380名妊娠期妇女牙周状况的调查和影响因素分析
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摘要
目的:调查妊娠期妇女的牙周状况并分析相关影响因素。方法:纳入20～43岁、10～35孕周的健康妊娠期妇女380名,进行问卷调查及临床牙周检查,对比分析不同年龄、孕周、学历对牙周状况的影响。结果:妊娠期牙周病患病率为87. 1%;孕早(10～15周)、孕中(16～27周)、孕晚期(28～35周)的牙周探诊(PD)深度(mm)分别为2. 48±0. 54、2. 60±0. 54、2. 71±0. 48(P <0. 05); PD≥4 mm的位点为2个的患者百分比分别为76. 5%、84. 1%和93. 5%(P <0. 05);牙龈指数(GI)、出血指数(BI)在孕周组间差异无显著性(P>0. 05); 20～27岁、28～35岁和36～43岁组患者的PD分别为2. 39±0. 51、2. 61±0. 53和2. 62±0. 56(P <0. 05)。年龄与GI和PD呈正相关(P <0. 05),与BI无相关性(P> 0. 05);孕周与PD呈正相关(P <0. 05),与GI和BI无相关性(P> 0. 05)。结论:妊娠期妇女牙周病患病率高,且随着妊娠妇女年龄及孕周的增大,牙周炎症状况加重。
Objective: To evaluate periodontal status of 380 pregnant women and its related factors. Methods: 380 healthy pregnant women aged 20 to 43 at 10-35 weeks of gestation were enrolled and received a questionnaire and a periodontal examination,in order to compare and analyse the effects of different ages,gestational weeks and educational levels on periodontal condition. Results: The prevalence of periodontal disease of the subjects was 87. 1%. In first( 10-15 weeks),second( 16-27 weeks) and third( 28-35 weeks) trimester PD( mm) was 2. 48 ± 0. 54,2. 60 ± 0. 54 and 2. 71 ± 0. 48 respectively( P < 0. 05); the percentage of PD≥4 mm in 2 or more sites were 76. 5%,84. 1% and 93. 5% respectively( P < 0. 05); GI and BI did not show significant differences among of the 3 groups trimester stages( P > 0. 05); PD in maternal age( year) 20-27,28-35 and 36-43 years was2. 39 ± 0. 51,2. 61 ± 0. 53 and 2. 61 ± 0. 56 respectively( P < 0. 05). A significantly positive linear trend was observed between age and GI( P < 0. 05) or PD( P < 0. 05),but without significant correlation between age and BI. Significant correlation was found between pregnant weeks and PD( P < 0. 05),but without correlation between pregnant weeks and GI( P > 0. 05) or BI( P > 0. 05).Conclusion: The prevalence of periodontal disease during pregnancy is high. Meanwhile,the periodontal inflammation is increasing worse with the increase of gestational weeks and maternal age.
Objective: To evaluate periodontal status of 380 pregnant women and its related factors. Methods: 380 healthy pregnant women aged 20 to 43 at 10-35 weeks of gestation were enrolled and received a questionnaire and a periodontal examination,in order to compare and analyse the effects of different ages,gestational weeks and educational levels on periodontal condition. Results: The prevalence of periodontal disease of the subjects was 87. 1%. In first( 10-15 weeks),second( 16-27 weeks) and third( 28-35 weeks) trimester PD( mm) was 2. 48 ± 0. 54,2. 60 ± 0. 54 and 2. 71 ± 0. 48 respectively( P < 0. 05); the percentage of PD≥4 mm in 2 or more sites were 76. 5%,84. 1% and 93. 5% respectively( P < 0. 05); GI and BI did not show significant differences among of the 3 groups trimester stages( P > 0. 05); PD in maternal age( year) 20-27,28-35 and 36-43 years was2. 39 ± 0. 51,2. 61 ± 0. 53 and 2. 61 ± 0. 56 respectively( P < 0. 05). A significantly positive linear trend was observed between age and GI( P < 0. 05) or PD( P < 0. 05),but without significant correlation between age and BI. Significant correlation was found between pregnant weeks and PD( P < 0. 05),but without correlation between pregnant weeks and GI( P > 0. 05) or BI( P > 0. 05).Conclusion: The prevalence of periodontal disease during pregnancy is high. Meanwhile,the periodontal inflammation is increasing worse with the increase of gestational weeks and maternal age.
引文
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[14]Haffajee AD,Socransky SS,Goodson JM.Comparison of different data analyses for detecting changes in attachment level[J].J Clin Periodontol,1983,10(3):298-310.
[15]Moore S,Randhawa M,Ide M.A case-control study to investigate an association between adverse pregnancy outcome and periodontal disease[J].J Clin Periodontol,2005,32(1):1-5.
[16]Chambrone L,Guglielmetti MR,Pannuti CM,et al.Evidence grade associating periodontitis to preterm birth and/or low birth weight:I.A systematic review of prospective cohort studies[J].J Clin Periodontol,2011,38(9):795-808.
[17]Koo YJ,Ryu HM,Yang JH,et al.Pregnancy outcomes according to increasing maternal age[J].Taiwan J Obstet Gynecol,2012,51(1):60-65.
[18]刘晓莉,邹丽颖,陈奕,等.孕产妇年龄对妊娠及分娩结局的影响[J]中华医学杂志,2014,94(25):1984-1988.
