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Chow DY, Tay JRH, Nascimento GG. Systematic Review of Prognosis Models in Predicting Tooth Loss in Periodontitis. J Dent Res 2024; 103:596-604. [PMID: 38726948 DOI: 10.1177/00220345241237448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024] Open
Abstract
This study reviews and appraises the methodological and reporting quality of prediction models for tooth loss in periodontitis patients, including the use of regression and machine learning models. Studies involving prediction modeling for tooth loss in periodontitis patients were screened. A search was performed in MEDLINE via PubMed, Embase, and CENTRAL up to 12 February 2022, with citation chasing. Studies exploring model development or external validation studies for models assessing tooth loss in periodontitis patients for clinical use at any time point, with all prediction horizons in English, were considered. Studies were excluded if models were not developed for use in periodontitis patients, were not developed or validated on any data set, predicted outcomes other than tooth loss, or were prognostic factor studies. The CHARMS checklist was used for data extraction, TRIPOD to assess reporting quality, and PROBAST to assess the risk of bias. In total, 4,661 records were screened, and 45 studies were included. Only 26 studies reported any kind of performance measure. The median C-statistic reported was 0.671 (range, 0.57-0.97). All studies were at a high risk of bias due to inappropriate handling of missing data (96%), inappropriate evaluation of model performance (92%), and lack of accounting for model overfitting in evaluating model performance (68%). Many models predicting tooth loss in periodontitis are available, but studies evaluating these models are at a high risk of bias. Model performance measures are likely to be overly optimistic and might not be replicated in clinical use. While this review is unable to recommend any model for clinical practice, it has collated the existing models and their model performance at external validation and their associated sample sizes, which would be helpful to identify promising models for future external validation studies.
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Affiliation(s)
- D Y Chow
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - J R H Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - G G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- ORH ACP, Duke-NUS Medical School Singapore, Singapore
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Peditto M, Rupe C, Gambino G, Di Martino M, Barbato L, Cairo F, Oteri G, Cavalcanti R. Influence of mobility on the long-term risk of tooth extraction/loss in periodontitis patients. A systematic review and meta-analysis. J Periodontal Res 2024. [PMID: 38766764 DOI: 10.1111/jre.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/22/2024]
Abstract
The aim of this systematic review (SR) was to assess whether tooth mobility (TM) increases the risk of tooth extraction/loss. The protocol was registered in PROSPERO database (CRD42023485425). The focused PECO questions were as follows: (1) "In patients with periodontitis, undergoing periodontal treatment, are teeth affected by mobility at higher risk of being extracted/lost compared to non-mobile teeth, with a minimum follow-up of 10 years?" and (2) "In these patients, does varying degrees of tooth mobility increase the risk of tooth extraction/loss, with a minimum follow-up of 10 years?". Results were reported according to PRISMA statement. Electronic and manual searches were conducted to identify longitudinal studies. The different assessments of tooth mobility were pooled into three groups: TM0: Undetectable tooth mobility, TM1: Horizontal/Mesio-distal mobility ≤1 mm, TM2: Horizontal/Mesio-distal mobility >1 mm or vertical tooth mobility. Tooth loss was the primary outcome. Various meta-analyses were conducted, including subgroup analyses considering different follow-up lengths and the timing of TM assessment, along with sensitivity analyses. A trial sequential analysis was also performed. Eleven studies were included (1883 patients). The mean follow-up range was 10-25 years. The weighted total of included teeth, based on the sample size, was 18 918, with a total of 1604 (8.47%) extracted/lost teeth. The overall rate of tooth extraction/loss increased with increasing mobility: TM0 was associated with a 5.85% rate (866/14822), TM1 with the 11.8% (384/3255), TM2 with the 40.3% (339/841). Mobile teeth (TM1/TM2) were at an increased risk for tooth extraction/loss, compared to TM0 (HR: 2.85; [95% CI 1.88-4.32]; p < .00001). TM1 had a higher risk than TM0 (HR: 1.96; [95% CI 1.09-3.53]; p < .00001). TM2 had a higher risk than TM1 (HR: 2.85; [95% CI 2.19-3.70]; p < .00001) and TM0 (HR: 7.12; [95% CI 3.27-15.51]; p < .00001). The results of the tests for subgroup differences were not significant. Sensitivity meta-analyses yielded consistent results with other meta-analyses. Within the limits of the quality of the studies included in the meta-analyses, mobile teeth were at higher risk of being extracted/lost in the long-term and higher degrees of TM significantly influenced clinicians' decision to extract a tooth. However, most teeth can be retained in the long-term and thus TM should not be considered a reason for extraction or a risk factor for tooth loss, regardless of the degree of TM.
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Affiliation(s)
- Matteo Peditto
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Cosimo Rupe
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Giorgia Gambino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Maria Di Martino
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Raffaele Cavalcanti
- Private Practice Bari, Bari, Italy
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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Ciardo A, Rampf S, Kim TS. Vital root resection with radicular retrograde partial pulpotomy in furcation-involved maxillary molars in patients with periodontitis: Technique description and case series considering clinical and economic aspects. Int Endod J 2024; 57:617-628. [PMID: 38306111 DOI: 10.1111/iej.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/03/2024]
Abstract
AIM Conventional root resection in periodontally compromised furcation-involved maxillary molars requires preceding endodontic treatment and is therefore associated with loss of tooth vitality, higher invasiveness, treatment time and costs, and the risk of endodontic complications. Vital root resection (VRR) could overcome these disadvantages while establishing stable periodontal and endodontic conditions. This case series aimed to introduce the concept of one-stage VRR with radicular retrograde partial pulpotomy (VRRretro). SUMMARY Seven vital maxillary molars with residual probing pocket depths (PPD) ≥ 6 mm and furcation ≥ class 2 of five patients with stage III/IV periodontitis were treated with VRRretro using mineral trioxide aggregate. Teeth with residual through-and-through furcations were additionally tunnelled. Follow-up up to 2.5 years postoperatively during supportive periodontal care included full periodontal status, percussion and thermal sensitivity testing. Periapical radiographs were obtained to rule out possible periradicular radiolucencies. All seven treated molars were in-situ at an average of 26.84 ± 5.37 months postoperatively and were clinically and radiographically inconspicuous independent of tooth position, the resected root, the need for tunnelling and the restorative status. The mean PPD on the seven treated molars was 4.02 ± 0.85 mm (6-10 mm) preoperatively and 2.62 ± 0.42 mm (3-4 mm) at the last follow-up. Clinical attachment level and bleeding on probing could also be decreased. The teeth showed no mobility over time and furcations class 2 were reduced to class 1 while the tunnelled furcations were accessible with interdental brushes. All molars reacted negatively to percussion and positively to thermal sensitivity testing. KEY LEARNING POINTS In carefully selected cases considering patient- and tooth-related factors, VRRretro could be a promising treatment option to establish stable periodontal and endodontic conditions in furcation-involved maxillary molars while preserving tooth vitality.
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Affiliation(s)
- Antonio Ciardo
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Sarah Rampf
- Section of Endodontology and Dental Traumatology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg University, Heidelberg, Germany
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Mitani AA, Feng X, Kaye EK. Modelling time-varying risk factors of tooth loss: Results from joint model compared with extended Cox regression model. J Clin Periodontol 2024; 51:110-117. [PMID: 37846605 DOI: 10.1111/jcpe.13888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/10/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023]
Abstract
AIM To illustrate the use of joint models (JMs) for longitudinal and survival data in estimating risk factors of tooth loss as a function of time-varying endogenous periodontal biomarkers (probing pocket depth [PPD], alveolar bone loss [ABL] and mobility [MOB]). MATERIALS AND METHODS We used data from the Veterans Affairs Dental Longitudinal Study, a longitudinal cohort study of over 30 years of follow-up. We compared the results from the JM with those from the extended Cox regression model which assumes that the time-varying covariates are exogenous. RESULTS Our results showed that PPD is an important risk factor of tooth loss, but each model produced different estimates of the hazard. In the tooth-level analysis, based on the JM, the hazard of tooth loss increased by 4.57 (95% confidence interval [CI]: 2.13-8.50) times for a 1-mm increase in maximum PPD, whereas based on the extended Cox model, the hazard of tooth loss increased by 1.60 (95% CI: 1.37-1.87) times. CONCLUSIONS JMs can incorporate time-varying periodontal biomarkers to estimate the hazard of tooth loss. As JMs are not commonly used in oral health research, we provide a comprehensive set of R codes and an example dataset to implement the method.
