Fine-tuning multilevel modeling of risk factors associated with nonsurgical periodontal treatment outcome

Abstract This retrospective study evaluated the influence of known risk factors on nonsurgical periodontal treatment (NSPT) response using a pocket depth fine-tuning multilevel linear model (MLM). Overall, 37 patients (24 males and 13 females) with moderate-to-severe chronic periodontitis underwent NSPT. Follow-up visits at 3, 6, and 12 months included measurements of several clinical periodontal parameters. Data were sourced from a previously reported database. In a total of 1416 initially affected sites (baseline PD ≥ 4 mm) on 536 teeth, probing depth (PD) and clinical attachment loss (CAL) reductions after NSPT were evaluated against known risk factors at 3 hierarchical levels (patient, tooth, and site). For each post-treatment follow-up, the variance component models fitted to evaluate the 3-level variance of PD and CAL decrease revealed that all levels contributed significantly to the overall variance (p摘要 本回顾性研究采用探诊深度微调多水平线性模型（multilevel linear model, MLM），评估已知危险因素对非手术牙周治疗（nonsurgical periodontal treatment, NSPT）疗效的影响。最终纳入37例中重度慢性牙周炎患者（男性24例、女性13例）接受非手术牙周治疗。分别于治疗后3、6、12个月开展随访，采集多项牙周临床参数。本研究数据源自已发表的既往数据库。共纳入536颗牙齿上的1416个初始受累位点（基线探诊深度≥4 mm），在患者、牙齿、位点三个层级上，针对非手术牙周治疗后探诊深度（probing depth, PD）与临床附着丧失（clinical attachment loss, CAL）的降低幅度，与已知危险因素进行关联分析。针对各治疗后随访时间点，通过拟合方差分量模型评估PD与CAL下降值的三级方差结构，结果显示所有层级均对总方差存在显著贡献（p