Tooth‐related factors for tooth loss 20 years after active periodontal therapy–A partially prospective study

Rahim-Wöstefeld, Sonja; Sayed, Nihad El; Weber, Dorothea; Kaltschmitt, Jens; Bäumer, Amelie; El-Sayed, Shirin; Eickholz, Peter; Pretzl, Bernadette

doi:10.1111/jcpe.13348

Cited by 13 publications

(30 citation statements)

References 49 publications

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“…This confirms other authors' findings who have reported survival rates of molars with FI III of 70% to 76.5% over 5 to 20 years. 13,46 Overall, survival rate decreases within the oral cavity from anteriors (97.8%) to premolars (94.7%) to molars (89.6%), which agrees with previous studies. 11,13 Tooth mobility is associated with a significantly increased risk of TLP for degree III.…”

Section: Discussionsupporting

confidence: 91%

“…43 With regard to the identified factors for OTL/TLP, binary logistic regression excluded variables that were often associated with TL previously due to a lack of significance. These include, in particular, smoking status, 3,20,39,44 diabetes mellitus, 6,44 adherence, 6,13,38,39,44 and initial diagnoses. 3,15,19 Initial diagnosis is determined by interproximal CAL (stages).…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, the limits of longterm tooth retention seem to be increasingly shifting to longer survival. 16 A large number of retrospective cohort studies in both, a university [6][7][8][10][11][12][13][14][17][18][19][20][21] as well as in a private practice setting 2,15,22,23 already exist, further long-term data are valuable, as they help to confirm and expand existing evidence and to incorporate therapy results of different concepts at different centers.…”

Section: Introductionmentioning

confidence: 99%

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Tooth loss in periodontally compromised patients: Retrospective long‐term results 10 years after active periodontal therapy – tooth‐related outcomes

Petsos

Ramich

Nickles

et al. 2021

Journal of Periodontology

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Background: Estimating prognosis of periodontally affected teeth at the beginning of supportive periodontal care (SPC) is an important component for further treatment planning. This study aimed to evaluate tooth loss (TL) during 10 years of SPC in periodontally compromised patients and to identify tooth-related factors affecting TL. Methods: Patients were re-examined 120 ± 12 months after accomplishment of active periodontal therapy. TL was defined as primary outcome variable and tooth-related factors (abutment status, furcation involvement [FI], tooth mobility, mean periodontal probing depth [PD], and clinical attachment level [CAL] at beginning of SPC, and initial bone loss [BL]) were estimated based on an adjusted regression analyses model.Results: Ninety-seven patients (51 females and 46 males; mean age, 65.3 ± 11 years) lost 119 of 2,323 teeth (overall TL [OTL]: 0.12 teeth/patient/y) during 10 years of SPC. Forty of these teeth (33.6%) were lost for periodontal reasons (TLP; 0.04 teeth/patient/y). Significantly more teeth were lost due to other reasons (P <0.0001). TLP (OTL) only occurred in 5.9% (14.7%) of all teeth, when BL was at least 80%. Use as abutment tooth, FI degree III, tooth mobility degrees I and II, mean PD, and CAL positively correlated with OTL (P <0.05). For TLP, FI and tooth mobility degree III as well as mean CAL were identified as tooth-related prognostic factors (P <0.05). Conclusions:During 10 years of SPC, most of the teeth (93.4%) of periodontally compromised patients were retained, showing the positive effect of a wellestablished treatment concept. Well-known tooth-related prognostic factors were confirmed.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tooth loss in periodontally compromised patients: Retrospective long‐term results 10 years after active periodontal therapy – tooth‐related outcomes

Petsos

Ramich

Nickles

et al. 2021

Journal of Periodontology

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“…For instance, we have previously demonstrated that an increasing rate of tooth loss was positively associated with the proportion of residual bleeding pockets at SPC enrollment [4]. Also, patient adherence with the suggested SPC program (i.e., the patient compliance) may frequently be less than optimal, with proportions of non-compliers up to 64.4% [18], and was associated with higher rates of tooth loss [19][20][21][22]. Variability in patient response to SPC raises the clinically relevant issue of the appropriateness of a specific protocol for the individual patient, including session intervals, intervention modalities, and strategies to optimize patient compliance [4].…”

Section: Introductionmentioning

confidence: 99%

Tooth loss in complying and non-complying periodontitis patients with different periodontal risk levels during supportive periodontal care

et al. 2021

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Objectives To evaluate yearly tooth loss rate (TLR) in periodontitis patients with different periodontal risk levels who had complied or not complied with supportive periodontal care (SPC). Materials and methods Data from 168 periodontitis patients enrolled in a SPC program based on a 3-month suggested recall interval for at least 3.5 years were analyzed. For patients with a mean recall interval within 2–4 months (“compliers”) or > 4 months (“non-compliers”) with different PerioRisk levels (Trombelli et al. 2009), TLR (irrespective of the cause for tooth loss) was calculated. TLR values were considered in relation to meaningful TLR benchmarks from the literature for periodontitis patients either under SPC (0.15 teeth/year; positive benchmark) or irregularly complying with SPC (0.36 teeth/year; negative benchmark). Results In both compliers and non-compliers, TLR was significantly below or similar to the positive benchmark in PerioRisk level 3 (0.08 and 0.03 teeth/year, respectively) and PerioRisk level 4 (0.12 and 0.18 teeth/year, respectively). Although marked and clinically relevant in non-compliers, the difference between TLR of compliers (0.32 teeth/year) and non-compliers (0.52 teeth/year) with PerioRisk level 5 and the negative benchmark was not significant. Conclusion A SPC protocol based on a 3- to 6-month recall interval may effectively limit long-term tooth loss in periodontitis patients with PerioRisk levels 3 and 4. A fully complied 3-month SPC protocol seems ineffective when applied to PerioRisk level 5 patients. Clinical relevance PerioRisk seems to represent a valid tool to inform the SPC recall interval as well as the intensity of active treatment prior to SPC enrollment.

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“…However, these models were not based on statistical methodology, and considered mostly tooth-related variables. Current scientific consensus shows that periodontitis represents a multifactorial disease influenced by many risk factors, which individually impinge upon disease progression and treatment management [5,8,9,[14][15][16][17]. In addition to tooth-related factors, patientrelated parameters are strongly associated with tooth loss and need to be taken into account [2,4].…”

Section: Introductionmentioning

confidence: 99%

Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

et al. 2021

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Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

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Tooth‐related factors for tooth loss 20 years after active periodontal therapy–A partially prospective study

Cited by 13 publications

References 49 publications

Tooth loss in periodontally compromised patients: Retrospective long‐term results 10 years after active periodontal therapy – tooth‐related outcomes

Tooth loss in periodontally compromised patients: Retrospective long‐term results 10 years after active periodontal therapy – tooth‐related outcomes

Tooth loss in complying and non-complying periodontitis patients with different periodontal risk levels during supportive periodontal care

Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

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