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Affiliation(s)
- Aya A Mitani
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Xinyang Feng
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth K Kaye
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
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Werner N, Heck K, Walter E, Ern C, Bumm CV, Folwaczny M. Probing pocket depth reduction after non-surgical periodontal therapy: Tooth-related factors. J Periodontol 2024; 95:29-39. [PMID: 37436696 DOI: 10.1002/jper.23-0285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND To investigate tooth-related factors that influence the reduction of probing pocket depths (PPD) after non-surgical periodontal therapy (NST). METHODS Seven hundred forty-six patients with a total of 16,825 teeth were included and retrospectively analyzed. PPD reduction after NST was correlated with the tooth-related factors; tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration; using logistic multilevel regression for statistical analysis. RESULTS NST was able to reduce probing depth overall stratified probing depths (1.20 ± 1.51 mm, p ≤ 0.001). The reduction was significantly higher at teeth with higher probing depths at baseline. At pockets with PPD ≥ 6 mm, PPD remains high after NST. Tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration are significantly and independently associated with the rate of pocket closure. CONCLUSIONS The tooth-related factors: tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration had a significant and clinically relevant influence on phase I and II therapy. Considering these factors in advance may enhance the prediction of sites not responding adequately and the potential need for additional treatment, such as re-instrumentation or periodontal surgery, to ultimately achieve the therapy end points.
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Affiliation(s)
- Nils Werner
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
| | - Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
| | - Elias Walter
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
| | | | - Caspar Victor Bumm
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
- Private practice, Munich, Germany
| | - Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
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Salvi GE, Roccuzzo A, Imber JC, Stähli A, Klinge B, Lang NP. Clinical periodontal diagnosis. Periodontol 2000 2023. [PMID: 37452444 DOI: 10.1111/prd.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 03/14/2023] [Indexed: 07/18/2023]
Abstract
Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Wada J, Wada K, Uctasli S, Wakabayashi N, Iwamoto T, Vallittu PK, Lassila L. Effect of splinting material type and location on resistance against deflection force of splinted periodontally compromised teeth with hypermobility. J Mech Behav Biomed Mater 2023; 142:105873. [PMID: 37119722 DOI: 10.1016/j.jmbbm.2023.105873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
This study aimed to evaluate the effect of splinting material type and material location on the force resistance of splinted periodontally compromised teeth with hypermobility. Extracted teeth including the target tooth (maxillary second premolar) and its adjacent teeth were placed into the alveolar sockets of a dental arch model via artificial periodontal ligaments made of elastic impression material. Three different experimental models with varied target tooth mobility including Periotest® values (PTVs) of 20, 30, and 40 were fabricated (named models #20, #30, and #40, respectively). For each experimental model, the force resistance of tooth splinting was tested using the following four materials: everStick PERIO (glass fiber reinforcement: GFR), FORESTAFLEX (braided stainless steel: BSS), Ortho-FlexTech (stainless steel chain: SSC), and Super-Bond (MMA-based resin cement: MRC). The evaluated measures were the PTV after tooth splinting and the required load to cause tooth displacements of 0.05 mm and 0.10 mm in the vertical and lateral directions, respectively. The splinting material type and material location as well as the original PTV of target the tooth significantly affected all the evaluated measures (p < 0.001). MRC revealed the significantly highest force resistance of tooth splinting regardless of material location in each experimental model and was followed by GFR. The PTVs of splinted teeth were comparable to those of adjacent anchor teeth in models #20 and #30 when using GFR, while that was comparable in model #40 when using MRC. Meanwhile, the load causing certain tooth displacement showed a similar tendency to previous-reported data with healthy teeth in model #20 when using GFR, while that showed a similar tendency in models #30 and #40 when using MRC. Overall results concluded that splinting material type and location play a role in the resistance against the deflection force of splinted periodontally compromised hypermobile tooth. It was noted that MRC provided the highest resistance against the deflection force of splinted teeth regardless of material location whereas GFR maintained the physiologically considered tooth mobility.
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Affiliation(s)
- Junichiro Wada
- Department of Biomaterials Science, Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B, Turku, 20520, Finland; Department of Advanced Prosthodontics, Tokyo Medical and Dental University - TMDU, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Kanae Wada
- Department of Biomaterials Science, Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B, Turku, 20520, Finland; Department of Pediatric Dentistry/Special Needs Dentistry, Tokyo Medical and Dental University - TMDU, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Sadullah Uctasli
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, 06790, Ankara, Turkey
| | - Noriyuki Wakabayashi
- Department of Advanced Prosthodontics, Tokyo Medical and Dental University - TMDU, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Tsutomu Iwamoto
- Department of Pediatric Dentistry/Special Needs Dentistry, Tokyo Medical and Dental University - TMDU, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Pekka K Vallittu
- Department of Biomaterials Science, Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B, Turku, 20520, Finland; Wellbeing Services County of South-West Finland, Lemminkäisenkatu 23, 20520, Turku, Finland
| | - Lippo Lassila
- Department of Biomaterials Science, Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B, Turku, 20520, Finland
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Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review. J Funct Biomater 2023; 14:jfb14030142. [PMID: 36976066 PMCID: PMC10055991 DOI: 10.3390/jfb14030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more “simplified approach” based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.
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Jepsen K, Jervøe-Storm PM, Henrichs I, Lensing I, Müller AL, Cosgarea R, Keilig L, Bourauel C, Jepsen S. Biomechanical properties of periodontal tissues in non-periodontitis and periodontitis patients assessed with an intraoral computerized electronic measurement device. Clin Oral Investig 2023; 27:797-805. [PMID: 36625961 PMCID: PMC9889448 DOI: 10.1007/s00784-023-04859-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To identify tooth mobility (TM) by time-dependent tooth displacement using an electronic intra-oral loading device (ILD) in periodontally healthy and periodontally compromised patients. MATERIALS AND METHODS Twenty-eight untreated periodontitis and 20 periodontally healthy patients [25 female and 26 male; ages: 20-81 years], contributing with 68 teeth (periodontitis: nteeth = 28; non-periodontitis: nteeth = 40), participated in the study. TM was measured in vivo by displacing central or lateral incisors to a maximum of 0.2 mm orally over durations of 0.5 s, 1 s, and 10 s with the ILD. The maximum force (Fmax) was extracted from the measured force/deflection curves for every single measurement. RESULTS Differences in TM-ILD values were found for periodontitis as compared to non-periodontitis patients derived from the same loading durations (differences of 3.9 (0.5 s), 3.1 (1 s), 2.8 (10 s), (95% CI for 0.5 s (1.2-6.7), p = 0.024; 1 s (1.4-6.0), p = 0.067; 10 s (0.2-5.3), p = 0.001), rejecting the null hypothesis of no difference (T-test) for durations of 0.5 and 10 s. There was a significant correlation of TM-ILD (Fmax) with BOP at 0.5 s (- 0.52) and with attachment loss at all time durations (- 0.47 at 0.5 s; - 0.57 at 1 s; - 0.47 at 10 s). CONCLUSIONS This clinical investigation could demonstrate that time-dependent tooth displacements using a new computerized electronic device were associated with attachment loss and bleeding on probing. CLINICAL RELEVANCE ILD can improve the monitoring of tooth mobility, as TM-ILD values reflect qualitative (inflammatory status interpreted by BOP) and quantitative parameters (interpreted as the amount of CAL loss) of periodontal disease.
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Affiliation(s)
- Karin Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany.
| | - Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Isabel Henrichs
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Ina Lensing
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Alja Larissa Müller
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
- Clinic for Periodontology and Peri-Implant Diseases, Philipps University Marburg, Marburg, Germany
- Clinic of Prosthodontics, Iuliu Hatieganu University Cluj-Napoca, Cluj-Napoca-Napoca, Romania
| | - Ludger Keilig
- Oral Technology, University Hospital Bonn, Bonn, Germany
- Department of Dental Prosthetics, Propaedeutics and Materials Science, University Hospital Bonn, Bonn, Germany
| | | | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
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Rădulescu V, Boariu M, Rusu D, Boldeanu C, Christodorescu R, Roman A, Surlin P, Didilescu AC, Vela O, Kardaras G, Veja I, Martu I, Stratul SI. Is the Diagnosis of Generalized Stage IV (Severe) Periodontitis Compatible with the Survival of Extended Stabilizing Prosthetic Restorations? A Medium-Term Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12123053. [PMID: 36553060 PMCID: PMC9776696 DOI: 10.3390/diagnostics12123053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of the study was to identify the most relevant patient-related factors directly involved (alone or in combinations) in the long-term survival and functionality of the abutment teeth of extensive stabilizing bridges and removable prosthesis, in patients treated for Stage IV periodontitis, adhering to SPT over a period of at least 5 years. Seventy-six patients treated between 2000-2022, rehabilitated with FDPs and RDPs, adhering to SPT for at least 5 years were included. Patient-related factors influencing retention of RDPs and FDP, survival rates in regular (RCs) and irregular compliers (ICs), and incidence of biological and technical complications were assessed. During a follow-up of 69 months, from 57 patients with FDPs and 19 patients with RDPs, 39 (51.32%) were ICs, while 37 (48.68%) were RCs. An overall statistically significant association (p = 0.04) was identified between biological complications and the type of prostheses. The RDP patients had more complications than FDP patients. In 5.26% of the RDP patients, root caries were identified, and 10.53% were diagnosed with a periapical (endodontic) lesion, while 3.51% of the FDPS patients presented root caries. In five (6.57%) cases, abutment loss resulted in the loss of the prosthesis. Statistically significant correlations were observed between systemic diseases and tooth loss, and between type of tooth lost and the reason for tooth loss, irrespective of the type of prosthesis. A total of 66.67% of the lost incisors, 85.71% of the lost premolars, and 88.89% of the lost molars occurred due to periodontal causes. Furthermore, 93% of the FDPs and RDPs were still in place and in function.
