Response of molars and non-molars to a strict supragingival control in periodontal patients

Abstract

The posterior position in the arches is one of the factors that underlies the poor prognosis of molar teeth (M). It is speculated that M do not benefit from the oral hygiene routine as well as non-molars (NM) do. This study evaluated the response of M and NM to supragingival control during a 6-month period in 25 smokers (S) and 25 never-smokers (NS) with moderate-to-severe periodontitis. One calibrated examiner assessed visible plaque (VPI) and gingival bleeding (GBI) indexes, periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) at days 0 (baseline), 30 and 180. At baseline, M showed significantly higher mean values of VPI (p = 0.017) and PPD (p < 0.001) compared with NM; CAL was also greater in M (p < 0.001) and was affected by smoking (p = 0.007). The reductions obtained for periodontal indicators at day 180 showed similar responses between M and NM. For CAL, M (NS 0.57 ± 0.50; S 0.67 ± 0.64) and NM (NS 0.38 ± 0.23; S 0.50 ± 0.33) reached an almost significant difference (p = 0.05). Smoking did not influence the response to treatment. Multilevel analysis revealed that, only for PDD reductions, the interaction between sites, teeth and patient was significant (p < 0.001). It was concluded that M benefit from an adequate regimen of supragingival biofilm control; therefore, supragingival condition should be considered in the prognosis of molar teeth.

Fine-Tuning Multilevel Modeling of Risk Factors Associated with Nonsurgical Periodontal Treatment Outcome

“…Unlike previous studies, these patients presented decreased tendency for Among tooth-level, anterior teeth (incisors and canines) had a more significant reduction of PD and CAL than molars throughout the follow-up time, but between molar and premolars, this significance was only expressed at 6 and 12 months. These results are in accordance with previous studies 21,23,28,29,40 , although Jiao et al 28 compared molar and non-molar teeth while Song et al 29 did not show as much meaning in the reduction of PD. As is widely accepted, molars have the worse healing prognosis due to anatomic and morphologic characteristics such as furcations and size of entrance, root trunk length, bifurcation ridges, root concavities and cervical enamel projections 12,40,41 .…”

“…These results are in accordance with previous studies 21,23,28,29,40 , although Jiao et al 28 compared molar and non-molar teeth while Song et al 29 did not show as much meaning in the reduction of PD. As is widely accepted, molars have the worse healing prognosis due to anatomic and morphologic characteristics such as furcations and size of entrance, root trunk length, bifurcation ridges, root concavities and cervical enamel projections 12,40,41 . Likewise, premolars have some peculiarities that decrease the prognosis, but far less sententious than molars 12,40,41 .…”

Clinical performance of non‐surgical periodontal therapy in a large Chinese population with generalized aggressive periodontitis

“…In the present study, the annualized number of tooth loss during SPT can be estimated by the gradient of the smoothing plot (Figure ). The estimated number of annual tooth loss was 0.097 per year, which was consistent to those reported by previous study (Angst ; Baumer et al., ; Diaz‐Faes et al., ; Dopico et al., ; Graetz et al., ; Nibali et al., ). In our future research, the influential factors of periodontal tooth loss of AgP patients will be explored in detail.…”

“…The annualized number of tooth loss of the present study (1.05 per year) was much higher than those of other studies or metaanalysis concerning long-term prognosis of AgP (ranging from 0.09 to 0.27 per year) (Angst 2013;Baumer et al, 2011;Diaz-Faes, Guerrero, Magan-Fernandez, Bravo, & Mesa, 2016;Dopico, Nibali, & Donos, 2016;Graetz et al, 2017;Nibali, Farias, Vajgel, Tu, & Donos, 2013). The primary reason is that the number reported above was the sum of teeth lost during both APT and SPT instead of SPT only reported in previous studies mentioned above.…”

Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation

“…Therapies focused solely on supragingival control 7,8 have been demonstrated to significantly reduce subgingival inflammatory markers, such as bleeding on probing (BOP) and periodontal probing depth (PPD). Use of a supragingival biofilm control regimen (SUPRA) reduced the PPD by an average of 2.4 mm in sites with 6.6 mm of PPD initially.…”