Tooth loss in individuals under periodontal maintenance therapy: prospective study

Abstract

This prospective study aimed to evaluate the incidence, the underlying reasons, and the influence of predictors of risk for the occurrence of tooth loss (TL) in a program of Periodontal Maintenance Therapy (PMT). The sample was composed of 150 complier individuals diagnosed with chronic moderate-severe periodontitis who had finished active periodontal treatment and were incorporated in a program of PMT. Social, demographic, behavioral and biological variables were collected at quarterly recalls, over a 12-month period. The effect of predictors of risk of and confounding for the dependent variable TL was tested by univariate and multivariate analysis, as well as the underlying reasons and the types of teeth lost. During the monitoring period, there was a considerable improvement in periodontal clinical parameters, with a stability of periodontal status in the majority of individuals. Twenty-eight subjects (18.66%) had TL, totaling 47 lost teeth (1.4%). The underlying reasons for TL were: periodontal disease (n = 34, 72.3%), caries (n = 3, 6.4%), prosthetic reasons (n = 9, 19.2%), and endodontic reasons (n = 1, 2.1%). Additionally, subjects with 10% of sites with probing depth between 4 and 6 mm were 5 times more likely to present TL (OR = 5.13, 95% CI 2.04-12.09). In this study, the incidence of TL was small and limited to few individuals. Additionally, gender and severity of periodontitis were significantly associated with TL during the monitoring period.

Chronic stress associated to contraceptives use on the progression of ligature-induced periodontitis in rats

“…Periodontitis is an inflammatory disease of infectious origin and is directly connected to environmental and internal risk factors, such as hormones, which gives plausibility to this study 4,16 . Associations between stress, i.e., cortisol hormone from the posterior portion of the pituitary gland, and estradiol-based contraceptive use, i.e., natural sex hormones from gonadotropins (luteinizing and follicle-stimulating hormone) originating from the anterior portion of the same gland, with the progression of periodontal disease were determined in this study 16,17 .…”

“…The long experimental period may have influenced the results 2 . This period was chosen based on the assumption that periodontitis is a chronic disease 4 and on the fact that hormonal changes combined with stress and contraceptive therapy could have synergistic effects over a shorter period of time 5 . After 15 days, the effects of disease progression are likely to be identified.…”

“…In periodontal disease, stress is considered an environmental factor that can modify the response to microorganisms 4 . It is believed that the mechanism that leads to the progression of periodontitis is associated with stress-induced changes and stimuli of hypothalamic-pituitary-adrenal (HPA) axis, which affects and modifies the body's defense system.…”

Mouthrinse recommendation for prosthodontic patients

“…2 Specifically in regard to Brazil, this explains the high rates of partial tooth loss, even in young populations 3,4 and edentulous subjects, a loss that becomes a reality in elder age groups. 5 In addition, recent government measures have led to the dissemination of prostheses in our country.…”

Number of Non-vital Teeth as Indicator of Tooth Loss during 10-year Maintenance: A Retrospective Study

“…Number of PT 20) , smoking status 5) , and periodontal disease 14) are associated with tooth loss during maintenance. Therefore, these factors were selected as confounding factors.…”