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Background: Estimating prognosis of periodontally affected teeth at the beginning of supportive periodontal care (SPC) is an important component for further treatment planning. This study aimed to evaluate tooth loss (TL) during 10 years of SPC in periodontally compromised patients and to identify tooth-related factors affecting TL.
Methods: Patients were re-examined 120 ± 12 months after accomplishment of active periodontal therapy. TL was defined as primary outcome variable and tooth-related factors (abutment status, furcation involvement [FI], tooth mobility, mean periodontal probing depth [PD], and clinical attachment level [CAL] at beginning of SPC, and initial bone loss [BL]) were estimated based on an adjusted regression analyses model.
Results: Ninety-seven patients (51 females and 46 males; mean age, 65.3 ± 11 years) lost 119 of 2,323 teeth (overall TL [OTL]: 0.12 teeth/patient/y) during 10 years of SPC. Forty of these teeth (33.6%) were lost for periodontal reasons (TLP; 0.04 teeth/patient/y). Significantly more teeth were lost due to other reasons (P <0.0001). TLP (OTL) only occurred in 5.9% (14.7%) of all teeth, when BL was at least 80%. Use as abutment tooth, FI degree III, tooth mobility degrees I and II, mean PD, and CAL positively correlated with OTL (P <0.05). For TLP, FI and tooth mobility degree III as well as mean CAL were identified as tooth-related prognostic factors (P <0.05).
Conclusions: During 10 years of SPC, most of the teeth (93.4%) of periodontally compromised patients were retained, showing the positive effect of a well-established treatment concept. Well-known tooth-related prognostic factors were confirmed.
Objective: Evaluation of survival of teeth with class III furcation involvement (FI) ≥5 years after active periodontal treatment (APT) and identification of prognostic factors. Methods: All charts of patients who completed APT at the Department of Periodontology of Goethe-University Frankfurt, Germany, beginning October 2004 were screened for teeth with class III FI. APT had to be accomplished for ≥5 years. Charts were analysed for data of class III FI teeth at baseline (T0), at accomplishment of APT (T1), and at the last supportive periodontal care (T2). Baseline radiographic bone loss (RBL) and treatment were assessed. Results: One-hundred and sixty patients (age: 54.4 ± 9.8 years; 82 females; 39 active smokers; 9 diabetics, 85 stage III, 75 stage IV, 59 grade B, 101 grade C) presented 265 teeth with class III FI. Ninety-eight teeth (37%) were lost during 110, 78/137 (median, lower/upper quartile) months. Logistic mixed-model regression and mixed Cox proportional hazard model associated adjunctive systemic antibiotics with fewer tooth loss (26% vs. 42%; p = .019/.004) and RBL (p = .014/.024) and mean probing pocket depth (PPD) at T1 (p < .001) with more tooth loss. Conclusions: Subgingival instrumentation with adjunctive systemic antibiotics favours retention of class III furcation-involved teeth. Baseline RBL and PPD at T1 deteriorate long-term prognosis.
Objective: Evaluation of survival of teeth with class III furcation involvement (FI) ≥5 years after active periodontal treatment (APT) and identification of prognostic factors. Methods: All charts of patients who completed APT at the Department of Periodontology of Goethe-University Frankfurt, Germany, beginning October 2004 were screened for teeth with class III FI. APT had to be accomplished for ≥5 years. Charts were analysed for data of class III FI teeth at baseline (T0), at accomplishment of APT (T1), and at the last supportive periodontal care (T2). Baseline radiographic bone loss (RBL) and treatment were assessed. Results: One-hundred and sixty patients (age: 54.4 ± 9.8 years; 82 females; 39 active smokers; 9 diabetics, 85 stage III, 75 stage IV, 59 grade B, 101 grade C) presented 265 teeth with class III FI. Ninety-eight teeth (37%) were lost during 110, 78/137 (median, lower/upper quartile) months. Logistic mixed-model regression and mixed Cox proportional hazard model associated adjunctive systemic antibiotics with fewer tooth loss (26% vs. 42%; p = .019/.004) and RBL (p = .014/.024) and mean probing pocket depth (PPD) at T1 (p < .001) with more tooth loss. Conclusions: Subgingival instrumentation with adjunctive systemic antibiotics favours retention of class III furcation-involved teeth. Baseline RBL and PPD at T1 deteriorate long-term prognosis.