The Association Between Clinical and Radiographic Periodontitis Measurements During Periodontal Maintenance

Abstract

Background To examine the association between clinical and radiographic periodontitis measurements during two years of periodontal maintenance. Methods Secondary analyses were performed from a two-year, double-blind, placebo-controlled, randomized clinical trial evaluating the efficacy and safety of subantimicrobial dose doxycycline (SDD) in 128 postmenopausal osteopenic women with moderate to severe chronic periodontitis. Relative clinical attachment level (RCAL) and probing depth (PD) measures were made. Posterior vertical bite-wings were taken for alveolar bone density (ABD) and alveolar bone height (ABH) measurements. Generalized estimating equations were used to model associations. Results One-year ABD changes and one-year RCAL/PD changes did not predict two-year ABH changes and ABH/ABD changes, respectively. Baseline RCAL and PD were positively associated with baseline ABH loss (p<0.0001) and baseline probing depths were associated with subsequent ABD and ABH loss (p<0.05 for each). Among placebo (but not SDD) participants, RCAL changes were associated with concurrent ABD loss (p=0.027) when considering one- and two-year changes combined. The odds of ABH loss were higher among sites with concurrent one-year ABD loss versus no change (OR=3.15, p<0.0001) or concurrent PD increases versus no change (OR=1.88, p=0.0025) when considering one- and two-year changes combined. Conclusions In postmenopausal osteopenic women undergoing periodontal maintenance, baseline PD was associated with subsequent ABD and ABH loss. Although no longitudinal change preceded another measurement change, changes in probing depths and relative clinical attachment levels appeared to reflect changes in the underlying alveolar bone over time.

Alveolar Bone Loss Is Associated With Circulating Anti‐Citrullinated Protein Antibody (ACPA) in Patients With Rheumatoid Arthritis

“…This is important, given the strong association of greater ABL with periodontitis observed in the study ( P <0.001; data not shown), suggesting that ABL, a hallmark and distinctive feature of periodontitis, is a reflection of a patient's periodontitis status. Indeed, the authors have previously shown that relative clinical attachment level (relative to the occlusal surface) and ABL were significantly and positively associated at baseline ( P <0.0001) in a study examining postmenopausal women with periodontitis and systemic osteopenia 30 . In the current study, for sites in patients with RA with high ABL (>8.80%), the average clinical AL (relative to the CEJ) was 3.75 mm.…”

Longitudinal Relationship between Plasma Reactive Oxygen Metabolites and Periodontal Condition in the Maintenance Phase of Periodontal Treatment

“…In this study, alterations in CAL were negatively correlated with PPD at baseline in subjects with high oxidative status. Recent research has suggested that baseline PPD is associated with subsequent alveolar bone density and height loss in postmenopausal osteopenic females undergoing periodontal maintenance [ 39 ]. However, it have been indicated that sites with deep PPD showed more attachment level gain after 3 months of scaling and root planning than those with shallow PPD [ 40 ].…”

Loss of alveolar bone density in postmenopausal, osteopenic women is associated with circulating levels of gelatinases

“…We previously hypothesized that ABD loss may precede ABH loss. However, we have since examined the data from this group of women and failed to detect this hypothesized sequence in periodontitis progression, possibly because the postmenopausal women in this study exhibited minimal local or systemic bone loss over the 2‐year study . The current study's finding that ABD loss was more common than periodontitis progression (measured by either ABH or RCAL) suggests that change in ABD may be a more sensitive diagnostic measure in patients undergoing periodontal maintenance.…”

“…Baseline, 1‐year, and 2‐year serum samples were assayed in 2008 by one investigator (Dr. Hsi‐Ming Lee). Details on the consenting process, which was approved by the Institutional Review Boards of the University of Nebraska Medical Center and Stony Brook University, are published as are other aspects of the original trial and its supplement …”