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Affiliation(s)
- Viorelia Rădulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Camelia Boldeanu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ruxandra Christodorescu
- Department V Internal Medicine, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: ; Tel.: +40-744641279
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Applicative Periodontal Regeneration Research Unit, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Andreea Cristiana Didilescu
- Department of Embryology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Giorgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Veja
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Martu
- Department of Dental Technology, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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11
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Jolivet G, Huck O, Petit C. Evaluation of furcation involvement with diagnostic imaging methods: a systematic review. Dentomaxillofac Radiol 2022; 51:20210529. [PMID: 35787071 PMCID: PMC9717400 DOI: 10.1259/dmfr.20210529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/09/2022] [Accepted: 07/01/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Multirooted teeth respond less favorably to non-surgical periodontal treatment and long-term tooth prognosis is influenced by the degree of furcation involvement (FI). Therapeutic strategy for multirooted teeth is essentially based on accurate diagnosis of the FI. The aim of this systematic review is to evaluate the accuracy of the different furcation assessment methods and to determine if radiographic help is needed to determine early stage of FI. METHODS Electronic databases were searched up to March 2021. Comparative studies describing the reliability of different clinical and/or radiological furcation assessment methods were identified. RESULTS A total of 22 studies comparing at least 2 furcation assessment methods, among which 15 retrospective studies, 5 prospective studies, 1 randomized controlled trial and 1 case series, were included in this review. The reliability of cone beam CT (CBCT), intraoral radiographs (IOs), orthopantomograms (OPGs) and MRI to identify FI was evaluated. Using OFS as a reference for FI detection and diagnosis, agreement ranged from 43.3 to 63% for OPG, 38.7 to 83.1% for IO and 82.4 to 84% for CBCT. The validity of the measurements was mainly influenced by the location of the furcation entrance. For radiological diagnosis, CBCT displayed the closest agreement with OFS while the accuracy of IO and OPG showed modest agreement and were influenced by the examiner's experience. CONCLUSION Altogether, it appears that the use of IO, OPG or CBCT allows detection of FI but could not be considered as gold-standard techniques.
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12
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Costa FO, Cortelli JR, Cortelli SC, Costa AA, Esteves Lima RP, Costa AM, Pereira GHM, Cota LOM. The loss of molars in supportive periodontal care: a 10-year follow-up for tooth- and patient-related factors. J Clin Periodontol 2021; 49:292-300. [PMID: 34905803 DOI: 10.1111/jcpe.13585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
AIM Determining the impact of the degree of furcation involvement (FI) on the longevity of molar teeth and assessing risk variables (tooth- and patients-related factors) associated with loss of molars (LM) in individuals treated for periodontitis and monitored in a private program of supportive periodontal care (SPC). MATERIALS AND METHODS The present retrospective cohort study included 222 individuals with 1,329 molars under a 10-year monitoring period in SPC. Periodontal clinical parameters, FI, type of molar, pulp vitality and other variables of interest were colleted at approximately 50 days after active periodontal therapy and after 10 years. The association of tooth- and patients-related factors with LM was assessed using a multilevel Cox regression analysis. RESULTS 235 molars were extracted during the SPC period of 12.4(±1.9) years. Age >50 years old, male gender, diabetes, smoking and no compliance were identified as relevant patient-related factors for LM during SPC (p<0.05). Significant tooth-related factors for LM were bleeding on probing (BOP) and probing depth (PD) ≥5mm, tooth non-vitality and class II and III FI (p<0.05). CONCLUSIONS Class III FI, tooth non-vitality, higher mean PD and BOP, age, male gender, diabetes and smoking all strongly influenced the prognosis of molars during SPC. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Roberto Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Sheila Cavalca Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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13
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Cimões R, Pinho RCM, Gurgel BCDV, Borges SB, Marcantonio Júnior E, Marcantonio CC, Melo MARDC, Piattelli A, Shibli JA. Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation. Braz Oral Res 2021; 35:e101. [PMID: 34586215 DOI: 10.1590/1807-3107bor-2021.vol35.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 01/21/2023] Open
Abstract
When periodontal disease is diagnosed, it is difficult to predict the clinical response of treatment of a tooth over time because the result of treatment is affected by several factors and will depend on the maintenance and support of periodontal treatment. Rehabilitation with removable dental prostheses, fixed prostheses, and dental implants makes it possible to restore the function and esthetics of patients with tooth loss due to periodontal disease. The predictive factors of tooth loss in periodontitis patients should be assessed by dentists to inform their clinical decision-making during dental treatment planning. This will provide detailed individualized information and level of risk of patients considered suitable for dental rehabilitation. Therefore, the aim of this article was to review the subject of "Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation" and the effect of fixed, removable, and implant-supported prostheses in periodontal patients.
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Affiliation(s)
- Renata Cimões
- Universidade Federal de Pernambuco - UFPE, Health Sciences Centre, Department of Prosthesis and Oral and Maxillofacial Surgery, Recife, PE, Brazil
| | | | | | - Samuel Batista Borges
- Universidade Federal do Rio Grande do Norte - UFRN, Health Sciences Centre, Department of Dentistry, Natal, RN Brazil
| | - Elcio Marcantonio Júnior
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Camila Chierici Marcantonio
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | | | - Adriano Piattelli
- University of Chieti, Dental School, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy
| | - Jamil Awad Shibli
- Universidade de Guarulhos - UnG, Dental Research Division, Department of Periodontology and Oral Implantology, Guarulhos, SP, Brazil
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14
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Al-Harthi S, Barbagallo G, Psaila A, d'Urso U, Nibali L. Tooth loss and radiographic bone loss in patients without regular supportive care: A retrospective study. J Periodontol 2021; 93:354-363. [PMID: 34564843 DOI: 10.1002/jper.21-0415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Very few studies have investigated the effect of patient and site factors on periodontal progression and long-term tooth loss in populations with minimal dental care. The aim of this retrospective study was to assess tooth loss and radiographic bone loss over at least 5 years in patients attending a national-health service primary care practice in Sicily and undergoing no regular care. METHODS Records of two hundred consecutive patients with at least 5 years follow-up were screened and demographic, clinical and radiographic data were retrieved. Analyses of associations between patient and site factors and tooth loss were performed. RESULTS After excluding not suitable patients, a total of 159 patient records with clinical and radiographic data with average 8.6 years follow-up were included. One hundred of these patients had no professional mechanical plaque removal (PMPR) carried out throughout the study follow-up. Nearly 65% of patients lost at least 1 tooth during the follow-up period, with a total of 400 extracted teeth (for periodontal and non-periodontal reasons). The annual tooth loss rate was slightly higher for "no PMPR" (untreated) patients (0.30 teeth/patient/year) compared with patients who had PMPR (0.27 teeth/patient/year). On a patient-level, only reduced frequency of daily tooth brushing was associated with tooth loss at logistic regression, whereas staging, grading and diagnosis of caries were associated with rates of tooth loss/year. At multilevel analysis including patient- and tooth-factors, age, diagnosis of caries and endodontic disease and percentage of bone loss at baseline were associated with tooth loss. CONCLUSION This study confirms the importance of tooth brushing, initial bone loss, caries and endodontic disease in predicting tooth survival in a primary care setting.
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Affiliation(s)
- Shaima Al-Harthi
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Giovanni Barbagallo
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Alessandro Psaila
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Umberto d'Urso
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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15
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Saleh MHA, Dukka H, Troiano G, Ravidà A, Galli M, Qazi M, Greenwell H, Wang HL. External validation and comparison of the predictive performance of 10 different tooth-level prognostic systems. J Clin Periodontol 2021; 48:1421-1429. [PMID: 34472120 DOI: 10.1111/jcpe.13542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/15/2021] [Indexed: 12/21/2022]
Abstract
AIM Tooth-level prognostic systems can be used for treatment planning and risk assessment. This retrospective longitudinal study aimed to evaluate the prognostic performance of 10 different tooth-level risk assessment systems in terms of their ability to predict periodontal-related tooth loss (TLP). MATERIALS AND METHODS Data were retrieved retrospectively from patients who received surgical and non-surgical periodontal treatment. Data on medical history and smoking status at baseline and the last maintenance visit were collected. Ten tooth-level prognostic systems were compared using both univariate and multivariate Cox proportional hazard regression models to analyse the prognostic capability of each system for predicting TLP risk. RESULTS One-hundred and forty-eight patients with 3787 teeth, followed-up for a mean period of 26.5 ± 7.4 years, were evaluated according to 10 different tooth-level prognostic systems, making up a total of 37,870 individual measurements. All compared prognostic systems were able to stratify the risk of TLP at baseline when different classes of association were compared. After controlling for maintenance, age, and gender, all systems exhibited excellent predictive capacity for TLP with no system scoring a Harrell's C-index less than 0.925. CONCLUSIONS All tooth-level prognostic systems displayed excellent predictive capability for TLP. Overall, the Miller and McEntire system may have shown the best discrimination and model fit, followed by the Nunn et al. system.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Himabindu Dukka
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Musa Qazi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Henry Greenwell
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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16
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Rahim-Wöstefeld S, Kronsteiner D, ElSayed S, ElSayed N, Eickholz P, Pretzl B. Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy. Clin Oral Investig 2021; 26:813-822. [PMID: 34435251 PMCID: PMC8791882 DOI: 10.1007/s00784-021-04060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/27/2021] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.
