Prognostic value of a simplified method for periodontal risk assessment during supportive periodontal therapy

Trombelli, Leonardo; Minenna, Luigi; Toselli, Luca; Zaetta, Antonio; Checchi, Luigi; Checchi, Vittorio; Nieri, Michele; Farina, Roberto

doi:10.1111/jcpe.12645

Cited by 26 publications

(34 citation statements)

References 28 publications

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“…In patients with a baseline risk score of 3 (moderate), 4 (moderate‐high), and 5 (high), a significant difference in the mean number of teeth lost during supportive periodontal therapy was observed (0.3, 0.9, and 1.8, respectively). The tooth loss rate per year of supportive periodontal therapy was 0.07, 0.14, and 0.32, respectively, with a borderline significant difference among risk groups ( P = .053) . Overall, these results corroborate the need for tailored secondary prevention strategies in patients with different risk profiles to decide the interval for supportive periodontal therapy.…”

Section: Tailoring Supportive Periodontal Therapy Using Risk Assessmesupporting

confidence: 52%

“…Supportive periodontal therapy sessions included supragingival and subgingival mechanical plaque removal every 3.4 ± 1.1 months, with 39.5% of patients attending 3‐4 month recalls, 34.9% attending 5‐6 month recalls, and 25.6% attending <6 month recalls. These results showed that the prescribed supportive periodontal therapy regimen was able to limit the rate of tooth and bone loss in the entire population (0.15 ± 0.26 teeth per year and 0.14 ± 0.64 mm, respectively) …”

Section: Bleeding Pockets May Inform the Frequency Of Periodontal Recmentioning

confidence: 84%

“…Patient‐related percentage proportion of bleeding on probing‐negative sites with a probing depth of ≤4 mm (namely, the healthy/stable [H/S] sites), bleeding on probing‐positive sites with a probing depth of ≥5 mm (namely, the bleeding pockets [BPs]), sites not falling into the healthy/stable and bleeding pockets categories (ie, bleeding on probing‐negative sites with a probing depth of ≥5 mm or bleeding on probing‐positive sites with a probing depth of ≤4 mm), and sites located at teeth lost during supportive periodontal therapy. Proportions are provided for either the completion of active periodontal therapy (baseline) or last supportive periodontal therapy (SPT) visit (original reanalysis of data from Trombelli et al)…”

Section: Bleeding Pockets May Inform the Frequency Of Periodontal Recmentioning

confidence: 99%

“…Proportion of bleeding on probing‐positive sites with a probing depth of ≥5 mm (namely, the bleeding pockets [BPs]) at the completion of active periodontal therapy in subgroups with different rates of tooth loss (no tooth loss, <0.25 teeth per year, and ≥0.25 teeth per year), and change in alveolar bone levels (no change or gain, bone loss ≤0.05 mm per year, and bone loss ≥0.05 mm per year) during supportive periodontal therapy (SPT) (original reanalysis of data from Trombelli et al)…”

Section: Bleeding Pockets May Inform the Frequency Of Periodontal Recmentioning

confidence: 99%

“…Recently, a retrospective study of a cohort of 109 subjects with variable periodontal conditions who had undergone supportive periodontal therapy for a mean period of 5.6 years was evaluated . Periodontal risk following active periodontal treatment was evaluated according to PerioRisk .…”

Section: Tailoring Supportive Periodontal Therapy Using Risk Assessmementioning

confidence: 99%

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What periodontal recall interval is supported by evidence?

Trombelli

Simonelli

Franceschetti

et al. 2020

Periodontology 2000

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Recall sessions are an integral part of supportive periodontal therapy. The aim of the current article is to review the existing evidence to support if and to what extent a predefined frequency of periodontal recall sessions ensures periodontal health and stability. Factors that potentially affect the time interval for recall are described. Moreover, original data on the relevance of residual diseased sites (ie, bleeding pockets) at patient level to predict the progression of periodontitis are presented. Overall, wide heterogeneity was found in the published literature with regards to the proposed supportive periodontal therapy recall frequency once active periodontal therapy has been completed. Available data clearly show that a primary and secondary preventive regimen based on routine supportive periodontal therapy is beneficial to preserve a periodontally healthy dentition and prevent tooth loss. However, convincing evidence regarding the appropriateness, risk‐benefit, and cost‐effectiveness of different recall intervals is currently scarce. In patients affected by moderate to advanced periodontitis, a supportive periodontal therapy protocol based on a 2‐4 month recall interval appears reasonable. Limited data suggest that the amount/proportion of residual diseased sites (intended as pockets or bleeding pockets) and risk assessment tools may be of value in establishing the appropriate recall frequency.

