Objective: To investigate the longitudinal patterns of tooth mobility and identify prognostic factors for mobile teeth in patients with periodontitis, providing an evidence-based basis for retaining natural teeth in clinical practice. Methods: A retrospective analysis was conducted on the clinical data of 44 patients with periodontitis (including 524 mobile teeth) treated at the Department of Periodontology, School and Hospital of Stomatology, Shandong University from January 2021 to October 2025. Clinical indices and radiographic data were collected following initial periodontal therapy and during the maintenance phase. Linear mixed-effects models were employed to process repeated measurement data to analyze the trends in mobility changes and associated factors. Receiver operating characteristic curves were utilized to analyze the predictive performance and optimal cutoff values of key indicators. Results: Teeth of Grade Ⅰ and Ⅱ mobility showed significant improvement at 3 months, with the improvement rates of 60.1% (185/308) and 73.9% (116/157), respectively. Improvement for Grade Ⅲ mobility was slower, reaching a peak of approximately 61.0% (36/59) after 1 year. Multivariate analysis indicated that higher residual bone-to-root ratio (β=-0.353 3, P=0.006), periodontal splinting (β=-0.233 6, P=0.002), and female gender (β=-0.177 2, P<0.001) were the primary independent protective factors promoting mobility improvement. The optimal cutoff value for the residual bone-to-root ratio in predicting mobile tooth survival was 0.24 (area under the curve=0.81). Conclusions: Tooth mobility exhibits significant dynamic reversibility following standardized periodontal treatment. Grade Ⅲ mobility should not be considered an absolute indication for extraction. Particularly in cases where the residual alveolar bone covers more than one-quarter of the root length, it is recommended to consider periodontal splinting and maintain a follow-up period of at least one year, so as to formulate more precise strategies for retaining mobile teeth and preserve natural teeth to the greatest extent possible. 目的： 探究牙周炎松动牙的纵向变化规律及预后预测因子，为临床保留天然牙提供循证依据。 方法： 回顾性分析2021年1月至2025年10月于山东大学口腔医院牙周科就诊的44例牙周炎患者的临床资料，共纳入524颗松动牙。收集患者在牙周基础治疗后及维护期的临床指标及影像学数据。采用线性混合效应模型处理重复测量数据以分析松动度变化趋势及相关因素，利用受试者工作特征曲线分析关键指标的预测效能及最佳截断值。 结果： Ⅰ度和Ⅱ度牙周炎松动患牙在牙周基础治疗后3个月时松动度显著改善，改善率分别为60.1%（185/308）和73.9%（116/157）；Ⅲ度松动患牙松动度改善较慢，1年后改善率达峰值，为61.0%（36/59）。多因素分析显示，较高的剩余骨根比（β=-0.353 3，P=0.006）、松牙固定（β=-0.233 6，P=0.002）及女性（β=-0.177 2，P<0.001）为促进牙周炎患牙松动度改善的主要独立保护因素。剩余骨根比预测松动牙存留的最佳截断值为0.24（曲线下面积为0.81）。 结论： 牙周炎松动患牙经规范牙周治疗后的松动度表现出动态可逆性。Ⅲ度松动非绝对拔牙指征，尤其当超过1/4根长仍存在骨支持时，建议牙周治疗中可考虑松牙固定且至少随访观察1年，从而制订更为精准的松动牙保留策略，尽可能保留天然牙。.
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arXiv · 2025-11-18
arXiv · 2022-05-17
arXiv · 2025-11-18