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

Costa, Fernando Oliveira; Cortelli, José Roberto; Cortelli, Sheila Cavalca; Costa, Amanda Almeida; Lima, Rafael Paschoal Esteves; Costa, Adriana Moreira; Pereira, Gustavo Henrique Mattos; Cota, Luís Otávio Miranda

doi:10.1111/jcpe.13585

Cited by 6 publications

(15 citation statements)

References 44 publications

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“…Factors associated with periodontitis progression were residual PPD 5–6 mm at the end of APT, furcation involvement, and maximum CAL = 6 mm (Table 4). These findings are largely consistent with existing literature (Matuliene et al, 2008; Graetz et al, 2015; Nibali et al, 2016, 2018; Costa et al, 2021) and clinical experience. Of note, tooth mobility, maximum PPD ≥7 mm, and maximum CAL ≥7 mm at the end of APT were associated with tooth loss but not periodontitis progression.…”

Section: Discussionsupporting

confidence: 91%

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Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy

Siow

Goh

Ong

et al. 2022

J Clinic Periodontology

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Aim The aim of this study was to investigate patient‐ and tooth‐level factors that may predict tooth loss and periodontitis progression in patients who have undergone at least 5 years of periodontal maintenance. Materials and Methods In this retrospective cohort study, 135 patients were examined after active periodontal therapy (APT) and periodontal maintenance for 5.09–8.65 years (mean 6.16 ± 0.74 years). Regression models were applied to identify risk factors associated with tooth loss and disease progression. Results Stage IV periodontitis (incidence rate ratio [IRR] = 4.61; 95% confidence interval, CI [2.97–7.18], p < .001), the presence of ≥5 sites with probing pocket depth (PPD) ≥5 mm at the end of APT (IRR = 2.04; 95% CI [1.32–3.20], p < .01), and residual PPD ≥7 mm at the end of APT (odds ratio [OR] = 3.01; 95% CI [1.14–7.94], p < .05) were risk factors for tooth loss. Residual PPDs of 5 mm (OR = 2.02; 95% CI [1.20–3.40], p < .01) and 6 mm (OR = 2.41; 95% CI [1.22–4.76], p < .05) at the end of APT were risk factors for disease progression. Above 3 mm, each 1 mm increase in maximum PPD/clinical attachment loss was associated with an increased risk of tooth loss and disease progression. Conclusions Stage IV periodontitis is associated with an increased risk of tooth loss. Teeth with PPD ≥5 mm at the end of APT are at risk of periodontitis progression or tooth loss.

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Section: Discussionsupporting

confidence: 91%

“…These findings are largely consistent with existing literature (Matuliene et al, 2008;Graetz et al, 2015;Nibali et al, 2016Nibali et al, , 2018Costa et al, 2021) and clinical experience. Of note, tooth mobility, maximum PPD ≥7 mm, and maximum CAL ≥7 mm at the end of APT were associated with tooth loss but not periodontitis progression.…”

Section: Discussionsupporting

confidence: 91%

Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy

Siow

Goh

Ong

et al. 2022

J Clinic Periodontology

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“…Data on cohort characteristics have been recently reported. 21 All participants underwent APT consisting of nonsurgical and/or surgical procedures (antibiotics were not used). Therefore, all participants entered the study with no persistent periodontal pockets.…”

Section: Study Design and Sampling Strategymentioning

confidence: 99%

“…[15][16][17] Thus, the evaluation of OH performance, motivation and re-instruction of OH practices are necessary for the long-term success of periodontal treatment [18][19][20] and must always be thoroughly reinforced at all PMT visits. 21 In recent years, periodontal literature has debated a list of true and surrogate endpoints for determining the success of periodontal intervention after APT, such as tooth loss, clinical attachment level (CAL), periodontal probing depth (PD), and patient-centered outcomes. [22][23][24] It has been argued that all periodontal treatment procedures for PE should aim to achieve low levels of bleeding on probing (BOP), for example, ≤15% of sites, shallow PD (≤4 mm), and absence of suppuration.…”

Section: Introductionmentioning

confidence: 99%

Effect of supragingival plaque control on recurrent periodontitis and clinical stability among individuals under periodontal maintenance therapy: 10‐year follow‐up

