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Chronic periodontitis (chronic periodontitis, CP) is an infectious disease, leading to tooth supporting tissue inflammation, progressive attachment loss and bone resorption. Which is characterized by the periodontal pocket formation and / or gingival recession. Chronic periodontitis is the most common type of periodontitis onset at any age, but is most commonly found in adults. Its prevalence and severity of the disease age increase, may involve a different number of teeth, the degree of progress may be different. The incidence of chronic periodontitis and continued existence depends on the plaque, but the host defense mechanism is also in the pathogenesis plays a necessary role. The progression of the disease can only be learned through repetitive inspections. Chronic periodontitis accounts for about 95% of patients with periodontitis, deep periodontal tissue expansion caused by long-term chronic gingivitis. Significantly increased in periodontitis prevalence after the age of 35, and increased with age, and also increased its severity. 2005 3rd National Oral Health Survey results show that China's 12-year-old boy bleeding gums was 57.7%, the calculus was 59.0%. Tartar up to 97% of 35 to 44-year-old adult group and bleeding gums rate of 75%; = 4 mm or 4 ~ 5 mm attachment loss of up to 38% of the depth of the periodontal pocket. The findings also show that periodontal health in this age group was only 14.2%. 65-74 years old group does not have bleeding gums, periodontal pocket, and no severe periodontal attachment loss ratio of only 13.6%. Periodontitis has become the main reason for the loss of our teeth, the prevalence of periodontal disease and control is extremely critical. The clear risk factors for periodontitis oral health situation, gender, age, race, certain systemic diseases, certain microorganisms. In recent years, a growing number of research results show that the susceptible host and certain factors affect the incidence of periodontal disease, the type of process and the response to treatment of the important factors to increase the host susceptibility. The etiology of periodontal disease, and help us to discover the impact of moderate to severe chronic periodontitis risk factors. Analysis of various risk factors, contribute to the diagnosis and treatment of moderate to severe chronic periodontitis, the more important thing is early prevention, to reduce the rate of tooth loss caused by periodontitis, and improve the patient's quality of life and health. In order to explore the risk factors for moderate to severe chronic periodontitis, provide the basis for the prevention and treatment of clinical research in the Zhengzhou city hospital dentistry. Materials and Methods 1. Choose dental visits in the period from January 2006 to June 2007 in the Central Hospital of Zhengzhou 203 patients with moderate to severe chronic periodontitis in adult patients as case group, over the same period in the department for treatment of periodontal health oral Branch of patients as a control. The survey questionnaire, oral examination and imaging studies. 1:1 matched pair design, according to age, gender, education level, place of residence. The qualify more control than a decimation closer to the age of a person as a control. The. Questionnaire content, including demographic data of the study, behavioral risk factors, psychological factors, history of present illness periodontitis related diseases, oral health behavior and habits as well as medical treatment behavior; oral examination includes simplified debris index (debris index -simplified, DI-S), to simplify calculus index (calculusindex-simplified, CI-S), simplified oral hygiene index (oral hygiene index-simplified, OHI-S), probing depth (probing depth PD) The caries fillings (decayed and filled tooth, DFT), with or without adverse prosthesis, with or without food impaction, Malocclusion, whether the wounds jaw; imaging tests include full jaw radiograph intake. Entry using Excel database to using software SAS9.1.3 analysis. Before adjustment OR and 95% CI calculated using the chi-square test conditions Logistic regression analysis is used to calculate the adjusted OR and 95% CI, risk factors for severe chronic periodontitis screening, test level is 