Tooth Loss in 100 Treated Patients With Periodontal Disease: A Long‐Term Study

Abstract

A population of 100 patients with periodontal disease who had been treated and maintained for 15 years or longer was studied for tooth loss. The patients averaged 43.8 years of age and consisted of 59 females and 41 males. Patients were examined and their dental records were reviewed. On the basis of response to therapy and tooth loss, the patients were classified as Well-Maintained (77), Downhill (15), or Extreme Downhill (8). At the completion of initial treatment, 2,627 teeth were present. Of this number, during the maintenance period, 259 teeth (9.8%) were lost due to periodontal disease, while 40 teeth (1.5%) were lost due to other causes. Evaluation was made as to patterns of tooth loss, loss of questionable teeth, loss of teeth with furcations, surgical vs. nonsurgical therapy, and presence of fixed or removable prostheses. Considerable variation occurred between response groups. Periodontal disease appears to be bilaterally symmetrical and tooth loss response emulated this pattern with greatest loss of maxillary second molars and least loss of mandibular cuspids.

Tooth loss in individuals under periodontal maintenance therapy: prospective study

“…4,6,8,[13][14][15][16][17] In a similar way to other prospective studies of TL in periodontal susceptible individuals, the present study aimed to describe the TL for periodontal disease and to analyze possible predictors of risk to the occurrence of this event.…”

“…3,5,[7][8][9][10][11] However, recent studies recommended the description of TL prevalence during the active therapy and its incidence during PMT as a mean of assessing the overall effectiveness of periodontal therapies. 12,13 Moreover, most of the studies on TL in programs of PMT have retrospective designs, 3,4,[6][7][8]14 and as a consequence, data may reflect the traditional bias related to the design methodology.…”

A comprehensive approach to assigning periodontal prognosis

“…The accuracy of the TLPD prediction has been identified with the actual percentage of TLPD of teeth being assigned a certain prognostic category (Becker et al., 1984; Fardal et al., 2004; McFall, 1982; McGuire & Nunn, 1996). This percentage also represents the probability of TLPD.…”

“…For hopeless prognosis, tooth loss due to periodontal disease (TLPD) prediction failed, implying a False +, in between 19.6% and 38% of the cases (Becker, Berg, & Becker, 1984; Fardal, Johannessen, & Linden, 2004; McGuire & Nunn, 1996). These percentages were much higher for questionable prognosis: the TLPD prediction failed in between 37% and 74% of cases (Becker et al., 1984; McFall, 1982; McGuire & Nunn, 1996). Thus, this low sensitivity or capability of anticipating the TLPD event represents a major limitation of periodontal prognosis.…”

“…On the contrary, the specificity or capability of ascertaining that TLPD will not occur has been shown to be much more accurate. This prediction only failed between 0.46% and 2% of times, implying a False—(Becker et al., 1984; McFall, 1982; McGuire & Nunn, 1996). …”