Long-term effects of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. I: recurrence of pockets, bleeding on probing and tooth loss

BACKGROUND: Periodontal surgery is indicated in the treatment of persistent pockets following cause-related therapy. The aim of this study was to evaluate the long-term effect of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. METHODS: Three-hundred and four consecutive patients were identified and retrospectively examined while presenting for a supportive periodontal care (SPC) appointment (T2). All had received non-surgical periodontal treatment and osseous resective surgery as needed, to obtain no sites with probing depth (PD) >3 mm before being enrolled in the SPC programme. The mean SPC duration for the patients was 7.8+/-3.2 years while the mean interval of SPC was 3.4+/-0.8 months. RESULTS: During SPC, a total of 67 teeth had been removed (0.9%). At T2, mean full-mouth plaque scores (FMPS) was 13+/-11.3% and full-mouth bleeding scores (FMBS) was 2+/-3%. In 98.5% of the sites, PD was minimal (or=6 mm was 68 and limited to 41 patients (13.8% of sample). Initial periodontal diagnosis of severe periodontitis, smoking habits, FMBS, number of teeth at completion of active periodontal therapy (T1), number of surgically treated teeth, number of teeth with furcation involvement and number of multi-rooted teeth were associated with the number of pockets at T2. A total of 598 sites (2.1%) displayed bleeding on probing (BOP) at T2. The odds ratio of sites 4 mm or deeper to be BOP positive was 32.9 compared with sites of <3 mm depth. Gender, FMBS, FMPS, furcation involvements and overall number of pockets were associated with the number of bleeding pockets at T2. CONCLUSION: Shallow PDs achieved by treatment of the persistent pockets by fibre retention osseous resective surgery can be maintained over time. These patients displayed minimal gingival inflammation and tooth loss during SPC.     

Tooth loss in treated periodontitis patients responsible for their supportive care arrangements

AIM: To identify risk indicators associated with tooth loss and periodontitis in treated patients responsible for arranging supportive periodontal care (SPC). MATERIALS AND METHODS: Ninety-seven Chinese subjects (34-77 years) who showed favourable responses to periodontal therapy provided in a teaching hospital 5-12 years previously were recalled. They were advised to seek regular SPC on discharge. Background information, general health status, smoking, oral hygiene habits, follow-up dental care, tooth loss, and periodontal parameters were investigated. Multiple regression analysis was performed. RESULTS: Two hundred and fifty-six teeth had been lost, 195 because of self-reported periodontal reasons. Up to 26.8% sites were with pockets > or =6 mm. Positive correlations were found between total/periodontal tooth loss and (i) smoking pack-years, (ii) time spent on oral hygiene, (iii) years since therapy's conclusion, (iv) age, and negative correlations with (v) inter-dental brush use, and (vi) education levels. Tooth loss by arch was correlated with wearing of removable partial denture in that arch. Percentage sites with pockets > or =6 mm were significantly negatively correlated with percentage sites without bleeding on probing. CONCLUSIONS: Smokers, more elderly patients, removable partial denture wearers, and patients with lower education levels or not using inter-dental brushes ought to be targeted for clinic-based SPC.     

Long-term effects of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. II: tooth extractions during active and supportive therapy

BACKGROUND: Long-term tooth retention is the main objective of periodontal treatment. The aim of this retrospective study was to describe the prevalence and reasons of tooth extraction during active periodontal therapy (APT) and supportive periodontal care (SPC) in periodontal patients. MATERIAL AND METHODS: Three hundred and four periodontal patients were examined. APT consisted of non-surgical periodontal treatment and fibre retention osseous resective surgery, where needed, to obtain no sites with PD>3 mm. All patients participated in an SPC programme for 3-17 years (mean time 7.8 years). RESULTS: At the initial examination, 45% of the patients had moderate periodontitis and 41% severe periodontitis. During APT, 576 teeth were extracted (7.5%). The main reason for tooth extraction during APT was the presence of advanced periodontal lesions (44%). The number of tooth extractions was higher in cases with severe periodontitis. Extracted teeth showed a mean bone loss of 76% of the total root length. During SPT, a total of 67 teeth were removed (0.9%) in a subgroup of 50 patients. The clinical problems were primarily related to the incidence of root fracture (48%) and secondarily to the progression of periodontal disease (30%). CONCLUSION: Prevalence of tooth extraction during APT is associated with the severity of periodontal disease. Tooth loss during supportive periodontal care may be negligible when a meticulous SPC programme is performed in patients where minimal probing depth is consequential to APT.     

