The Long‐Term Effectiveness of Periodontal Therapy in a Clinical Practice

Abstract

A retrospective study was conducted of 620 patients in a periodontal practice over the years 1960 to 1982. Various periodontal therapies were assessed by using careful office protocols, meticulous record-keeping and well-defined outcome criteria. Four treatment outcome categories were used: two representing satisfactory outcomes (referred to as "STABLE"), and two unsatisfactory outcomes ("UNSTABLE"). The percentages of patients in the STABLE categories following different therapies were: (1) nonsurgical treatment, 63.6%; (2) closed curettage, 73.1%; (3) open curettage, 95.0%; (4) modified Widman flap, 91.6%; (5) full flap and osseous surgery, 71.1%. The major conclusions were that the modified Widman flap and open curettage were more effective than flap and osseous surgery, and much more effective than closed curettage when it was employed as an alternative treatment (54.8% STABLE) to the osseous surgery (71.1% STABLE). Thus, moderate surgical therapies appear to be at least as effective as ostectomy procedures in the treatment of periodontal disease, while nonsurgical and closed curettage therapies appear to be less effective.

Periodontal Disease as a Specific, albeit Chronic, Infection: Diagnosis and Treatment

“…Accordingly very few, if any, dental insurance plans include the full cost of periodontal surgery, and it is not covered by Medicare or Medicaid. This out-of-pocket cost to the individual, plus patient concerns over the surgical procedures themselves (29,187,190), would discourage some individuals from seeking treatment.…”

The Antimicrobial Treatment of Periodontal Disease: Changing the Treatment Paradigm

“…(Hujoel and DeRouen, 1995). Several clinicians have described the long-term survival of teeth following periodontal treatment in their private practices (Hirshfeld and Wassermann, 1978;McFall, 1982;Meador et al, 1985). These case reports indicate that about 73 to 83% of patients retain all or most of their teeth as a result of treatment.…”

“…Since surgery can be a deterrent for the patient, due to both cost and perceived discomfort (Meador et al, 1985;Matthews and McCulloch, 1993), a decision was made to determine whether successful treatment would reduce the need for surgery. We also stopped the a priori extraction of "hopeless teeth" so that these teeth could be used as indicators to monitor the effect of treatment.…”

The American Academy of Pediatric Dentistry

“…[9][10][11] As a result of advances in knowledge and therapy, the great majority of patients retain their dentition over their lifetime with proper treatment, reasonable plaque control, and continuing maintenance care. [12][13][14][15][16][17][18][19][20][21] However, there are some situations when traditional therapy is not effective in arresting the disease. In these instances, the progression of the disease may be slowed, but eventually the teeth may be lost.…”

“…In these instances, the progression of the disease may be slowed, but eventually the teeth may be lost. [14][15][16][17][18][19][20][21] Adherence to the following guidelines will not guarantee a successful outcome and will not obviate all complications or postcare problems in periodontal therapy. Additionally, these guidelines should not be deemed inclusive of all methods of care, or exclusive of treatment reasonably directed at obtaining the same results.…”