Prospective evaluation of periodontally diseased molars in smokers using the Miller–McEntire Periodontal Prognostic Index

Abstract

Background:The purpose of this 2-year prospective survival analysis study is to determine a statistically validated periodontal prognostic score for diseased molars in smokers using the Miller-McEntire Periodontal Prognostic Index (MMPPI).Materials and Methods:Two hundred molars were evaluated from 25 patients who were smokers with moderate-to-severe chronic periodontitis. The factors evaluated included age, probing depth, mobility, furcation involvement, smoking, and molar type. A modified, 5 level, scoring criterion for smoking based on smoking-dose was adopted. MMPPI was computed as the sum of scores for all six prognostic factors. Appropriate periodontal treatment and supportive periodontal therapy were provided. All patients were evaluated at baseline and 2 years posttreatment. Hazard risk ratio (HR) was computed for each prognostic factor.Results:A total of 3 (1.5%) teeth of the 200 molars were extracted over the 2-year follow-up duration, with a mean of 0.015 teeth lost. The HR was found as significantly higher for three individual prognostic factors: mobility (HR = 5.57, P = 0.02), smoking (HR = 3.35, P = 0.04), and furcation involvement (HR = 7.30, P = 0.01). Significant and positive HR (HR = 1.70, P = 0.01) was noted for the total MMPPI score, validating its prognostic value for molar survival at 2 years prospectively.Conclusions:The findings of the current study demonstrate the prognostic validity of MMPPI incorporating a more detailed smoking score criterion. The factors smoking, furcation involvement, and mobility significantly impacted the likelihood of survival of periodontally diseased molars. Further studies with a larger sample size and longer follow-up are required to confirm these findings.

lncRNA FGD5-AS1 and miR-130a Can Be Used for Prognosis Analysis of Patients with Chronic Periodontitis

“…We then explored the independent risk factors for poor prognosis of patients with chronic periodontitis and found that the higher the periodontal pockets, the higher the loss of attachment; lower FGD5-AS1 and higher miR-130a levels were independent risk factors for their prognosis. In previous studies, age, bone height, and periodontal pocket were mentioned as prognostic factors of patients [ 23 , 24 ], while our study first found that FGD5-AS1 and miR-130a were also independent prognostic factors of chronic periodontitis. Hence, in the future, we can predict the prognosis of patients through the levels of two indicators, so as to implement the corresponding treatment plans.…”

A 5-year prospective validation of the Miller–McEntire Periodontal Prognostic Index

“…A subsection of the patients from this cohort has been reported. [ 6 7 ] All study procedures were conducted after approval from the institutional ethics committee and have been described earlier, and written informed consent was obtained from all the 129 patients. [ 6 7 ] The sample size was computed assuming an expected event rate of tooth loss of 0.12 teeth/year, as reported for a periodontal maintenance group earlier, a planned follow-up period of 5 years, alpha = 0.05, and beta = 0.8.…”

“…[ 6 7 ] All study procedures were conducted after approval from the institutional ethics committee and have been described earlier, and written informed consent was obtained from all the 129 patients. [ 6 7 ] The sample size was computed assuming an expected event rate of tooth loss of 0.12 teeth/year, as reported for a periodontal maintenance group earlier, a planned follow-up period of 5 years, alpha = 0.05, and beta = 0.8. [ 8 ] At the end of the follow-up period, all patients exited by remaining in the regular periodontal maintenance program at the postgraduate periodontics clinics.…”

“…[ 2 ] Subsequent prospective studies validated the applicability of MMPPI index in both smoker and diabetic populations over 2 years. [ 6 7 ] In our previous study, the survival outcomes of 200 molar teeth for 2 years were assessed using this scoring system. Tooth-related prognostic factors such as furcation and mobility showed a significant and positive hazards ratio, predictive of molar tooth loss at 2 years.…”

“…[ 6 ] At the same time, diabetes mellitus (DM) showed an HR of 5.2 implying a five times greater risk for molar loss. [ 7 ] However, long-term outcomes in larger cohorts over a longer duration can further inform the validity of the MMPPI for clinical application. Hence, the present study was designed to prospectively assess the validity of the MMPPI in a large cohort over a period of 5 years.…”