Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

  • Objectives: The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods: Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results: Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion: This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance: In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.
Author:Sonja Rahim-Wöstefeld, Dorothea Kronsteiner, Shirin El-Sayed, Nihad el Sayed, Peter EickholzORCiDGND, Bernadette Pretzl
Parent Title (English):Clinical oral investigations
Place of publication:Berlin ; Heidelberg
Document Type:Article
Date of Publication (online):2021/08/25
Date of first Publication:2021/08/25
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/05/18
Tag:Model; Periodontal treatment; Prognostic tool; Risk factors; Tooth loss
Issue:online version before inclusion in an issue
Page Number:10
Open Access funding enabled and organized by Projekt DEAL. This study was self-funded by the authors and their institutions.
Early View: Online Version before inclusion in an issue.
Version of Record:
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0