Influence of residual pockets on periodontal tooth loss: A retrospective analysis

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology Pub Date : 2023-12-19 DOI:10.1002/JPER.23-0448

Muhammad H. A. Saleh, Debora R. Dias, Obada Mandil, Ricardo P. de Oliveira, Abdusalam Alrmali, Maurício G. Araújo, Hom-Lay Wang, Zoltan Barath, Istvan A. Urban

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Abstract

Background

Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined “threshold” at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk.

Methods

Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model.

Results

Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4 mm/grade A. Grading exhibited the best discrimination and model fit.

Conclusion

Patients with RPc ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5 mm displayed very good predictive capability of TLP.

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残留牙周袋对牙周牙齿脱落的影响：回顾性分析。

背景：接受支持性牙周治疗（SPT）的患者仍有可能因牙周炎（TLP）而导致牙齿脱落。关于残余牙周袋（RPc）的影响以及将患者的情况设定为 TLP 高风险的 "阈值"，文献中的证据很有限。因此，本研究旨在评估RPc对TLP的影响，并确定RPc与牙周炎分期和分级相比对TLP风险的预后效果：这项回顾性研究评估了168名牙周炎患者（3869颗牙齿）接受SPT治疗至少10年的临床数据。收集了每位患者的TLP和RPc≥5毫米或≥6毫米的部位百分比。采用多层次考克斯比例危险回归模型将RPc的预后表现与TLP的疾病分期和分级进行比较：在中位 25 年的随访中，13.7% 的牙齿脱落，其中 4.6% 是由于牙周炎造成的。大多数TLP患者有≥1个部位的RPc≥5毫米（90.8%）或≥6毫米（77.6%）。多变量多层次Cox回归显示，与RPc≤4毫米/A级相比，RPc≥5毫米的部位>15%的患者的危险比为2.34，C级的TLP危险比为4.6：结论：RPc≥5 mm的患者，>15%的部位有牙齿脱落的风险。分级和 RPc ≥5 mm 对 TLP 有很好的预测能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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