Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy

Abstract

Aim The aim of this study was to investigate patient‐ and tooth‐level factors that may predict tooth loss and periodontitis progression in patients who have undergone at least 5 years of periodontal maintenance. Materials and Methods In this retrospective cohort study, 135 patients were examined after active periodontal therapy (APT) and periodontal maintenance for 5.09–8.65 years (mean 6.16 ± 0.74 years). Regression models were applied to identify risk factors associated with tooth loss and disease progression. Results Stage IV periodontitis (incidence rate ratio [IRR] = 4.61; 95% confidence interval, CI [2.97–7.18], p < .001), the presence of ≥5 sites with probing pocket depth (PPD) ≥5 mm at the end of APT (IRR = 2.04; 95% CI [1.32–3.20], p < .01), and residual PPD ≥7 mm at the end of APT (odds ratio [OR] = 3.01; 95% CI [1.14–7.94], p < .05) were risk factors for tooth loss. Residual PPDs of 5 mm (OR = 2.02; 95% CI [1.20–3.40], p < .01) and 6 mm (OR = 2.41; 95% CI [1.22–4.76], p < .05) at the end of APT were risk factors for disease progression. Above 3 mm, each 1 mm increase in maximum PPD/clinical attachment loss was associated with an increased risk of tooth loss and disease progression. Conclusions Stage IV periodontitis is associated with an increased risk of tooth loss. Teeth with PPD ≥5 mm at the end of APT are at risk of periodontitis progression or tooth loss.

Prevalence of stable and successfully treated periodontitis subjects and incidence of subsequent tooth loss within supportive periodontal care: A systematic review with meta‐analyses

“…‘Controlled periodontitis’ was the most frequently achieved endpoint (52.42%) among studies following conventional APT. At the subject level, it has an RR of 2.78 ( p = .0068) of tooth loss during SPC when not achieved, which is similar to the findings reported elsewhere (Siow et al, 2022). Unlike other subject‐level endpoints, this endpoint considers multiple residual sites, which is relevant, as subject‐ and tooth‐level factors can affect the treatment response, particularly in relation to specific tooth types (Tomasi et al, 2007).…”

Influence of residual pockets on periodontal tooth loss: A retrospective analysis

“…These findings are in agreement with previous studies, suggesting that TL is a consequence of periodontal disease that is occasionally observed and must be prevented. 6,26 RPc are commonly observed after APT. [27][28][29] In the present study, about 89% of the individuals had at least one site with RPc ≥ 5 mm and 70% with RPc ≥ 6 mm.…”

“…Numerous patient-related (age, sex, smoking, diabetes mellitus, severity of the disease, and compliance with SPT) and tooth-related factors (tooth type, tooth location, probing depth [PD], bleeding on probing [BOP], presence of furcation involvement, mobility, and bone loss) have been suggested to increase the risk of TL or TLP during SPT, including the presence of residual pockets (RPc). 1,[4][5][6][7] According to the 2017 World Workshop Classification (WWC), periodontal health in a successfully treated periodontitis patient can be described as PD ≤4 mm at all sites or no PD ≥4 mm with BOP. 8 The European Federation of Periodontology has established the absence of RPc >4 mm with BOP or no deep pockets ≥6 mm as the endpoint of periodontal therapy.…”

Advances in hydrogels for the treatment of periodontitis

“…4 In severe cases, it can directly lead to tooth loosening or loss. 5 Several studies have also demonstrated an association between periodontitis and systemic diseases, such as Alzheimer's disease, 6,7 cardiovascular disease, 8,9 and diabetes. 10,11 The optimal treatment period for periodontitis focuses on prevention and early mild symptoms, controlling inflammation with medication, regulating the immune response, and reducing tissue fester.…”

“…4 In severe cases, it can directly lead to tooth loosening or loss. 5 Several studies have also demonstrated an association between periodontitis and systemic diseases, such as Alzheimer's disease, 6,7 cardiovascular disease, 8,9 and diabetes. 10,11…”