Periodontal Risk Assessment Model in a Sample of Regular and Irregular Compliers Under Maintenance Therapy: A 3‐Year Prospective Study

Costa, Fernando Oliveira; Cota, Luís Otávio Miranda; Lages, Eugênio José Pereira; Oliveira, Ana Paula Lima; Cortelli, Sheila Cavalca; Cortelli, José Roberto; Lorentz, Telma Campos Medeiros; Costa, José Eustáquio da

doi:10.1902/jop.2011.110187

Cited by 59 publications

(97 citation statements)

References 33 publications

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“…The definition of compliers and non-compliers was according to Costa et al, 2012, compliers being considered those showing 100% cooperation with the recall visits interval suggested by the periodontist. Non-compliers were considered those that lost any regular visit but continued, irregularly, with their PMP appointments (7).…”

Section: Methodsmentioning

confidence: 99%

Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study

et al. 2017

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The aim of the present study was to evaluate the incidence and causes of tooth loss in periodontal subjects from a private practice in Brazil. Two trained examiners extracted data from the records of subjects who sought periodontal treatment from 1980 to 2013. Only records of patients who completed the non-surgical periodontal treatment and had at least one visit for maintenance were included. Data were analyzed by chi-square test, Student's t-test, Kaplan-Meier survival curve and Cox regression. A total of 3,319 records were reviewed and 737 records included (58.6% women, mean age of 46.6±13.0 years at the beginning of the treatment). Maintenance period ranged from 1 to 33 years (7.4±6 years). During this period, 202 individuals (27.4%) lost 360 teeth, 47.5% of losses within the first five years (n=171). Non-compliers lost more teeth than compliers (p<0.001), respectively 211 and 149 teeth. Regarding reasons of tooth loss, 84 individuals lost 38% of the teeth from periodontal disease progression (n=137). Survival analysis showed that most patients lost only one tooth from periodontal disease, and differences in the survival rates between compliers and non-compliers were observed following the second tooth loss. Approximately one-third of tooth losses was related to periodontal disease progression, and there was stability in time of the proportion of losses from disease progression and other reasons. Therefore, it is possible to conclude that compliant patients in a private practice lose fewer teeth than do non-compliers. Among compliers, periodontal disease progression was not the main cause of tooth loss.

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Section: Methodsmentioning

confidence: 99%

Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study

et al. 2017

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“…It appears that there is a reasonable need to research further the very basis of such a suggested interval. An increasing number of studies [47][48][49][50][51] have highlighted the importance of utilizing risk-based models to identify patients at higher risk with some promising developments being made in this arena. The Periodontal Risk Calculator (PRC) was introduced 47 by Page et al Based on mathematically derived algorithms it assigns relative weights to the various known risks that may increase patients' susceptibility to develop periodontitis.…”

Section: Discussionmentioning

confidence: 99%

“…Another tool described by Lang and Tonetti 49 as Periodontal Risk Assessment (PRA) is of some relevance here. Using known risk factors/indicators in each individual patient, it aims to enable the practitioner to determine the frequency and extent of professional support necessary to maintain periodontal health following active therapy.…”

Section: Discussionmentioning

confidence: 99%

Appropriate Recall Interval for Periodontal Maintenance: A Systematic Review

Farooqi¹,

Wehler

Gibson

et al. 2015

Journal of Evidence Based Dental Practice

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Objectives-A systematic review of the literature was undertaken to assess the evidence to support a specific time interval between periodontal maintenance (PM) visits.Methods-Relevant articles were identified through searches in MEDLINE, EMBASE and PubMed using specific search terms, until April, 2014, resulting in 1095 abstracts and/or titles with possible relevance. Critical Appraisal Skills Programme (CASP) guidelines were used to evaluate the strength of studies and synthesize findings. If mean recall interval was not reported for study groups, authors were contacted to attempt to retrieve this information.Results-Eight cohort studies met the inclusion criteria. No randomized control trials were found. All included studies assessed the effect of PM recall intervals in terms of compliance with a recommended regimen (3-6 months) as a primary outcome. Shorter PM intervals (3-6 months) favored more teeth retention but also statistically insignificant differences between RC and IC/EC, or converse findings are also found. In the 2 studies reporting mean recall interval in groups, significant tooth loss differences were noted as the interval neared the 12 month limit.Conclusions-Evidence for a specific recall interval (e.g. every 3 months) for all patients following periodontal therapy is weak. Further studies, such as RCTs or large electronic database evaluations would be appropriate. The merits of risk-based recommendations over fixed recall interval regimens should be explored.

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“…Evidence regarding how to determine the maintenance interval in SPT is still weak [6]. A popular and valid approach is based on the risk assessment approach proposed by Lang and Tonetti [7], who defined several risk parameters, including BOP, PPD, tooth loss, age-related bone loss, systemic diseases, and environment/smoking [8]. However, different approaches have been discussed, considering additional diagnostics as a way to improve the validity of risk-oriented maintenance estimation [6283031].…”

Section: Discussionmentioning

confidence: 99%

“…The classical parameters that serve as a basis for risk assessment are periodontal probing depth (PPD), bleeding on probing (BOP), bone loss in relation to the patient's age, tooth loss, records of pre-existing systemic diseases (e.g., diabetes), and environmental risk factors, such as smoking habits [7]. After the completion of initial treatment, individualized intervals of SPT are determined by evaluating these parameters according to existing definitions [89]. However, the evidence supporting specific maintenance intervals for patients receiving SPT is still weak [6].…”

Section: Introductionmentioning

confidence: 99%

Association of chairside salivary aMMP-8 findings with periodontal risk assessment parameters in patients receiving supportive periodontal therapy

Schmalz

Kummer

Kottmann³

et al. 2018

J Periodontal Implant Sci

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PurposeThe aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT).MethodsA total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and χ2 test, as appropriate (P<0.05).ResultsOnly the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: 27.8%±20.9% vs. aMMP-8 negative: 18.0%±14.5%; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05).ConclusionsSalivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.

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Periodontal Risk Assessment Model in a Sample of Regular and Irregular Compliers Under Maintenance Therapy: A 3‐Year Prospective Study

Abstract: The risk profile influenced the recurrence of periodontitis and tooth loss. RCs had less recurrence of periodontitis and less tooth loss. The PRA model can be useful in particularizing the risk of patients and adjusting recall intervals.

Cited by 59 publications

References 33 publications

Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study

Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study

Appropriate Recall Interval for Periodontal Maintenance: A Systematic Review

Association of chairside salivary aMMP-8 findings with periodontal risk assessment parameters in patients receiving supportive periodontal therapy

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