Risk factors for tooth loss with a mean follow-up period of 13.9 years in supportive periodontal therapy patients

Abstract

Background Clinical evidence indicates that there are various risk factors of tooth loss. However, the degree of this risk among other risk factors remains unclear. In this retrospective cohort study, the authors evaluated the hazard ratios of several risk factors for tooth loss. Methods Included patients had all been treated for dental disorders, were in the supportive phase of periodontal therapy by dental hygienists, and visited a Japanese dental office continually during a 10-year period. Periodontal parameters, tooth condition, and general status of all teeth (excluding third molars) at the initial visit and at least 10 years later were evaluated by using multiple classification analysis. Results The authors evaluated a total of 7584 teeth in 297 patients (average age: 45.3, mean follow-up time: 13.9 years) Non-vital pulp was the most significant predictor of tooth loss according to Cox hazards regression analysis (hazard ratio: 3.31). The 10-year survival rate was approximately 90% for teeth with non-vital pulp and 99% for teeth with vital pulp. Fracture was the most common reason for tooth loss. Conclusions Non-vital pulp had the most significant association with tooth loss among the parameters. Therefore, it is very important to minimize dental pulp extirpation.

The loss of molars in supportive periodontal care: A 10‐year follow‐up for tooth‐ and patient‐related factors

“…Our findings show that smoking (HR = 3.73; p = .011) and diabetes (HR = 3.12; p = .022) are certainly potent risk factors related to LM. These findings are in accordance with previous studies with the same follow-up periods (Salvi et al, 2014;Dannewitz et al, 2016;Petsos et al, 2020;Kato et al, 2021). Hence, it seems that smoking is the most important factor to be addressed in SPC, as smokers lost more teeth irrespective of regular or irregular compliance (Costa et al, 2014;Nibali et al, 2016).…”

“…The following tooth-related factors were significant for LM: mean BoP, PD ≥5 mm, non-vital molars, and FI class II and III. Several studies have reported that the severity of periodontitis and worse periodontal parameters during or after APT were associated with LM (Dannewitz et al, 2006;Salvi et al, 2014;Dannewitz et al, 2016;Petsos et al, 2020;Kato et al, 2021), which were confirmed in our findings. Nevertheless, it is to be emphasized that they may be dependent on the effectiveness of APT and compliance during SPC (Huynh-Ba et al, 2009;Nibali et al, 2016).…”

“…Nevertheless, it is to be emphasized that they may be dependent on the effectiveness of APT and compliance during SPC (Huynh-Ba et al, 2009;Nibali et al, 2016). Another common factor reported for longitudinal LM is the non-vitality of the tooth (Faggion Jr et al, 2007;Graetz et al, 2015;Dannewitz et al, 2016;Kato et al, 2021). Our present study reported a strong impact of tooth vitality on LM (HR = 2.88; p < .001).…”

“…Several studies have reported how patient-and tooth-related factors contribute to TL or put certain teeth at risk during active periodontal therapy (APT) and SPC (Dannewitz et al, 2006;Faggion Jr et al, 2007;Eickholz et al, 2008;Costa et al, 2012;Costa et al, 2014;Dannewitz et al, 2016;Petsos et al, 2021). The following different factors at tooth level have been described: periodontal bone loss (Pretzl et al, 2008;Costa et al, 2012;Graetz et al, 2015), tooth mobility, degree of furcation involvement (FI) (Hamp et al, 1975;McGuire & Nunn 1996;Dannewitz et al, 2006;Park et al, 2009;Johansson et al, 2013;Dannewitz et al, 2016;Petsos et al, 2021), tooth type (Muzzi et al, 2006;Pretzl et al, 2008), and tooth vitality (Faggion Jr et al, 2007;Graetz et al, 2015;Kato et al, 2021). It is noteworthy that FI is a major predictor of tooth survival (Eickholz et al, 2008).…”

The survival of periodontally treated molars in long‐term maintenance: A systematic review and meta‐analysis

“…Other studies reported molar loss in general, which may have been extracted owing to the presence of apical lesions, root fractures or prosthodontic considerations, in addition to periodontal reasons. Endodontically treated molars tend to increase the endodontium‐related risk of loss (Kato et al, 2021; Kawahara et al, 2021). None of the included studies reported data on combined endo‐periodontal lesions, the clinical diagnosis and treatment of which continue to pose a challenge.…”