The study aims were (1) to explore whether “periodontal treatment” consisting of surgical therapy (flap, resective, or regenerative) or scaling and root planing treatment with long‐term periodontal maintenance treatment, is cost‐effective in terms of preventing periodontitis‐attributable tooth extraction and replacement by implant‐supported crowns (“extraction/replacement”); (2) to assess the effect of cigarette smoking on this cost‐effectiveness. Data for this observational retrospective study were collected from dental charts of patients who had received periodontal therapy and at least annual follow‐up visits for >10 years were analyzed by linear regression generalized estimating equations and generalized linear models. Among 399 adults (199 males, 200 females), those with the least mean annual treatment cost experienced the greatest mean annual costs for extraction/replacement, indicating general cost‐effectiveness. Cigarette smoking adversely impacted this cost‐effectiveness, with current heavy smokers experiencing no cost‐effectiveness. Former smokers with Grade C periodontitis benefitted most, whereas smoking did not influence cost‐effectiveness for Grade B periodontitis. Assessed by mean annual costs of “extraction/replacement,” periodontal treatment was cost‐effective, which decreased in a dose–response manner by former and current smoking intensity. Cigarette smoking should be factored into treatment planning and cost‐effective analyses of periodontal treatment. Smoking cessation should be encouraged.

中文翻译：

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吸烟对 10-48 年牙周护理成本效益的影响


该研究的目的是（1）探讨由手术治疗（翻瓣、切除或再生）或洁治和根面平整治疗加上长期牙周维持治疗组成的“牙周治疗”在预防牙周炎方面是否具有成本效益。归因牙齿拔除和种植牙冠替换（“拔除/替换”）； (2) 评估吸烟对成本效益的影响。这项观察性回顾性研究的数据收集自接受过牙周治疗的患者的牙科病历，并通过线性回归广义估计方程和广义线性模型对至少 10 年以上的年度随访进行分析。在 399 名成年人（199 名男性，200 名女性）中，年平均治疗费用最低的人的拔牙/置换年平均费用最高，这表明总体成本效益。吸烟对这种成本效益产生了不利影响，目前的重度吸烟者没有体验到成本效益。患有 C 级牙周炎的前吸烟者受益最多，而吸烟并不影响 B 级牙周炎的成本效益。通过“拔牙/替换”的平均每年费用进行评估，牙周治疗具有成本效益，并且根据以前和当前的吸烟强度以剂量反应方式降低。吸烟应纳入牙周治疗的治疗计划和成本效益分析中。应鼓励戒烟。