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Affiliation(s)
- Sonja Rahim-Wöstefeld
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany.
- Private Practice, 68159, Mannheim, Germany.
| | - Dorothea Kronsteiner
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Shirin ElSayed
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Nihad ElSayed
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, 60596, Frankfurt, Germany
| | - Bernadette Pretzl
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany
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17
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Junge T, Topoll H, Eickholz P, Petsos H. Retrospective long-term analysis of tooth loss over 20 years in a specialist practice setting: Periodontally healthy/gingivitis and compromised patients. J Clin Periodontol 2021; 48:1356-1366. [PMID: 34251030 DOI: 10.1111/jcpe.13520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/26/2021] [Accepted: 07/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess tooth loss (TL) in initially periodontally healthy/gingivitis (PHG) and periodontally compromised (PC) individuals during a 15- to 25-year follow-up in a specialist practice and to identify the factors influencing TL. MATERIALS AND METHODS Patients were re-examined 240 ± 60 months after active periodontal therapy (PC) or initial examination (PHG). PHG patients were periodontally healthy or had gingivitis, and PC patients exhibited at least stage II periodontitis. TL, patient-related outcomes, and risk factors for TL were assessed at the patient level (group-relation, gender, age, smoking, bleeding on probing, educational status, mean number of visits/year). RESULTS Fifty-six PC patients receiving regular supportive periodontal care (12 female, mean age 49.1 ± 10.9 years, stage II: 10, stage III/IV: 46) lost 38 teeth (0.03 ± 0.05 teeth/year). Fifty-one PHG patients (23 female, mean age 34.5 ± 12.4 years) following regular oral prevention lost 39 teeth (0.04 ± 0.05 teeth/year) (p = .631). Both PC and PHG groups did not show any significant differences regarding visual analogue scale measurements [aesthetics (p = .309), chewing function (p = .362), hygiene (p = .989)] and overall Oral Health Impact Profile (p = .484). Age at the start of follow-up was identified as a risk factor for TL (p < .0001). CONCLUSION PC and PHG patients exhibited similarly small TL rates over 240 ± 60 months, which should, however, be interpreted with caution in view of the group heterogeneity. Clinical trial number: DRKS00018840 (URL: https://drks.de).
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Affiliation(s)
| | - Heinz Topoll
- Private Practice, Münster, Germany.,Department of Periodontology, University Hospital Münster, Münster, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Hari Petsos
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.,Private Practice, Soest, Germany
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18
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Probst M, Burian E, Robl T, Weidlich D, Karampinos D, Brunner T, Zimmer C, Probst FA, Folwaczny M. Magnetic resonance imaging as a diagnostic tool for periodontal disease: A prospective study with correlation to standard clinical findings-Is there added value? J Clin Periodontol 2021; 48:929-948. [PMID: 33745132 DOI: 10.1111/jcpe.13458] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the correlation between standard clinical findings, radiographic (OPT) and magnetic resonance imaging (MRI) as well as to assess whether MRI is capable of providing additional information related to the severity and extent of periodontal disease. METHODS 42 patients with generalized periodontitis received pre-interventional MRI scans. These were compared to MR images of a periodontal healthy control group (n = 34). The extent of the osseous oedema, detected by MRI, was set in correlation with clinical periodontitis-associated findings. RESULTS A highly significant correlation between bone oedema and clinical testings such as probing depth (p < 0.0001) and bleeding on probing (p < 0.0001) was revealed. The oedema exceeded the extent of demineralized bone. Patients with a positive BOP test showed a 2.51-fold increase in risk of already having a bone oedema around the respective tooth even if probing depth was ≤3 mm (logistic binary regression analysis, OR 2.51; 95% CI: 1.54-4.11; p < 0.0001). CONCLUSION MRI findings correlated with standard clinical findings, and MRI was able to depict intraosseous changes before any osseous defect had occurred.
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Affiliation(s)
- Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Teresa Robl
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Dimitrios Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Teresa Brunner
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Florian Andreas Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
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Kato T, Fujiwara N, Ogawa T, Numabe Y. Risk factors for tooth loss with a mean follow-up period of 13.9 years in supportive periodontal therapy patients. BMC Oral Health 2021; 21:202. [PMID: 33888123 PMCID: PMC8063418 DOI: 10.1186/s12903-021-01573-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 04/13/2021] [Indexed: 12/23/2022] Open
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.
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Affiliation(s)
- Tomotaka Kato
- Division of General Dentistry, Nippon Dental University Hospital, 2-3-16 Fujimi Chiyoda-ku, Tokyo, Japan.
| | | | - Tomohisa Ogawa
- Division of General Dentistry, Nippon Dental University Hospital, 2-3-16 Fujimi Chiyoda-ku, Tokyo, Japan
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
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20
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Association, prediction, generalizability: Cross-center validity of predicting tooth loss in periodontitis patients. J Dent 2021; 109:103662. [PMID: 33857544 DOI: 10.1016/j.jdent.2021.103662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/24/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To predict patients' tooth loss during supportive periodontal therapy across four German university centers. METHODS Tooth loss in 897 patients in four centers (Kiel (KI) n = 391; Greifswald (GW) n = 282; Heidelberg (HD) n = 175; Frankfurt/Main (F) n = 49) during supportive periodontal therapy (SPT) was assessed. Our outcome was annualized tooth loss per patient. Multivariable linear regression models were built on data of 75 % of patients from one center and used for predictions on the remaining 25 % of this center and 100 % of data from the other three centers. The prediction error was assessed as root-mean-squared-error (RMSE), i.e., the deviation of predicted from actually lost teeth per patient and year. RESULTS Annualized tooth loss/patient differed significantly between centers (between median 0.00 (interquartile interval: 0.00, 0.17) in GW and 0.09 (0.00, 0.19) in F, p = 0.001). Age, smoking status and number of teeth before SPT were significantly associated with tooth loss (p < 0.03). Prediction within centers showed RMSE of 0.14-0.30, and cross-center RMSE was 0.15-0.31. Predictions were more accurate in F and KI than in HD and GW, while the center on which the model was trained had a less consistent impact. No model showed useful predictive values. CONCLUSION While covariates were significantly associated with tooth loss in linear regression models, a clinically useful prediction was not possible with any of the models and generalizability was not given. Predictions were more accurate for certain centers. CLINICAL RELEVANCE Association should not be confused with predictive value: Despite significant associations of covariates with tooth loss, none of our models was useful for prediction. Usually, model accuracy was even lower when tested across centers, indicating low generalizability.
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21
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Loos BG, Needleman I. Endpoints of active periodontal therapy. J Clin Periodontol 2021; 47 Suppl 22:61-71. [PMID: 31912527 PMCID: PMC7670400 DOI: 10.1111/jcpe.13253] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/21/2019] [Accepted: 01/04/2020] [Indexed: 01/01/2023]
Abstract
Aim Position paper on endpoints of active periodontal therapy for designing treatment guidelines. The question was as follows: How are, for an individual patient, commonly applied periodontal probing measures—recorded after active periodontal therapy—related to (a) stability of clinical attachment level, (b) tooth survival, (c) need for re‐treatment or (d) oral health‐related quality of life. Methods A literature search was conducted in Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations and Daily <1946 to 07 June 2019>. Results A total of 94 papers were retrieved. From the literature search, it was found that periodontitis patients with a low proportion of deep residual pockets after active periodontal therapy are more likely to have stability of clinical attachment level over a follow‐up time of ≥1 year. Other supporting literature confirms this finding and additionally reports, at the patient level, that probing pocket depths ≥6 mm and bleeding on probing scores ≥30% are risks for tooth loss. There is lack of evidence that periodontal probing measures after completion of active periodontal treatment are tangible to the patient. Conclusions Based on literature and biological plausibility, it is reasonable to state that periodontitis patients with a low proportion of residual periodontal pockets and little inflammation are more likely to have stability of clinical attachment levels and less tooth loss over time. Guidelines for periodontal therapy should take into consideration (a) long‐term tangible patient outcomes, (b) that shallow pockets (≤4 mm) without bleeding on probing in patients with <30% bleeding sites are the best guarantee for the patient for stability of his/her periodontal attachment, (c) patient heterogeneity and patient changes in immune response over time, and (d) that treatment strategies include lifestyle changes of the patient. Long‐term large population‐based and practice‐based studies on the efficacy of periodontal therapies including both clinical and patient‐reported outcomes (PROs) need to be initiated, which include the understanding that periodontitis is a complex disease with variation of inflammatory responses due to environment, (epi)genetics, lifestyle and ageing. Involving people living with periodontitis as co‐researchers in the design of these studies would also help to improve their relevance.
