2018年新歯周病分類による歯周炎関連歯牙喪失の評価

Evaluation of periodontitis-related tooth loss according to the new 2018 classification of periodontitis.

抄録

2018年の新歯周炎分類は、支持的歯周療法（SPT）中の歯周病による歯の喪失（TLPD）と関係があると報告されています。しかし、アジア人を対象にこの関係を評価した報告や、積極的歯周治療（APT）とSPTを区別して新分類とTLPDの関連性を分析した報告は少ない。本研究では，日本人歯周炎患者 607 名を対象に新分類をレトロスペクティブに適用し，新分類と各期間における患者 1 人当たりの年間 TLPD 率の関係を検討した．APT、SPTともにステージIV、グレードCの患者においてTLPD率が高かった。SPT中のTLPDは、APT中のTLPDの有無と関連はなかった。多変量解析の結果、独立変数としてのステージIVとグレードCは、全治療期間中だけでなく、APTまたはSPT中のTLPDの発生件数と有意に関連した。この結果から，新分類は APT と SPT の両期間において TLPD と有意に強い相関があり，ステージ IV および/またはグレード C の歯周炎と診断された患者は，両期間において TLPD のリスクが高いことが示唆された．

The new 2018 classification of periodontal diseases is reported to be related to tooth loss due to periodontal disease (TLPD) during supportive periodontal therapy (SPT). However, few reports have evaluated this relationship for Asians or have analyzed the association of the new classification and TLPD by distinguishing between active periodontal therapy (APT) and SPT. In this study, we retrospectively applied the new classification to 607 Japanese periodontitis patients and examined the relationship between the new classification and annual TLPD rates per patient during the respective periods. TLPD rates were higher in patients in stage IV and/or grade C during both APT and SPT. TLPD during SPT was not associated with the presence or absence of TLPD during APT. Multivariate analysis revealed that stage IV and grade C as independent variables were significantly associated with the number of instances of TLPD not only during the total treatment period, but also during APT or SPT. Our results suggest that the new classification has a significantly strong association with TLPD during both APT and SPT, and that patients diagnosed with stage IV and/or grade C periodontitis had a higher risk of TLPD during both periods.