Surgical and Non-Surgical Procedures Associated with Recurrence of Periodontitis in Periodontal Maintenance Therapy: 5-Year Prospective Study

Abstract

Background and ObjectiveProspective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT.Materials and MethodsA total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression.ResultsRecurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT.ConclusionsIrregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures.

Cumulative smoking exposure and cessation associated with the recurrence of periodontitis in periodontal maintenance therapy: A 6‐year follow‐up

“…There was a significant dose‐response relationship between pack‐years of smoking and the RP, as well as a significant decrease in the risk for the RP as the years of smoking cessation increased. Thus, results from the present study are consistent with the findings from previous studies in PMT that reported worse periodontal clinical conditions and greater RP in CS in relationship to FS and NS …”

“…PD changes were first retreated with non‐surgical procedures through mechanical subgingival debridement. After periodontal re‐evaluation (45 to 60 days), sites with persistent PD ≥ 5 mm and AL ≥ 3 mm underwent surgical procedures performed preferably by Widman modified flap surgery . After successful outcomes in surgical or non‐surgical periodontal therapy (absence of PD >4 mm without BOP and/or SU), patients were reincorporated into the PMT cohort.…”

Effect of compliance during periodontal maintenance therapy on levels of bacteria associated with periodontitis: A 6‐year prospective study

“…Clinical periodontal condition and tooth loss of this cohort (n = 212) in a 5‐year prospective study was previously reported in Costa et al . Thus, in the current study, according to the pattern of compliance during PMT visits, individuals from this cohort were classified as RC (n = 85 individuals who were 100% compliant for PMT visits, with a maximum between‐visit interval period of 6 months) or IC (n = 99 individuals who missed any of the PMT visits but continued to appear on an irregular basis, with a maximum between‐visit interval of 18 months) . A total of 28 individuals were lost to follow‐up during this 6‐year period.…”

“…Methodology for data collection and periodontal clinical procedures during all PMT visits were the same as reported by Lorentz et al . and Costa et al . During the PMT visits, the following procedures were performed: a) oral hygiene instructions; b) coronal prophylaxis and fluoride application; and c) mechanical non‐surgical or surgical debridement, when appropriate.…”

“…Studies have demonstrated that periodontitis can be successfully treated by both non‐surgical and surgical protocols . However, without a regular program of periodontal maintenance therapy (PMT) comprising periodic clinical re‐evaluations, adequate biofilm control, and oral hygiene reinforcements, the benefits of active periodontal therapy (APT) cannot be maintained .…”