Tooth loss in patients undergoing supportive periodontal maintenance care

Abstract

Objectives: Prognostic factors for periodontal diseases have been substantially researched for Caucasian population; yet, few studies have been done on Asians. The aim of present preliminary investigation was to retrospectively overview factors affecting progression of periodontal disease in patients during supportive periodontal maintenance care (SPC) in a local dental hospital in Hong Kong. Methods: Patients were identified through the computer database in Prince Philip Dental Hospital. The inclusion criteria were: (1) age >20; (2) diagnosed with periodontal disease at baseline; (3) completed active periodontal therapy (APT) with no periodontal pockets >5mm on the remaining dentition and received SPC ≥5 years from graduate students under specialist training; (4) with reliable clinical and radiological records at baseline. A two-level mixed effect logistic regression was fitted to investigate significant subject- and tooth-level predictors for tooth loss due to periodontal reasons (TLPR). Forward selection was used to select significant predictors with p<0.05. Results: Twenty-six Chinese patients (aged 44.9±3.6 years) with moderate to severe periodontitis were included in this preliminary analysis. These patients were under SPC for an average of 6.7±0.6 years (range: 5.1–11.4 years). Altogether 637 teeth that have entered SPC were analyzed. During SPC, a total of 29 teeth were extracted and 13 were TLPR. Results from the logistic regression model showed that patients with higher number of tooth loss during APT (OR=1.39, p=0.0450); teeth with higher % sites with BOP (OR=1.06, p=0.0011) and with more severe mobility (OR>3, p=0.0007) during SPC had a higher chance to be TLPR. Conclusions: Within the limitation of this preliminary analysis, some subject- and tooth-level factors were found to be possible prognostic factors. Further analysis with a larger sample would be needed and the use of these factors could be of great value to assist dental practitioners on tooth prognosis of Chinese patients with periodontal disease.