Costa

Cortelli

et al. 2022

Journal of Periodontology

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Background The aim of this study was to evaluate the effect of supragingival plaque control on the recurrence of periodontitis (RP) and the achievement of a stable periodontal clinical endpoint after 10 years of periodontal maintenance therapy (PMT). Methods The present retrospective cohort study included 225 individuals in continuous PMT. The plaque index (PI) determining the oral hygiene (OH) status, periodontal clinical parameters, and other variables of interest were collected at three time points: T1 (prior to active periodontal therapy [APT]), T2 (after APT), and T3 (10 years after T2). According to PI records at T3, participants were categorized into: (1) good OH (GOH; PI ≤ 30%, n = 63); (2) fair OH (FOH; PI > 30% and ≤40%, n = 73); and (3) poor OH (POH; PI > 40%, n = 88). Data were analyzed using the chi‐square and Student t tests, analysis of variance (ANOVA), and mediation and regression analyses. Results Significant differences in all periodontal clinical parameters between the GOH, FOH, and POH groups were observed at T3. The POH group exhibited higher mean bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL), as well as higher tooth loss (POH > FOH > GOH; P < .001). There was an increased risk for RP in the FOH (odds ratio [OR] 2.02; CI, 1.10‐4.38) and POH (OR 4.33; CI, 2.17‐8.65) groups. Moreover, the FOH and POH groups had an approximately 2.5 and 6.0 times greater chance of not achieving a stable periodontal clinical endpoint, respectively. Conclusions After 10 years of monitoring in PMT, individuals with higher PI scores (>30%) presented an unhealthier periodontal status, a higher risk for RP, and a lower chance of achieving ≤4 sites with PD ≥ 5 mm.

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“…Furthermore, previous studies have reported the relationship between poor metabolic control and the severity as well as the progression of PD [ 45 , 46 , 47 , 48 , 49 , 50 ]. Similarly to smoking, patients with poorly controlled DM display a poorer treatment outcome of periodontal treatment [ 51 ], whereas well-controlled diabetic patients and non-diabetic subjects have similar responses [ 52 , 53 , 54 ]. The interaction between DM and PD seems to be a “two-way street”: Just as an increased severity of periodontal tissue destruction is observed in subjects with DM, studies indicate a higher incidence of DM complications and poorer metabolic control of diabetes in PD patients [ 50 ].…”

Section: Introductionmentioning

confidence: 99%

A Tale of Two Fimbriae: How Invasion of Dendritic Cells by Porphyromonas gingivalis Disrupts DC Maturation and Depolarizes the T-Cell-Mediated Immune Response

2022

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Porphyromonas gingivalis (P. gingivalis) is a unique pathogen implicated in severe forms of periodontitis (PD), a disease that affects around 50% of the US population. P. gingivalis is equipped with a plethora of virulence factors that it uses to exploit its environment and survive. These include distinct fimbrial adhesins that enable it to bind to other microbes, colonize inflamed tissues, acquire nutrients, and invade cells of the stroma and immune system. Most notable for this review is its ability to invade dendritic cells (DCs), which bridge the innate and adaptive immune systems. This invasion process is tightly linked to the bridging functions of resultant DCs, in that it can disable (or stimulate) the maturation function of DCs and cytokines that are secreted. Maturation molecules (e.g., MHCII, CD80/CD86, CD40) and inflammatory cytokines (e.g., IL-1b, TNFa, IL-6) are essential signals for antigen presentation and for proliferation of effector T-cells such as Th17 cells. In this regard, the ability of P. gingivalis to coordinately regulate its expression of major (fimA) and minor (mfa-1) fimbriae under different environmental influences becomes highly relevant. This review will, therefore, focus on the immunoregulatory role of P. gingivalis fimbriae in the invasion of DCs, intracellular signaling, and functional outcomes such as alveolar bone loss and immune senescence.

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

Cited by 6 publications

References 44 publications

Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy

Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy

Effect of supragingival plaque control on recurrent periodontitis and clinical stability among individuals under periodontal maintenance therapy: 10‐year follow‐up

A Tale of Two Fimbriae: How Invasion of Dendritic Cells by Porphyromonas gingivalis Disrupts DC Maturation and Depolarizes the T-Cell-Mediated Immune Response

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