0.05. Results 1. Study general subjects a total of 203 pairs of male 108, accounting for 53.20%, 95 pairs of women, accounting for 46.80%, university or higher education level of 51, accounting for 25.12%, high school (secondary school) or less education level 152 pairs, accounting for 74.88%, 189 pairs of urban residents, accounting for 92.86%, 14 pairs of rural residents, accounting for 7.14%. The average age of the cases and control groups were 53.24 ± 4.32 years old, and 53.02 ± 2.36 years old balanced age (t = 0.88, P = 0.38). Cases and control groups in farmers accounted for 4.93% and 11.33%, workers accounted for 47.78% and 43.84%, respectively, cadres accounted for 18.23% and 21.18%, respectively, of professional and technical personnel accounting for 25.62% and 23.65%, respectively, drinker 5 1.23 % and 45.32%, tea drinkers accounted for 62.56% and 58.62%, smokers accounted for 34.96% and 24.14%, respectively. 2 study of periodontal 2.1 periodontal examination of the case and control groups in the case group patients with moderate periodontitis 165 cases, accounting for 81.3%, 38 cases of severe periodontitis patients, accounting for 18.6%. Case group the subjects teeth and missing teeth were 4714 and 974 5375 and 309, respectively; subjects in the control group teeth and missing teeth. Case group average PD and average clinical attachment loss (clinical attachmentloss, CAL) were 2.53 ± 0.64mm and 2.66 ± 0.78 mm; average PD and average CAL control group were 2.11 ± 0.32 mm and 0.37 ± 0.43 mm. Statistically significant difference in mean PD and mean CAL, t = 7.87, P <0.01; t = 57.24, P <0.01 2.2 case group and control group, bone tissue case group alveolar bone height and PMI were 6.17 ± 1.66mm and 0.28 ± 0.08; alveolar bone height of the control group and the PMI were 10.99 ± 1.26mm and 0.47 ± 0.16. Significant difference in two groups of alveolar bone height and PMI, t = 26.79, P <0.01; t = 9.44, P <0.01, single-factor analysis of 15 factors associated with moderate to severe chronic periodontitis. CI-S, poor restoration, smoking, OHI-S, food impaction, systemic diseases, work pressure, jaw trauma, negative life events for the past two years and DI-S for moderate to severe chronic periodontitis risk factors OR and 95% CI were 4.33 (1.42,13.15) 3.99 (1.71,9.32) 3.91 (1.93,7.93) 2.90 (1.96,4.29), 2.67 (1.33,5.40), 2.31 (1.21,4.42) 2.28 (1.09,4.77) 1.93 (1.12,3.69) 1.48 (1.22,1.79) 1.35 (1.22,1.50). Oral health education to change toothbrushes time is short, brushing a long time, the correct method of brushing, brush your teeth more than the number of protective factors, the OR and 95% CI were 0.80 (0.67,0.96) 0.68 (0.47,0.99), 0.36 (0.18,0.72) 0.17 (0.07,0.39) 0.15 (0.07,0.30). 4. Conditional logistic regression analysis Univariate analysis meaningful factor in multivariate conditional logistic regression analysis, the results of eight factors are introduced into the model: CI-S, smoking, OHI-S, work pressure, systemic disease and negative life events and risk factors for moderate to severe chronic periodontitis incidence, OR and 95% CI were 3.37 (1.05,10.78), 3.30 (1.51,7.23), 2.50 (1.59,3.94), 2.19 (1.13, 4.71), 2.11 (1.04,4.46) and 1.43 (1.21,1.68). The correct method of brushing and brushing the number of protective factors, the OR and 95% CI were 0.26 (0.12,0.57) and 0.21 (0.11,0.40). Conclusion 1, patients with moderate to severe chronic periodontitis with alveolar bone resorption and the mandibular cortex bone loss, reduced bone mineral density of the mandible. CI-S OHI-S, smoking, systemic disease, work stress and negative life events for moderate to severe chronic periodontitis incidence of risk factors, the correct method of brushing, daily brushing frequency mostly protective factors. Therefore, the prevention and control of severe chronic periodontitis, should strengthen the publicity of oral health education and guidance, to develop good oral hygiene habits, to promote the correct method of brushing, to improve the oral health status, improve self oral health of patients with periodontitis and maintenance periodontal health capacity; actively promote smoking cessation; treatment of systemic diseases associated with periodontitis, and maintain a healthy physical and mental state.
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