[19]谢惠兰,杨莉,江汉,等.武汉市1 009名孕妇牙周状况调查[J].牙体牙髓牙周病学杂志,2008,18(10):584-587.
[20]孟焕新.临床牙周病学[M].2版.北京:北京医科大学出版社,2017:269.
[21]刘雪楠,陈育德,卞金有,等.影响牙周健康的相关因素分析[J].现代口腔医学杂志,2003,17(2):136-139.
[22]Gürsoy M,Pajukanta R,Sorsa T,et al.Clinical changes in periodontium during pregnancy and post-partum[J].J ClinPeriodontol,2008,35(7):576-583.
[23]Figuero E,Carrillo-de-Albornoz A,Herrera D,et al.Gingival changes during pregnancy:I.Influence of hormonal variations on clinical and immunological parameters[J].JClin Periodontol,2010,37(3):220-229.
[24]Kashetty M,Kumbhar S,Patil S,et al.Oral status,gingival status,periodontal status,and treatment needs among pregnant and nonpregnant women:A comparative study[J].J Indian Soc Periodontol,2018,22(2):164-170.
[2]Armitage GC.Bi-directional relationship between pregnancy and periodontal disease[J].Periodontol 2000,2013,61(1):160-176.
[3]Offenbacher S,Katz VL,Fertik GS,et al.Periodontal Infection as a possible risk factor for preterm low birth weight[J].JPeriodontol,1996,67(10 Suppl):1103-1113.
[4]Spivakovsky S.Periodontal treatment forthe prevention of adverse birth outcomes[J].Evid Based Dent,2018,19(1):12-13.
[5]Holt KA.Oral health care during pregnancy:A national consensus statement[J].Apha Meeting&Exposition,2012,11(3):xv-xvi.
[6]吴亚菲.女性牙周炎患者的临床诊疗[J].中华口腔医学杂志,2017,52(2):75-76.
[7]Becerik S,Ozcaka O,Nalbantsoy A,et al.Effects of menstrual cycle on periodontal health and gingival crevicular fluid markers[J]J Periodontol,2010,81(5):673-681.
[8]孟焕新.临床牙周病学[M].2版.北京:北京医科大学出版社,2017:149.
[9]Martínez-Martínez RE,Moreno-Castillo DF,Loyola-Rodríguez JP,et al.Association between periodontitis,periodontopathogens and preterm birth:Is it real?[J].Arch Gynecol Obstet,2016,294(1):47-54.
[10]Sanz M,Kornman K,working group 3 of the joint EFP/AAPworkshop.Periodontitis and adverse pregnancy outcomes:consensus report of the joint EFP/AAP workshop on periodontitis and systemic diseases[J].J Periodontol,2013,84(4 Suppl):S164-169.
[11]吴敏,陈少武,王亚琛,等.妊娠妇女牙周组织的临床改变[J].临床口腔医学杂志,2013,29(5):296-298.
[12]Wu M,Chen SW,Su WL,et al.Sex Hormones Enhance Gingival Inflammation without Affecting IL-1βand TNF-αin Periodontally Healthy Women during Pregnancy[J].Mediators Inflamm,2016,2016:4897890.
[13]Kashetty M,Kumbhar S,Patil S,et al.Oral hygiene status,gingival status,periodontal status,and treatment needs among pregnant and nonpregnant women:A comparative study[J].J Indian Soc Periodontol,2018,22(2):164-170.
[14]Haffajee AD,Socransky SS,Goodson JM.Comparison of different data analyses for detecting changes in attachment level[J].J Clin Periodontol,1983,10(3):298-310.
[15]Moore S,Randhawa M,Ide M.A case-control study to investigate an association between adverse pregnancy outcome and periodontal disease[J].J Clin Periodontol,2005,32(1):1-5.
[16]Chambrone L,Guglielmetti MR,Pannuti CM,et al.Evidence grade associating periodontitis to preterm birth and/or low birth weight:I.A systematic review of prospective cohort studies[J].J Clin Periodontol,2011,38(9):795-808.
[17]Koo YJ,Ryu HM,Yang JH,et al.Pregnancy outcomes according to increasing maternal age[J].Taiwan J Obstet Gynecol,2012,51(1):60-65.
[18]刘晓莉,邹丽颖,陈奕,等.孕产妇年龄对妊娠及分娩结局的影响[J]中华医学杂志,2014,94(25):1984-1988.
[19]谢惠兰,杨莉,江汉,等.武汉市1 009名孕妇牙周状况调查[J].牙体牙髓牙周病学杂志,2008,18(10):584-587.
[20]孟焕新.临床牙周病学[M].2版.北京:北京医科大学出版社,2017:269.
[21]刘雪楠,陈育德,卞金有,等.影响牙周健康的相关因素分析[J].现代口腔医学杂志,2003,17(2):136-139.
[22]Gürsoy M,Pajukanta R,Sorsa T,et al.Clinical changes in periodontium during pregnancy and post-partum[J].J ClinPeriodontol,2008,35(7):576-583.
[23]Figuero E,Carrillo-de-Albornoz A,Herrera D,et al.Gingival changes during pregnancy:I.Influence of hormonal variations on clinical and immunological parameters[J].JClin Periodontol,2010,37(3):220-229.
[24]Kashetty M,Kumbhar S,Patil S,et al.Oral status,gingival status,periodontal status,and treatment needs among pregnant and nonpregnant women:A comparative study[J].J Indian Soc Periodontol,2018,22(2):164-170.