를 높일 수 있는 전략을 마련하는 것이 SPT 의 성공률을 높이는 데 도움이 될 것이다.
more목차
Ⅰ. INTRODUCTION 1
Ⅱ. MATERIALS AND METHODS 3
A. Study population 3
B. Non-surgical periodontal therapy 5
C. Supportive periodontal therapy 6
D. Clinical assessment 6
E. Statistical analysis 10
Ⅲ. RESULTS 11
A. Demographics 11
B. Changes in clinical parameters during supportive periodontal therapy 11
C. Pocket closure 13
D. Clinical endpoint 18
E. Extraction due to periodontitis 28
Ⅳ. DISCUSSION 35
Ⅴ. CONCLUSION 40
REFERENCES 41
국문요약 46
