Predictors for tooth loss in periodontitis patients: Systematic review and meta‐analysis

Abstract

Aim A range of predictors for tooth loss in periodontitis patients have been reported. We performed a systematic review and meta‐analysis to assess the consistency and magnitude of any association between a total of 12 predictors and tooth loss. Materials and Methods Medline/Embase/Central were searched for longitudinal studies investigating the association between predictors and tooth loss in periodontitis patients. Random‐effects meta‐analysis was performed, and study quality assessed. Results Twenty studies (15,422 patients, mean follow‐up: 12 years) were included. The mean annual tooth loss/patient was 0.12 (min./max: 0.01/0.36). Older patients (n = 8 studies; OR: 1.05, 95% CI: 1.03–1.08/year), non‐compliant ones (n = 11; 1.51, 1.06–2.16), diabetics (n = 7; 1.80, 1.26–2.57), those with IL‐1‐polymorphism (n = 3; 1.80; 1.29–2.52) and smokers (n = 15; 1.98, 1.58–2.48) had a significantly higher risk of tooth loss. Teeth with bone loss (n = 3; 1.04, 1.03–1.05/%), high probing pocket depth (n = 6; 3.19, 1.70–5.98), mobility (n = 4; 3.71, 1.65–8.38) and molars (n = 4; 4.22, 2.12–8.39), especially with furcation involvement (n = 5; 2.68, 1.75–4.08) also showed higher risks. Gender (n = 16; 0.95, 0.86–1.05) and endodontic affection (n = 3; 3.62, 0.99–13.2) were not significantly associated with tooth loss. Conclusions Older, non‐compliant, smoking or diabetic patients, and teeth with bone loss, high probing pocket depth, mobility, or molars, especially with furcation involvement showed higher risks of tooth loss.

Bidirectional Association between Tooth Loss and Hypertension: A Systematic Review and Meta-analysis

“…Our result suggested that hypertension was signi cantly associated with incidence of tooth loss. Consistent with our study, a recent review showed that hypertension could predict tooth loss among patients with periodontitis [32] . Therefore, individuals with hypertension should pay more attention to the oral health.…”

“…Secondly, hypertension was associated with vascular dysfunction and might result in arteriosclerosis and microcirculation disorders [50,51] , which might in uence the blood supply of root of tooth, promote oral infection and result in tooth extraction. Lastly, patients with hypertension show a high risk of developing other chronic diseases, including diabetes, metabolic syndrome and coronary heart disease, all of which was reported to be associated with tooth loss [32,52,53] . Combined with these chronic diseases, hypertensive patients might experience an earlier and severer tooth loss.…”

Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study

“…FI has been widely established as a risk factor for tooth loss. [38][39][40][41][42] Results from this study found survival rates of 86.5% and 74.3% for molars treated with an allogeneic cancellous bone graft and a collagen membrane at 5, and 10 years, respectively. It is important to highlight that most of the studies evaluating the survival of FI teeth treated with GTR had only included molars with degree 2 furcation defects.…”

Tooth survival and clinical outcomes up to 26 years after guided tissue regeneration therapy in deep intra‐bony defects: Follow‐up investigation of three randomized clinical trials

“…Accordingly, when evaluating tooth survival with regard to the site‐specific factor tooth type and CAL at baseline, there was a trend for higher tooth loss in premolars and molars and defects with higher CAL at baseline. Helal et al also reported significantly higher risk of tooth loss for molars (odds ratio (OR): 4.22, 95% confidence intervals (CI): 2.12–8.39) and teeth with high PPD (OR: 3.19; 95% CI: 1.7–5.98) in their systematic review on predictors of tooth loss in periodontitis patients (Helal et al., 2019). Multi‐rooted teeth may be, in general, more prone to periodontal disease due to potential furcation involvement, but also may have higher risk for endodontic complications and may be more heavily restored as compared to single‐rooted teeth (Helal et al., 2019).…”

“…Helal et al also reported significantly higher risk of tooth loss for molars (odds ratio (OR): 4.22, 95% confidence intervals (CI): 2.12–8.39) and teeth with high PPD (OR: 3.19; 95% CI: 1.7–5.98) in their systematic review on predictors of tooth loss in periodontitis patients (Helal et al., 2019). Multi‐rooted teeth may be, in general, more prone to periodontal disease due to potential furcation involvement, but also may have higher risk for endodontic complications and may be more heavily restored as compared to single‐rooted teeth (Helal et al., 2019). When stratifying according to the 1‐year data, we also found significantly less tooth survival in teeth still showing CAL ≥ 7 mm and a tendency for less tooth survival in teeth with a residual PPD ≥ 6 mm after 1 year.…”