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Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Ian Needleman
- Unit of Periodontology, University College London Eastman Dental Institute, London, UK
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Early Tooth Loss after Periodontal Diagnosis: Development and Validation of a Clinical Decision Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031363. [PMID: 33540933 PMCID: PMC7908103 DOI: 10.3390/ijerph18031363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/23/2021] [Accepted: 01/30/2021] [Indexed: 11/22/2022]
Abstract
The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at the university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% confidence interval (95% CI): 0.629–0.989) for the validation sample and 0.920 (95% CI: 0.891–0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.
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Rahim‐Wöstefeld S, El Sayed N, Weber D, Kaltschmitt J, Bäumer A, El‐Sayed S, Eickholz P, Pretzl B. Tooth‐related factors for tooth loss 20 years after active periodontal therapy–A partially prospective study. J Clin Periodontol 2020; 47:1227-1236. [DOI: 10.1111/jcpe.13348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/28/2020] [Accepted: 06/28/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Sonja Rahim‐Wöstefeld
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
| | - Nihad El Sayed
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
| | - Dorothea Weber
- Institute of Medical Biometry and Informatics (IMBI) University Hospital Heidelberg Heidelberg Germany
| | | | - Amelie Bäumer
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
- Private Practice Bielefeld Germany
| | - Shirin El‐Sayed
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
| | - Peter Eickholz
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main, Frankfurt Germany
| | - Bernadette Pretzl
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
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Raedel M, Noack B, Priess HW, Bohm S, Walter MH. Massive data analyses show negative impact of type 1 and 2 diabetes on the outcome of periodontal treatment. Clin Oral Investig 2020; 25:2037-2043. [PMID: 32820433 PMCID: PMC7966218 DOI: 10.1007/s00784-020-03512-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/06/2020] [Indexed: 11/25/2022]
Abstract
Objectives The aim was to evaluate the impact of diabetes on the outcome of periodontal treatment based on massive data analyses. Materials and methods Data originated from the database of a major German National Health Insurance. Patients who underwent periodontal treatment were allocated to four groups according to their medical condition: type 1 diabetes (D1), type 2 diabetes with the intake of oral anti-diabetics (D2M), type 2 diabetes without the intake of oral anti-diabetics (D2), and a control group without diabetes (ND). Four-year Kaplan-Meier survival analyses on the patient level and multivariate regression analyses were conducted for tooth extraction. Results Of 415,718 patients, 4139 matched the criteria for D1, 22,430 for D2M, and 23,576 for D2. At 4 years, the cumulative survival rate (no extraction) was 51.7% in the D1 group, 54.0% in the D2M group, and 57.7% in the D2 group. The ND control group had a significantly higher survival rate of 65.9% (P < 0.0001). In the multivariate analyses, both diabetes types were significantly associated with further tooth loss after periodontal treatment. Conclusions The diagnosis of diabetes type 1 or 2 seems to be associated with a higher risk of tooth loss after periodontal treatment. Clinical relevance The long-term prognosis of teeth in diabetes patients should be judged carefully.
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Affiliation(s)
- Michael Raedel
- Prosthodontics, Carl Gustav Carus Faculty of Medicine, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Barbara Noack
- Periodontics, Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | | | | | - Michael H Walter
- Prosthodontics, Carl Gustav Carus Faculty of Medicine, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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Shi S, Meng Y, Li W, Jiao J, Meng H, Feng X. A nomogram prediction for mandibular molar survival in Chinese patients with periodontitis: A 10-year retrospective cohort study. J Clin Periodontol 2020; 47:1121-1131. [PMID: 32645225 DOI: 10.1111/jcpe.13343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 11/27/2022]
Abstract
AIMS To develop a nomogram prediction model of mandibular molar survival by comprehensively analysing clinical and radiographic risk factors of mandibular molar loss. MATERIALS AND METHODS Four hundred and seventy-eight mandibular molars of 139 subjects who underwent non-surgical periodontal treatment were examined retrospectively within a mean follow-up period of 11.1 years. The association of risk factors including clinical and radiographic parameters with mandibular molar loss was assessed using univariate and multivariate Cox regression analyses. A nomogram prediction model was developed, and the validation and discriminatory ability of it were analysed. RESULTS Hundred and four molars were lost in this study. Probing depth (PD), attachment loss (AL), furcation involvement (FI), bleeding on probing (BOP), tooth mobility and radiographic bone loss were significantly associated with tooth loss (p < .01). A gradient effect of degree of FI on mandibular molar loss existed increasing from degree Ⅱ (HR = 2.37, 95% CI: 1.48, 3.79) to Ⅲ (HR = 5.61, 95% CI: 3.01, 10.45) versus none & degree Ⅰ. The area under the curve (AUC) of the model was 0.891. The calibration curve and decision curve analysis demonstrated good performance and high net benefit of nomogram, respectively. CONCLUSIONS A specific nomogram could be adopted to predict the mandibular molar survival and formulate tailored treatment plans in Chinese.
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Affiliation(s)
- Shuwen Shi
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yang Meng
- Department of Periodontology, Qingdao Municipal Hospital of Stomatology, Qingdao, China
| | - Wenjing Li
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jian Jiao
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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Supportive Implant Therapy (SIT): A Prospective 10-Year Study of Patient Compliance Rates and Impacting Factors. J Clin Med 2020; 9:jcm9061988. [PMID: 32630385 PMCID: PMC7357043 DOI: 10.3390/jcm9061988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/10/2020] [Accepted: 06/21/2020] [Indexed: 11/25/2022] Open
Abstract
The main objective of this study is to present patient compliance rates and influential factors for regular attendance in a systematic implant aftercare program (Supportive Implant Therapy; SIT) within a 10-year observation period. From 2005 to 2008, we identified 233 patients with 524 implants and implant-supported restorations at the study center. They had been instructed to attend an SIT program with 3-month recall intervals. A 2019 clinical prospective cohort study on 10-year compliance rates was performed. Data were assessed yearly in regression analyses to identify influential factors. Noncompliance rates increased during the period (4.8%, year 1; 39.7%, year 10). Total noncompliance was observed in four patients (1.7%) with 10 implants. “Age,” “Gender,” “Diabetes”, and “Surgical case complexity” showed no correlation with patient compliance. “Smoking” and “Cardiovascular diseases” significantly influenced patients in one of ten years, while “Number of implants per patient”, “Type of implant-supported prostheses”, and “Pre-existing experience in a prophylaxis program” reached significance after several years. When patients with implant-supported restorations are strongly recommended and frequently remotivated to comply with an SIT program with 3-month recall, an approximately 60% compliance rate after 10 years is achievable. Previous prophylaxis program experience, increased number of implants per patient, and removable implant-supported prostheses may be strong influential factors for increased patient compliance.
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Graetz C, Bäumer A, Eickholz P, Kocher T, Petsos H, Pretzl B, Schwendicke F, Holtfreter B. Long-term tooth retention in periodontitis patients in four German university centres. J Dent 2020; 94:103307. [DOI: 10.1016/j.jdent.2020.103307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/31/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
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Nagayama T, Wada J, Watanabe C, Murakami N, Takakusaki K, Uchida H, Utsumi M, Wakabayashi N. Influence of retainer and major connector designs of removable partial dentures on the stabilization of mobile teeth: A preliminary study. Dent Mater J 2020; 39:89-100. [PMID: 31582595 DOI: 10.4012/dmj.2018-272] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to investigate the influence of retainers and major connector designs on the stabilization of remaining mobile teeth using removable partial dentures (RPDs). We prepared experimental RPDs with several retainer designs and major connectors for lower Kennedy class I models. The simulated RPD insertion and removal test was conducted and retentive force and mobility of mobile remaining teeth with and without RPD placement were measured throughout a simulation test. Regardless of reduction of retentive force, the placement of RPDs using cast clasps and/or lingual plates resulted in reduced mobility of the remaining teeth than use of wrought wire clasps and/or lingual bars. The results suggested that cast clasps and lingual plates are effective for the stabilization of mobile, remaining teeth. Additionally, the stabilizing effect of RPD on abutment teeth was not diminished, despite decreases in retentive force.
