Patient-related prognostic risk factors in severe periodontitis patients after periodontal therapy

Minabe, Masato; Takano, S; Harai, Kazuo; Inagaki, Koji; Nagaki, Yuko; Urushihara, Joji; Kodama, Tatsuhiko; Katsuki, Makiko; Sugiyama, Takashi; Sato, Tachio; Kouno, Kanji; Nakanishi, Rie; Higashi, Katsuaki; Honda, Mina; Nakazawa, Minato; Seino, Hiroaki; Taniguchi, Takeo; Horiuchi, Junko; Yamamoto, Yuko; Kaneko, Itaru; Ito, Miho; Makino, Akihiro; Kurokawa, Sumie; Kato, Mari; Noguchi, Toshihide

doi:10.2329/perio.55.170

Cited by 1 publication

(5 citation statements)

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“…The TRP assessment, which is under consideration in Japan, switched the outcome from extractions for any reason to extractions due to periodontal disease in response to an issue raised in a previous study [20] and has also been found to be effective when the duration of SPT is taken into account. Our results suggested that its predictive accuracy could be further improved by taking account of the number of teeth lost by the start of SPT.…”

Section: Discussionmentioning

confidence: 99%

“…In the institutions, specialist periodontists and dental hygienists board-certified by the Japanese Society of Periodontology were employed full-time. As the subjects of a previous study [20], out of 1,614 patients with periodontitis undergoing regular examinations in these 11 institutions who had moved on to SPT after re-evaluation following the completion of basic periodontitis treatment or periodontal surgical treatment, we initially selected 208 patients with severe periodontitis on the basis of the following criteria: age ≥20 years at initial examination, ≥16 remaining teeth, and ≥1 periodontal pocket measuring ≥6 mm. In this study, severe periodontitis was defined as ≥1 periodontal pocket measuring ≥6 mm.…”

Section: Methodsmentioning

confidence: 99%

“…We also used the TRP assessment [20], which calculates the proportion of sites of PD ≥6 mm at initial examination that improved by ≥2 mm after basic periodontal treatment. Patients in whom improvement was evident at ≥70% of sites were classed as favorable responsiveness to treatment, and those in whom it was evident in <70% as poor responsiveness.…”

Section: Methodsmentioning

confidence: 99%

“…In Japan, the therapy-resistant periodontitis (TRP) assessment diagnostic tool has been shown to be useful as a predictive factor for tooth loss during SPT [20]. TRP assesses the improvement rate of deep periodontal pockets in basic periodontal treatment based on previous studies [21, 22].…”

Section: Introductionmentioning

confidence: 99%

“…TRP is defined as <70% of sites with PD ≥6 mm at initial examination that improved by ≥2 mm after basic periodontal treatment. TRP diagnosis was found to be a significant risk factor for tooth loss with an odds ratio of 2.81 ( p = 0.006) [20]. However, the outcome of tooth loss includes teeth lost to extractions due to causes other than periodontal disease.…”

Section: Introductionmentioning

confidence: 99%

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Predictive factors for tooth loss during supportive periodontal therapy in patients with severe periodontitis: a Japanese multicenter study

et al. 2019

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BackgroundSupportive periodontal therapy (SPT) must take individual patient risk factors into account. We conducted a multicenter joint retrospective cohort study to investigate the value of modified periodontal risk assessment (MPRA) and therapy-resistant periodontitis (TRP) assessment as predictive factors for tooth loss due to periodontal disease in patients with severe periodontitis during SPT.MethodsThe subjects were 82 patients from 11 dental institutions who were diagnosed with severe periodontitis and continued SPT for at least 1 year (mean follow-up = 4.9 years) between 1981 and 2008. The outcome was tooth loss due to periodontal disease during SPT. The Cox proportional hazards model was used to analyze sex, age, diabetes status, smoking history, number of periodontal pockets measuring ≥6 mm, rate of bleeding on probing, bone loss/age ratio, number of teeth lost, MPRA, and TRP assessment as explanatory variables.ResultsUnivariate analysis showed that loss of ≥8 teeth by the start of SPT [hazard ratio (HR) 2.86], MPRA score indicating moderate risk (HR 8.73) or high risk (HR 11.04), and TRP assessment as poor responsiveness to treatment (HR 2.79) were significantly associated with tooth loss (p < 0.05). In a model in which the explanatory variables of an association that was statistically significant were added simultaneously, the HR for poor responsiveness to treatment and ≥8 teeth lost was significant at 20.17 compared with patients whose TRP assessment indicated that they responded favorably to treatment and who had lost <8 teeth by the start of SPT.ConclusionMPRA and TRP assessment may be useful predictive factors for tooth loss due to periodontal disease during SPT in Japanese patients with severe periodontitis. Additionally, considering the number of teeth lost by the start of SPT in TRP assessment may improve its predictive accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%