Susceptibility to periodontal disease depends on individual factors within the host response to the bacterial challenge. The study of these factors requires longitudinal studies of an undisturbed development of the disease process. On the basis of the original longitudinal studies on the natural histology of periodontal disease staged in Sri Lanka and Oslo/Norway, several analyses of periodontal parameters and tooth status have been performed. The main findings were that in the first 20 years of complete absence of oral hygiene practices or preventive services attachment was lost at various rates. Three groups of subjects could be identified: rapidly progressing (RP) (8%), moderately progressing (MP) (81%), and subjects with no disease progression (NP) (11%). In the second two decades, the RP subjects have lost most of their teeth and no NP patients were identified anymore. The progression rate in these two decades was much slower, and the tooth mortality decreased. It could be predicted that subjects who had lost more than 2 mm at age 30 would not maintain a functional dentition at age 60. The corresponding control population in Oslo was used to study the influence of gingival inflammation on the initiation and progression of periodontal disease. The pattern and rates of attachment loss were identified in a population that was exposed to optimal and regular preventive services from age 3 onward. In the observation period of 26 years, it could be demonstrated that gingival inflammation varied little throughout adult life and always bleeding sites occurred consistently in 10% to 20%. The role of ongoing gingivitis in the pathogenesis of attachment loss was identified and also reflected stability whenever it was absent. Tooth mortality was only found in subjects with ongoing gingivitis. After 50 years of tooth age, 63% of the teeth were still maintained, while 99.8% were maintained after 50 years when gingival inflammation had been absent. Consequently, continuous gingivitis represented a risk factor for tooth loss.

中文翻译：

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牙周病的自然史：斯里兰卡和奥斯陆的原始研究


对牙周病的易感性取决于宿主对细菌挑战的反应中的个体因素。对这些因素的研究需要对疾病过程不受干扰的发展进行纵向研究。在斯里兰卡和奥斯陆/挪威对牙周病自然组织学进行的原始纵向研究的基础上，对牙周参数和牙齿状态进行了多项分析。主要发现是，在完全缺乏口腔卫生习惯或预防性服务的最初 20 年里，依恋会以不同的速度丧失。可以确定三组受试者：快速进展 (RP) (8%)、中度进展 (MP) (81%) 和无疾病进展 (NP) 受试者 (11%)。在接下来的二十年里，RP 受试者失去了大部分牙齿，并且不再发现 NP 患者。这二十年的进展速度要慢得多，牙齿死亡率也下降了。可以预测，30岁时失去超过2毫米的受试者在60岁时将无法维持功能性牙列。奥斯陆的相应对照人群被用来研究牙龈炎症对牙周病发生和发展的影响。在从 3 岁起就接受最佳和定期预防服务的人群中确定了依恋丧失的模式和比率。在26年的观察期内，可以证明，牙龈炎症在整个成年过程中变化不大，出血部位始终一致地在10%至20%之间发生。持续性牙龈炎在附着丧失发病机制中的作用已被确定，并且在其不存在时也反映了稳定性。 仅在患有持续牙龈炎的受试者中发现牙齿死亡。牙龄50年后，63%的牙齿仍得以保留，而50年后，当牙龈炎症已不存在时，99.8%的牙齿得以保留。因此，持续的牙龈炎是牙齿脱落的危险因素。