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Affiliation(s)
- Tomiharu Nagayama
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU)
| | - Junichiro Wada
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU)
| | - Chie Watanabe
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU)
| | - Natsuko Murakami
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU)
| | - Kensuke Takakusaki
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU)
| | - Hirofumi Uchida
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU)
| | - Miona Utsumi
- School of Dentistry, Faculty of Dentistry, Tokyo Medical and Dental University (TMDU)
| | - Noriyuki Wakabayashi
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU)
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Ravidà A, Qazi M, Troiano G, Saleh MHA, Greenwell H, Kornman K, Wang H. Using periodontal staging and grading system as a prognostic factor for future tooth loss: A long‐term retrospective study. J Periodontol 2019; 91:454-461. [DOI: 10.1002/jper.19-0390] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/22/2019] [Accepted: 08/25/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
| | - Musa Qazi
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
| | - Giuseppe Troiano
- Department of Clinical and Experimental MedicineUniversity of Foggia Foggia Italy
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
- Department of PeriodonticsUniversity of Louisville School of Dentistry Louisville KY
| | - Henry Greenwell
- Department of PeriodonticsUniversity of Louisville School of Dentistry Louisville KY
| | - Kenneth Kornman
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
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Krois J, Graetz C, Holtfreter B, Brinkmann P, Kocher T, Schwendicke F. Evaluating Modeling and Validation Strategies for Tooth Loss. J Dent Res 2019; 98:1088-1095. [PMID: 31361174 PMCID: PMC6710618 DOI: 10.1177/0022034519864889] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Prediction models learn patterns from available data (training) and are then validated on new data (testing). Prediction modeling is increasingly common in dental research. We aimed to evaluate how different model development and validation steps affect the predictive performance of tooth loss prediction models of patients with periodontitis. Two independent cohorts (627 patients, 11,651 teeth) were followed over a mean ± SD 18.2 ± 5.6 y (Kiel cohort) and 6.6 ± 2.9 y (Greifswald cohort). Tooth loss and 10 patient- and tooth-level predictors were recorded. The impact of different model development and validation steps was evaluated: 1) model complexity (logistic regression, recursive partitioning, random forest, extreme gradient boosting), 2) sample size (full data set or 10%, 25%, or 75% of cases dropped at random), 3) prediction periods (maximum 10, 15, or 20 y or uncensored), and 4) validation schemes (internal or external by centers/time). Tooth loss was generally a rare event (880 teeth were lost). All models showed limited sensitivity but high specificity. Patients' age and tooth loss at baseline as well as probing pocket depths showed high variable importance. More complex models (random forest, extreme gradient boosting) had no consistent advantages over simpler ones (logistic regression, recursive partitioning). Internal validation (in sample) overestimated the predictive power (area under the curve up to 0.90), while external validation (out of sample) found lower areas under the curve (range 0.62 to 0.82). Reducing the sample size decreased the predictive power, particularly for more complex models. Censoring the prediction period had only limited impact. When the model was trained in one period and tested in another, model outcomes were similar to the base case, indicating temporal validation as a valid option. No model showed higher accuracy than the no-information rate. In conclusion, none of the developed models would be useful in a clinical setting, despite high accuracy. During modeling, rigorous development and external validation should be applied and reported accordingly.
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Affiliation(s)
- J Krois
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Graetz
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - B Holtfreter
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - P Brinkmann
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - T Kocher
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - F Schwendicke
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
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31
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Helal O, Göstemeyer G, Krois J, Fawzy El Sayed K, Graetz C, Schwendicke F. Predictors for tooth loss in periodontitis patients: Systematic review and meta-analysis. J Clin Periodontol 2019; 46:699-712. [PMID: 31025366 DOI: 10.1111/jcpe.13118] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/19/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023]
Abstract
AIM A range of predictors for tooth loss in periodontitis patients have been reported. We performed a systematic review and meta-analysis to assess the consistency and magnitude of any association between a total of 12 predictors and tooth loss. MATERIALS AND METHODS Medline/Embase/Central were searched for longitudinal studies investigating the association between predictors and tooth loss in periodontitis patients. Random-effects meta-analysis was performed, and study quality assessed. RESULTS Twenty studies (15,422 patients, mean follow-up: 12 years) were included. The mean annual tooth loss/patient was 0.12 (min./max: 0.01/0.36). Older patients (n = 8 studies; OR: 1.05, 95% CI: 1.03-1.08/year), non-compliant ones (n = 11; 1.51, 1.06-2.16), diabetics (n = 7; 1.80, 1.26-2.57), those with IL-1-polymorphism (n = 3; 1.80; 1.29-2.52) and smokers (n = 15; 1.98, 1.58-2.48) had a significantly higher risk of tooth loss. Teeth with bone loss (n = 3; 1.04, 1.03-1.05/%), high probing pocket depth (n = 6; 3.19, 1.70-5.98), mobility (n = 4; 3.71, 1.65-8.38) and molars (n = 4; 4.22, 2.12-8.39), especially with furcation involvement (n = 5; 2.68, 1.75-4.08) also showed higher risks. Gender (n = 16; 0.95, 0.86-1.05) and endodontic affection (n = 3; 3.62, 0.99-13.2) were not significantly associated with tooth loss. CONCLUSIONS Older, non-compliant, smoking or diabetic patients, and teeth with bone loss, high probing pocket depth, mobility, or molars, especially with furcation involvement showed higher risks of tooth loss.
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Affiliation(s)
- Omar Helal
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Karim Fawzy El Sayed
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.,Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo, Egypt
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
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Costa FO, Cortelli SC, Costa AA, Cyrino RM, Cortelli JR, Miranda Cota LO. Impact of compliance during periodontal maintenance therapy on oral health-related quality of life: A 6-year follow-up. J Dent 2019; 83:50-55. [PMID: 30831209 DOI: 10.1016/j.jdent.2019.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate the effects of compliance during periodontal maintenance therapy (PMT) in the oral impact on daily performance (OIDP) measures, as well as to determine and compare the periodontal condition of acceptable and irregular compliers. MATERIAL AND METHODS From a 6-year prospective cohort study with 268 individuals under PMT, 232 individuals had complete periodontal clinical data and OIDP questionnaires completed between T1 (data was recorded after the first PMT appointment) and T2 (final data at the last PMT appointment), were determined to be eligible. Individuals were divided into two groups: 124 acceptable compliers (AC) and 108 irregular compliers (IC). Full-mouth periodontal examination and questionnaires were evaluated in 2 times, at T1 and T2. RESULTS At T2, the periodontal status of the AC group was significantly better than the IC group. The IC group also presented with higher OIDP scores (63.31 ± 19.11) compared to the AC group (57.72 ± 15.30, p = 0.005). On analyzing the OIDP dimensions independently, both groups (AC and IC) presented with high scores in the functional, psychological and social performances; however, the impacts were significantly higher in IC group. CONCLUSION The AC group presented with better periodontal conditions and lower OIDP, compared to the IC group. The discomfort and dissatisfaction with appearance, showed more influence on these daily impacts. CLINICAL SIGNIFICANCE Acceptable compliers showed lower scores of OIDP when compared to erratic ones. Thus, clinicians could take the chance to gain advantage from the positive impacts of acceptable compliance in the OHRQL for subsequent patient-centred motivation during PMT.
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Affiliation(s)
- Fernando Oliveira Costa
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, Brazil.
| | - Amanda Almeida Costa
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil; Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, Brazil.
| | - Renata Magalhães Cyrino
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, Brazil.
| | - Luís Otávio Miranda Cota
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Hirata T, Fuchida S, Yamamoto T, Kudo C, Minabe M. Predictive factors for tooth loss during supportive periodontal therapy in patients with severe periodontitis: a Japanese multicenter study. BMC Oral Health 2019; 19:19. [PMID: 30646875 PMCID: PMC6334425 DOI: 10.1186/s12903-019-0712-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/04/2019] [Indexed: 01/09/2023] Open
Abstract
Background Supportive periodontal therapy (SPT) must take individual patient risk factors into account. We conducted a multicenter joint retrospective cohort study to investigate the value of modified periodontal risk assessment (MPRA) and therapy-resistant periodontitis (TRP) assessment as predictive factors for tooth loss due to periodontal disease in patients with severe periodontitis during SPT. Methods The subjects were 82 patients from 11 dental institutions who were diagnosed with severe periodontitis and continued SPT for at least 1 year (mean follow-up = 4.9 years) between 1981 and 2008. The outcome was tooth loss due to periodontal disease during SPT. The Cox proportional hazards model was used to analyze sex, age, diabetes status, smoking history, number of periodontal pockets measuring ≥6 mm, rate of bleeding on probing, bone loss/age ratio, number of teeth lost, MPRA, and TRP assessment as explanatory variables. Results Univariate analysis showed that loss of ≥8 teeth by the start of SPT [hazard ratio (HR) 2.86], MPRA score indicating moderate risk (HR 8.73) or high risk (HR 11.04), and TRP assessment as poor responsiveness to treatment (HR 2.79) were significantly associated with tooth loss (p < 0.05). In a model in which the explanatory variables of an association that was statistically significant were added simultaneously, the HR for poor responsiveness to treatment and ≥8 teeth lost was significant at 20.17 compared with patients whose TRP assessment indicated that they responded favorably to treatment and who had lost <8 teeth by the start of SPT. Conclusion MPRA and TRP assessment may be useful predictive factors for tooth loss due to periodontal disease during SPT in Japanese patients with severe periodontitis. Additionally, considering the number of teeth lost by the start of SPT in TRP assessment may improve its predictive accuracy.
