Periodontal maintenance in a specialist periodontal clinic and in general dental practice

Preshaw, PM; Heasman, P. A.

doi:10.1308/135576106776337977

Cited by 12 publications

(31 citation statements)

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“…This fact is corroborated by numerous studies. 1,6,8,13,17,19 However, higher age groups were not associated with TL in the final multivariate model. This fact can be substantiated by the hypothesis previously cited or by the greater stratification of the variable age in the present study.…”

Section: Discussionmentioning

confidence: 85%

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Tooth loss in individuals under periodontal maintenance therapy: prospective study

et al. 2010

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This prospective study aimed to evaluate the incidence, the underlying reasons, and the influence of predictors of risk for the occurrence of tooth loss (TL) in a program of Periodontal Maintenance Therapy (PMT). The sample was composed of 150 complier individuals diagnosed with chronic moderate-severe periodontitis who had finished active periodontal treatment and were incorporated in a program of PMT. Social, demographic, behavioral and biological variables were collected at quarterly recalls, over a 12-month period. The effect of predictors of risk of and confounding for the dependent variable TL was tested by univariate and multivariate analysis, as well as the underlying reasons and the types of teeth lost. During the monitoring period, there was a considerable improvement in periodontal clinical parameters, with a stability of periodontal status in the majority of individuals. Twenty-eight subjects (18.66%) had TL, totaling 47 lost teeth (1.4%). The underlying reasons for TL were: periodontal disease (n = 34, 72.3%), caries (n = 3, 6.4%), prosthetic reasons (n = 9, 19.2%), and endodontic reasons (n = 1, 2.1%). Additionally, subjects with 10% of sites with probing depth between 4 and 6 mm were 5 times more likely to present TL (OR = 5.13, 95% CI 2.04-12.09). In this study, the incidence of TL was small and limited to few individuals. Additionally, gender and severity of periodontitis were significantly associated with TL during the monitoring period.

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Section: Discussionmentioning

confidence: 85%

“…8,15,19,20 Effects of smoking were also reported to be dose-dependent 4 and a good predictor of alveolar bone loss. 21 It is interesting to observe that smoking and diabetes were not associated with TL in the present study.…”

Section: Discussionmentioning

confidence: 99%

Tooth loss in individuals under periodontal maintenance therapy: prospective study

et al. 2010

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“…Eight cohort studies were chosen for inclusion (Figure ) . Seven studies examined patients with a diagnosis of ChP, while one study reported on patients with AgP. The main reason for exclusion was not having elements of both PDC and specialist PM within the same study (Figure ).…”

Section: Resultsmentioning

confidence: 99%

Periodontal maintenance following active specialist treatment: Should patients stay put or return to primary dental care for continuing care? A comparison of outcomes based on the literature

Leavy

Robertson

2017

Int J Dental Hygiene

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Objectives: To review the evidence for the efficacy of periodontal maintenance (PM) carried out in primary dental care (PDC) compared to the specialist setting for patients previously treated in a specialist setting for chronic (ChP) or aggressive (AgP) periodontitis. Methods:A focused PICO question and search protocol were developed. Online databases including MEDLINE, EMBASE, WEB OF SCIENCE™ and COCHRANE LIBRARY were searched along with specialist journals in the subject area of periodontal research.Selection criteria included studies that investigated delivery of PM in both specialist and PDC settings for patients with ChP or AgP over a minimum 12 months. We looked for studies that reported changes in clinical attachment levels (CAL), tooth loss, pocket probing depths (PPDs) and bleeding on probing (BoP) as outcome measures.Results: Eight cohort studies were chosen for inclusion. There was considerable heterogeneity found between the eight studies, which did not allow for quantitative (meta) analysis and statistical testing of differences between groups. Clinical attachment levels remained relatively stable in patients who received specialist PM with mean changes of −0.42 mm to +0.2 mm, while for those enrolled in PDC-based PM for periods >12 months, mean CAL losses were between −0.13 mm and −2.80 mm. PPD reduction for those subjects receiving specialist PM was between 0.05 and 1.8 mm for five studies but two cohorts experienced increases of 0.32 and 0.80 mm, respectively.Increases of up to 2.90 mm (range: −0.1 to +2.90) and a higher proportion of deeper pockets were noted among PDC PM cohorts. Higher rates of BoP among those in receipt of PDC PM were reported in half of all studies. There were insufficient long-term data to make any firm conclusions about the effect of the delivery of PM on tooth loss. Conclusion:Within the limitations of the data available, it appears that specialist PM is effective in sustaining periodontal stability following active specialist intervention.There is limited evidence that PDC provides the same level of care; however, the limited comparative data available suggest that outcomes could be slightly worse in PDC. | INTRODUCTIONPeriodontal maintenance (PM) follows active periodontal therapy (APT) and aims to prevent periodontal disease progression through close monitoring of the periodontal condition along with supra-and subgingival debridement and behaviour modification. | MATERIAL AND METHODSThe following PICO question was utilized to develop our review protocol:"for patients who have received specialist treatment for periodontitis (P), does receiving periodontal maintenance in PDC (I) prove as effective as receiving it in a specialist setting (C) in preventing disease progression and recurrence? (O)" A checklist based on the PRISMA (Preferred Reporting Items for Systematic Review and Metaanalyses) statement 18 was used and is summarized below (Figure 1). | Eligibility criteriaThe hierarchy of evidence search scope for this review included randomized controlled cli...

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“…This therapy must be scheduled at regular intervals, usually ranging from 2 to 6 months, depending on the clinical needs of the individual patient continuing for the life of the dentition. 15 Periodontal care at each recall visit comprises three parts. The first part is concerned with examination and evaluation of the patient's current oral health.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of honey solution as plaque reducing agent

Indriani

et al. 2010

Dent. J. (Majalah Kedokteran Gigi)

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Periodontal maintenance in a specialist periodontal clinic and in general dental practice

Cited by 12 publications

References 0 publications

Tooth loss in individuals under periodontal maintenance therapy: prospective study

Tooth loss in individuals under periodontal maintenance therapy: prospective study

Periodontal maintenance following active specialist treatment: Should patients stay put or return to primary dental care for continuing care? A comparison of outcomes based on the literature

The efficacy of honey solution as plaque reducing agent

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