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Section: Tailoring Supportive Periodontal Therapy Using Risk Assessmesupporting

confidence: 52%

Section: Bleeding Pockets May Inform the Frequency Of Periodontal Recmentioning

confidence: 84%

Section: Bleeding Pockets May Inform the Frequency Of Periodontal Recmentioning

confidence: 99%

Section: Bleeding Pockets May Inform the Frequency Of Periodontal Recmentioning

confidence: 99%

Section: Tailoring Supportive Periodontal Therapy Using Risk Assessmementioning

confidence: 99%

See 3 more Smart Citations

What periodontal recall interval is supported by evidence?

Trombelli

Simonelli

Franceschetti

et al. 2020

Periodontology 2000

Self Cite

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Long term comparison of the prognostic performance of PerioRisk, periodontal risk assessment, periodontal risk calculator, and staging and grading systems

Saleh

Dukka

Troiano

et al. 2021

Journal of Periodontology

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Background Clinicians predominantly use personal judgment for risk assessment. Periodontal risk assessment tools (PRATs) provide an effective and logical system to stratify patients based on their individual treatment needs. This retrospective longitudinal study aimed to validate the association of different risk categories of four PRATs (Staging and grading; Periodontal Risk Assessment (PRA); Periodontal Risk Calculator; and PerioRisk) with periodontal related tooth loss (TLP), and to compare their prognostic performance. Methods Data on medical history, smoking status, and clinical periodontal parameters were retrieved from patients who received surgical and non‐surgical periodontal treatment. A comparison of the rate of TLP and non‐periodontal related tooth loss (TLO) within the risk tool classes were performed by means of Kruskal‐Wallis test followed by post‐hoc comparison with the Bonferroni test. Both univariate and multivariate Cox Proportional hazard regression models were built to analyze the prognostic significance for each single risk assessment tool class on TLP. Results A total of 167 patients with 4321 teeth followed up for a mean period of 26 years were assigned to four PRATs. PerioRisk class 5 had a hazard ratio of 18.43, Stage 4 had a hazard ratio of 7.99, and PRA class 3 had a hazard ratio of 6.13 compared with class/stage I. With respect to prognostic performance, PerioRisk tool demonstrated the best discrimination and model fit followed by PRA. Conclusion All PRATs displayed very good predictive capability of TLP. PerioRisk showed the best discrimination and model fit, followed by PRA.

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Prognostic value of a composite outcome measure for periodontal stability following periodontal regenerative treatment: A retrospective analysis at 4 years

Simonelli

Farina

Minenna

et al. 2023

Journal of Periodontology

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BackgroundRecently, a composite outcome measure (COM) was proposed to describe the short‐term results of periodontal regenerative treatment. The present retrospective study aimed at evaluating the prognostic value of COM on clinical attachment level (CAL) change over a 4‐year period of supportive periodontal care (SPC).MethodsSeventy‐four intraosseous defects in 59 patients were evaluated at 6 months and 4 years following regenerative treatment. Based on 6‐month CAL change and probing depth (PD), defects were classified as: COM1 (CAL gain ≥3 mm, PD ≤4 mm); COM2 (CAL gain <3 mm, PD ≤4 mm); COM3 (CAL gain ≥3 mm, PD >4 mm); or COM4 (CAL gain <3 mm, PD >4 mm). COM groups were compared for “stability” (i.e., CAL gain, no change in CAL or CAL loss <1 mm) at 4 years. Also, groups were compared for mean change in PD and CAL, need for surgical retreatment, and tooth survival.ResultsAt 4 years, the proportion of stable defects in COM1, COM2, COM3, and COM4 group was 69.2%, 75%, 50%, and 28.6%, respectively, with a substantially higher probability for a defect to show stability for COM1, COM2, and COM3 compared with COM4 (odds ratio 4.6, 9.1, and 2.4, respectively). Although higher prevalence of surgical reinterventions and lower tooth survival were observed in COM4, no significant differences were detected among COM groups.ConclusionsCOM may be of value in predicting CAL change at sites undergoing SPC following periodontal regenerative surgery. Studies on larger cohorts, however, are needed to substantiate the present findings.

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Prognostic value of a simplified method for periodontal risk assessment during supportive periodontal therapy

Abstract: Periodontal risk assessment according to Perio Risk may help to identify patients at risk for tooth loss during SPT.

Cited by 26 publications

References 28 publications

What periodontal recall interval is supported by evidence?

What periodontal recall interval is supported by evidence?

Long term comparison of the prognostic performance of PerioRisk, periodontal risk assessment, periodontal risk calculator, and staging and grading systems

Prognostic value of a composite outcome measure for periodontal stability following periodontal regenerative treatment: A retrospective analysis at 4 years

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