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Affiliation(s)
- Takahisa Hirata
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Shinya Fuchida
- Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.
| | - Tatsuo Yamamoto
- Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Chieko Kudo
- Institute of Medical Corporation Shinsekai, Tokyo, Japan
| | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
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Suzuki S, Yoshino K, Takayanagi A, Sugiyama S, Okamoto M, Tanaka M, Ishizuka Y, Satou R, Onose Y, Kamijo H, Sugihara N. Number of Non-vital Teeth as Indicator of Tooth Loss during 10-year Maintenance: A Retrospective Study. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 58:223-230. [PMID: 29269716 DOI: 10.2209/tdcpublication.2016-0044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The purpose of this study was to investigate whether number of non-vital teeth was an indicator of tooth loss during maintenance. Thirty-three general practitioners provided data on 321 patients undergoing maintenance over 10 years. The number of present teeth (PT), smoking status, level of bone loss, number of non-vital teeth, and reason for tooth loss during that period were investigated. Multiple logistic regression was performed to identify whether the number of non-vital teeth was associated with tooth loss. The average number of lost teeth was 1.07±1.82; that of PT at baseline was 24.4±3.9; and that of non-vital teeth at baseline was 5.4±4.5. Multiple logistic regression revealed a significant association between >8 non-vital teeth and tooth loss during maintenance (odds ratio [OR]: 2.40; 95% confidence interval [CI]: 1.18-4.87). It also demonstrated relationships between >8 non-vital teeth and root fracture or caries (OR: 3.90; 95%CI: 1.68-9.03 or OR: 2.85, 95%CI: 1.14-7.10, respectively). The number of non-vital teeth was associated with tooth loss during maintenance. The results suggest that patients with many non-vital teeth before commencement of maintenance are particularly at risk of tooth loss due to root fracture or caries. Therefore, the number of non-vital teeth offers a useful indicator of potential tooth loss.
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Affiliation(s)
- Seitaro Suzuki
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Koichi Yoshino
- Department of Epidemiology and Public Health, Tokyo Dental College
| | | | | | | | | | - Yoichi Ishizuka
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Ryouichi Satou
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Yuki Onose
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Hideyuki Kamijo
- Department of Social Security for Dentistry, Tokyo Dental College
| | - Naoki Sugihara
- Department of Epidemiology and Public Health, Tokyo Dental College
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35
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Pretzl B, El Sayed S, Weber D, Eickholz P, Bäumer A. Tooth loss in periodontally compromised patients: Results 20 years after active periodontal therapy. J Clin Periodontol 2018; 45:1356-1364. [DOI: 10.1111/jcpe.13010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/31/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Bernadette Pretzl
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral, Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
| | - Shirin El Sayed
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral, Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
| | - Dorothea Weber
- Institute of Medical Biometry and Informatics (IMBI); University Hospital Heidelberg; Heidelberg Germany
| | - Peter Eickholz
- Department of Periodontology; Center of Dentistry and Oral Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Amelie Bäumer
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral, Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
- Private Practice; Bielefeld Germany
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36
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Cabanillas‐Balsera D, Martín‐González J, Montero‐Miralles P, Sánchez‐Domínguez B, Jiménez‐Sánchez MC, Segura‐Egea JJ. Association between diabetes and nonretention of root filled teeth: a systematic review and meta‐analysis. Int Endod J 2018; 52:297-306. [DOI: 10.1111/iej.13011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- D. Cabanillas‐Balsera
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - J. Martín‐González
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - P. Montero‐Miralles
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - B. Sánchez‐Domínguez
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - M. C. Jiménez‐Sánchez
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
| | - J. J. Segura‐Egea
- Endodontic Section Department of Stomatology School of Dentistry University of Sevilla Sevilla Spain
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37
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Kocher T, König J, Borgnakke WS, Pink C, Meisel P. Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge. Periodontol 2000 2018; 78:59-97. [DOI: 10.1111/prd.12235] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Jörgen König
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Christiane Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Peter Meisel
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
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38
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Martinez-Canut P, Llobell A, Romero A. Predictors of long-term outcomes in patients undergoing periodontal maintenance. J Clin Periodontol 2018; 44:620-631. [PMID: 28419497 PMCID: PMC5519943 DOI: 10.1111/jcpe.12730] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 01/03/2023]
Abstract
AIM This retrospective study aimed to characterize the baseline status of patients following periodontal maintenance, analysing the association between the long-term outcome of these patients, smoking, bruxism, and the main clinical and radiographic variables. MATERIAL AND METHODS A sample of 174 patients with moderate to severe periodontitis was refined into homogeneous subsamples according to smoking and bruxism and the rate of tooth loss due to periodontal disease (TLPD): 0, 1-2, and >2 teeth. The association and the distribution (χ² test) of the variables within the subsamples were analysed. RESULTS Smoking and bruxism were significantly associated with higher TLPD rates. Vertical and circumferential bone defects (p < .0001), and abfractions (p < .0001) were associated with bruxism and particularly with bruxism and TLPD >2. Furcation defects (p = .0002), fewer radio-opaque subgingival calculus (χ² p < .0001), a lower mean Gingival index (χ² p = .027), and increased mean recessions >1.5 mm (χ² p = .0026) were associated with smoking and higher TLPD rates. The mean baseline mobility, abfractions, and recessions characterized two basic types of TLPD. CONCLUSIONS Smoking, bruxism, and routine clinical and radiological parameters can be used to characterize the baseline status of patients with worse outcomes.
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Affiliation(s)
- Pedro Martinez-Canut
- Division of Periodontics, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain.,Private practice, Valencia, Spain
| | - Andrés Llobell
- Private practice, Valencia, Spain.,Division of Periodontics, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain
| | - Antonio Romero
- Private practice, Valencia, Spain.,Orofacial Pain. Tufts U. School of Dental Medicine, Boston, MA, USA
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39
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Schwendicke F, Schmietendorf E, Plaumann A, Sälzer S, Dörfer CE, Graetz C. Validation of multivariable models for predicting tooth loss in periodontitis patients. J Clin Periodontol 2018; 45:701-710. [DOI: 10.1111/jcpe.12900] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
| | - Elisa Schmietendorf
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof E. Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
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40
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Chatzopoulos G, Doufexi AE, Wolff L, Kouvatsi A. Interleukin-6 and interleukin-10 gene polymorphisms and the risk of further periodontal disease progression. Braz Oral Res 2018. [PMID: 29538476 DOI: 10.1590/1807-3107bor-2018.vol32.0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Susceptible genotypes to periodontal disease are associated with disease onset and progression. The aim of this study was to examine the effect of gene polymorphisms on the risk of further disease progression and the need for further treatment among adults with chronic periodontal disease. Sixty-seven patients diagnosed with chronic periodontitis were grouped according to genotype status and risk of further progression of disease and tooth loss. All individuals were clinically evaluated for probing pocket depth, clinical attachment loss and bleeding on probing at baseline and 45 days after treatment. Blood samples were collected at baseline and genotyping of the polymorphisms in IL-6 (rs1800796) and IL-10 (rs1800872) genes were performed by PCR. Following DNA separation and genotyping, 65.7% of the patients were homozygous carriers of the IL-6 -572G and 49.3% were carriers of the IL-10 -592A allele. Individuals at risk of disease progression ranged from 7.5% to 62.7% based on the criteria used. Carriers of the IL-10 -592A allele were significantly associated with BOP ≥ 30% and therefore exhibited a higher risk of further periodontal breakdown (p = 0.018) with an odds ratio of 1.18. None of the other definitions of disease progression were significantly associated with the examined IL-6 and IL-10 genotypes (p > 0.05). IL-10 polymorphism was associated with an increased risk of further disease progression and the potential need for further treatment following non-surgical periodontal treatment. Susceptible IL-6 genotypes were not associated with the risk of persisting or recurrent disease activity.
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Affiliation(s)
- Georgios Chatzopoulos
- University of Minnesota, School of Dentistry, Department of Surgical and Developmental Sciences, Minneapolis, MN, USA
| | | | - Larry Wolff
- University of Minnesota, School of Dentistry, Department of Surgical and Developmental Sciences, Minneapolis, MN, USA
| | - Anastasia Kouvatsi
- Aristotle University of Thessaloniki, Faculty of Sciences, Department of Genetics, Development and Molecular Biology, Thessaloniki, Greece
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41
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Martinez‐Canut P, Alcaraz J, Alcaraz J, Alvarez‐Novoa P, Alvarez‐Novoa C, Marcos A, Noguerol B, Noguerol F, Zabalegui I. Introduction of a prediction model to assigning periodontal prognosis based on survival time. J Clin Periodontol 2018; 45:46-55. [PMID: 28871596 PMCID: PMC5767737 DOI: 10.1111/jcpe.12810] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 12/17/2022]
Abstract
AIMS To develop a prediction model for tooth loss due to periodontal disease (TLPD) in patients following periodontal maintenance (PM), and assess its performance using a multicentre approach. MATERIAL AND METHODS A multilevel analysis of eleven predictors of TLPD in 500 patients following PM was carried out to calculate the probability of TLPD. This algorithm was applied to three different TLPD samples (369 teeth) gathered retrospectively by nine periodontist, associating several intervals of probability with the corresponding survival time, based on significant differences in the mean survival time. The reproducibility of these associations was assessed in each sample (One-way ANOVA and pairwise comparison with Bonferroni corrections). RESULTS The model presented high specificity and moderate sensitivity, with optimal calibration and discrimination measurements. Seven intervals of probability were associated with seven survival time and these associations contained close to 80% of the cases: the probability predicted the survival time at this percentage. The model performed well in the three samples, as the mean survival time of each association were significantly different within each sample, while no significant differences between the samples were found in pairwise comparisons of means. CONCLUSIONS This model might be useful for predicting survival time in different TLPD samples.
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Affiliation(s)
- Pedro Martinez‐Canut
- Private PracticeValenciaSpain
- Division of PeriodonticsFacultad de Medicina y OdontologíaU. ValenciaValenciaSpain
| | - Jaime Alcaraz
- Assistant professor Postgraduate Program in PeriodonticsFacultad de Medicina y OdontologíaU. ValenciaValenciaSpain
- Private PracticeAlicanteSpain
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42
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McGowan T, McGowan K, Ivanovski S. A Novel Evidence-Based Periodontal Prognosis Model. J Evid Based Dent Pract 2017; 17:350-360. [DOI: 10.1016/j.jebdp.2017.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 11/28/2022]
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43
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Martinez G, Majster M, Bjurshammar N, Johannsen A, Figueredo C, Boström E. Salivary Colony Stimulating Factor-1 and Interleukin-34 in Periodontal Disease. J Periodontol 2017; 88:e140-e149. [DOI: 10.1902/jop.2017.170081] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- G.L. Martinez
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - M. Majster
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden
| | - N. Bjurshammar
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden
| | - A. Johannsen
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden
| | - C.M. Figueredo
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - E.A. Boström
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden
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44
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Graetz C, Sälzer S, Plaumann A, Schlattmann P, Kahl M, Springer C, Dörfer C, Schwendicke F. Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment. J Clin Periodontol 2017; 44:612-619. [DOI: 10.1111/jcpe.12725] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics; Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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45
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Lü D, Meng H, Xu L, Wang X, Zhang L, Tian Y. Root abnormalities and nonsurgical management of generalized aggressive periodontitis. J Oral Sci 2017; 59:103-110. [PMID: 28367890 DOI: 10.2334/josnusd.16-0258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
To investigate long-term nonsurgical treatment outcomes in patients with generalized aggressive periodontitis (GAgP) and the impact of root abnormalities (RAs) and other patient-level factors in relation to GAgP progression. Patients (n = 64) from a GAgP cohort who completed active nonsurgical periodontal treatment and consented to re-evaluation after 3 to 11 (mean 5.3) years, were enrolled. RAs were identified using radiographs. Periodontal parameters (e.g., probing depths [PDs], and tooth loss [TL]) were investigated. Multivariate analysis was performed to identify factors contributing to TL and bone level alteration (∆BL). After treatment, the mean number of sites with PDs > 5 mm decreased from 54.3 to 17.2. Annual TL was 0.11/patient. Twenty-one patients (32.8%) had >4 teeth with root abnormalities (RA-teeth) and exhibited a higher risk for TL (univariate odds ration [OR] = 3.52, multivariate logistic OR = 6.57). Factors correlated to ∆BL were sites with residual PD > 5 mm (β = -0.400) and observation time (β = -0.210). Nonsurgical treatment provides beneficial outcomes in GAgP patients. Higher incidence of RAs and high prevalence of residual deep pockets have a negative impact on long-term outcomes. PRACTICAL IMPLICATIONS in cases of GAgP with residual deep pockets and high incidence of RAs, clinicians must emphasize that long-term outcomes of nonsurgical treatment may be compromised.
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Affiliation(s)
- Da Lü
- Department of Periodontology, Peking University School and Hospital of Stomatology
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46
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Graetz C, Plaumann A, Schlattmann P, Kahl M, Springer C, Sälzer S, Gomer K, Dörfer C, Schwendicke F. Long-term tooth retention in chronic periodontitis - results after 18 years of a conservative periodontal treatment regimen in a university setting. J Clin Periodontol 2017; 44:169-177. [DOI: 10.1111/jcpe.12680] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics, Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Konstantin Gomer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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47
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Nibali L, Sun C, Akcalı A, Meng X, Tu YK, Donos N. A retrospective study on periodontal disease progression in private practice. J Clin Periodontol 2016; 44:290-297. [DOI: 10.1111/jcpe.12653] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Luigi Nibali
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Chuanming Sun
- Department of Periodontology; Faculty of Dentistry; Suzhou Health College; Suzhou China
| | - Aliye Akcalı
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Xsuan Meng
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Nikos Donos
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
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48
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Hasiuk P, Hasiuk N, Kindiy D, Ivanchyshyn V, Kalashnikov D, Zubchenko S. Characteristics of cellular composition of periodontal pockets. Interv Med Appl Sci 2016; 8:172-177. [PMID: 28180007 PMCID: PMC5283776 DOI: 10.1556/1646.8.2016.4.5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The development of inflammatory periodontal disease in young people is an urgent problem of today's periodontology, and requires a development of new methods that would give an opportunity not only to diagnose but also for prognosis of periodontitis course in a given patients contingent. Results Cellular structure of periodontal pockets is presented by hematogenous and epithelial cells. Our results are confirmed by previous studies, and show that the penetration of periodontal pathogens leads to formation in periodontal tissue of a highly active complex compounds—cytokines that are able to modify the activity of neutrophils and reduce their specific antibacterial properties. Cytokines not only adversely affect the periodontal tissues, but also cause further activation of cells that synthesized them, and inhibit tissue repair and process of resynthesis of connective tissue by fibroblasts. Conclusion Neutrophilic granulocytes present in each of the types of smear types, but their functional status and quantitative composition is different. The results of our cytological study confirmed the results of immunohistochemical studies, and show that in generalized periodontitis, an inflammatory cellular elements with disorganized epithelial cells and connective tissue of the gums and periodontium, and bacteria form specific types of infiltration in periodontal tissues.
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Affiliation(s)
- Petro Hasiuk
- Orthopedic Dentistry Department, State Higher Educational Institution, I. Horbachevsky Ternopil State Medical University , Ternopil, Ukraine
| | - Nataliya Hasiuk
- Therapeutic Dentistry Department, State Higher Educational Institution, I. Horbachevsky Ternopil State Medical University , Ternopil, Ukraine
| | - Dmytro Kindiy
- Propedeutics of Orthopedic Dentistry Department, Ukrainian Medical Dental Academy , Poltava, Ukraine
| | - Victoriya Ivanchyshyn
- Pediatric Dentistry Department, Danylo Halytsky Lviv National Medical University , Lviv, Ukraine
| | - Dmytro Kalashnikov
- Propedeutics of Orthopedic Dentistry Department, Ukrainian Medical Dental Academy , Poltava, Ukraine
| | - Sergiy Zubchenko
- Propedeutics of Orthopedic Dentistry Department, Ukrainian Medical Dental Academy , Poltava, Ukraine
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49
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Pretzl B, Eickholz P, Saure D, Pfefferle T, Zeidler A, Dannewitz B. Endodontic status and retention of molars in periodontally treated patients: results after 10 or more years of supportive periodontal therapy. J Clin Periodontol 2016; 43:1116-1123. [PMID: 27570936 DOI: 10.1111/jcpe.12621] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the influence of endodontic status on retention of molars in patients under supportive periodontal treatment (SPT). MATERIAL & METHODS A total of 136 subjects with 1015 molars at baseline were examined retrospectively, including 188 endodontically treated molars in 90 patients. Multilevel Cox regression analysis identified factors contributing to loss of molars. RESULTS Root canal treatments contributed significantly to loss of molars during on average 13.2 years of SPT (Hazard ratio: 2.98, 95% CI: 1.74-5.1, p < 0.001). Endodontic treatment was more frequently present in first molars (p < 0.001) and in the maxilla (p = 0.01). In endodontically treated molars, degree III furcation involvement could be detected more often compared to molars without root canal treatment (p < 0.001). Among the root canal-treated molars, several patient and tooth-related factors showed an impact on tooth retention, but only molars with a periapical index of 4 and 5 (labelled "diseased") were significantly more often lost. CONCLUSION The retention of molars in periodontally compromised patients after periodontal treatment is influenced by periodontal as well as endodontal factors. On a long-term basis, it is feasible to retain these teeth via active periodontal treatment and SPT for more than 10 years.
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Affiliation(s)
- Bernadette Pretzl
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Daniel Saure
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Heidelberg, Germany
| | - Thorsten Pfefferle
- Section of Endodontics and Dental Traumatology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Zeidler
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Bettina Dannewitz
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.,Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany.,Private Dental Practice, Weilburg, Germany
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50
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Díaz-Faes L, Guerrero A, Magán-Fernández A, Bravo M, Mesa F. Tooth loss and alveolar bone crest loss during supportive periodontal therapy in patients with generalized aggressive periodontitis: retrospective study with follow-up of 8 to 15 years. J Clin Periodontol 2016; 43:1109-1115. [DOI: 10.1111/jcpe.12596] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Lucía Díaz-Faes
- Periodontology Department; School of Dentistry; University of Granada; Granada Spain
| | - Adrián Guerrero
- Private Practice in Periodontology “Clinica Guerrero”; Marbella Spain
| | | | - Manuel Bravo
- Department of Preventive Dentistry and Epidemiology; School of Dentistry; University of Granada; Granada Spain
| | - Francisco Mesa
- Periodontology Department; School of Dentistry; University of Granada; Granada Spain
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