Initial extractions and tooth loss during supportive care in a periodontal population seeking comprehensive care

BACKGROUND/AIMS: This retrospective survey was aimed at determining the prevalence of tooth extractions and the dental pathologies associated with them during both the active and maintenance phase of periodontal therapy in a periodontal population seeking comprehensive dental care. METHODS: A total of 273 randomly selected subjects from the oral prophylaxis clinic of the University of Berne were included. All subjects had received comprehensive care consisting of periodontal and restorative treatment and participated in a supervised maintenance program for an average of 67+/-46 months (range 5 to 278 months). The population consisted of 39.6% current smokers and 27.8% previous smokers. 6.2% of the patients had gingivitis, 20.5% mild periodontitis, 48.4% moderate and 24.9% severe periodontitis. The average frequency of the recall visits was 4.4+/-1.5 appointments/year (range 1.7-12 appointments/year). RESULTS: Results indicated that 574 out of a total of 6503 teeth were extracted; 311 teeth were extracted during active therapy and 263 during the supportive periodontal care (SPC) phase of therapy. 46% of patients received tooth extractions as part of their active treatment and 41% during their participation in the secondary prevention program. In the subgroup whose treatment plan included extractions the average number was 2.5+/-1.6 teeth per patient. Likewise, the patients who received extractions during recall lost an average of 2.35+/-1.9 teeth per subject with an incidence of 0.4+/-0.37 teeth per patient per year. These data reinforce the concept that a minority of the population is responsible for the majority of tooth extractions, both during active therapy and SPC. Periodontal disease was the only pathology observed at 57% of the extracted teeth; while caries, endodontic pathology and technical problems in the absence of periodontitis were observed in 29% of cases. CONCLUSIONS: These observations indicate that the rendered treatment was effective in the long-term maintenance of the dentition of these subjects and suggest that advanced periodontal disease represented the major cause of tooth loss in this population.     

Periodontitis progession in patients subjected to supportive maintenance care

The maintenance care following the initial active therapy phase plays an essential part in periodontal treatment to prevent disease progression and includes supportive periodontal therapy based on the patient's individual needs. The purpose of this study was to investigate the longitudinal proximal alveolar bone loss and tooth loss in periodontitis-prone patients during the active treatment and maintenance phase. In addition, the effect on disease progression of potential predictors was investigated. The investigation was conducted as a retrospective longitudinal study over a period of at least 10 years on a randomly selected population of patients referred for periodontal treatment in a specialist periodontal clinic. The mean number of teeth lost between baseline and the first re-evaluation was 2.4 and another 2.3 teeth were lost between the first and last re-evaluation. More than 50% of the periodontal pockets > or = 6 mm were reduced to < or = 5 mm at the re-evaluations. The mean longitudinal bone loss was 9% of the root length, corresponding to a mean annual marginal bone loss of about 0.09 mm. Smoking was significantly correlated to an increased longitudinal tooth loss, while the number of periodontal pockets > or = 6 mm at baseline was significantly correlated to an increased longitudinal bone loss. The magnitudes of marginal bone loss and tooth loss during a maintenance phase of 10-26 years were in accordance with the results from longitudinal studies performed on normal populations in Sweden.     

���������׻�������֧�����ƶ��ٴ���Чָ���Ӱ��

??Supportive periodontal therapy can stabilize the periodontal condition obtained after active periodontal therapy. The influence of supportive periodontal therapy on the bleeding on probing??BOP????probing depth??PD????attachment loss??AL????alveolar bone height??tooth loss and the different treatment effect on different teeth was reviewed in this paper.     

慢性牙周炎患者牙周支持治疗对临床疗效指标的影响

慢性牙周炎患者牙周支持治疗可以维持基础治疗和手术治疗效果的长期稳定性。文章从牙周支持治疗对探诊出血（bleeding on probing,BOP）、探诊深度（probing depth,PD）、附着丧失（attachment loss,AL）、牙槽骨高度、年缺失牙率、不同牙位治疗效果等临床疗效指标的影响方面做一综述。     

Retrospective study of tooth loss in 92 treated periodontal patients

BACKGROUND/AIMS: In this retrospective study, the efficacy of periodontal therapy and maintenance in preventing tooth loss was evaluated. METHODS: The study included 92 patients with 2310 teeth diagnosed with chronic adult periodontitis and observed over a mean period of 6.7 years, with each patient receiving surgical therapy in two or more quadrants. The group was divided into two subgroups: those who complied with the recommended maintenance schedule and those whose compliance was erratic. Individual tooth prognosis was assigned according to radiographic parameters. RESULTS: At the completion of active periodontal therapy, 2184 teeth were present. During the maintenance period, 44 teeth were lost due to periodontal reasons. Tooth mortality revealed a mean annual adjusted tooth loss rate of 0.07/year. Molars were the teeth most frequently lost; canines the least. The number of teeth lost in the three prognostic categories was: one (0.07%) for teeth with good prognoses, 21 (3.63%) for questionable prognoses and 22 (11.34%) for hopeless prognoses. Patients complying erratically with supportive periodontal therapy were at a 5.6 times greater risk for tooth loss following active therapy than regularly compliant patients. Conclusions: The results demonstrated a low tooth mortality rate in periodontal patients following active treatment combined with a strict maintenance program.     

Progression of periodontal disease in patients with mild to moderate adult periodontitis

Abstract The aim of the present study was to determine the progression rate of periodontal disease in patients treated for localized or generalized mild to moderate adult periodontitis. 52 patients with a mean age of 53.7 years (S.D. 12. 6 years) were instructed in optimal home care procedures and exposed to initial periodontal therapy, before reconstructive therapy was initiated. Following completion of the prosthetic procedures, supportive therapy was offered to a limited extent and maintenance visits were irregularly scheduled corresponding to traditional dental care. Clinical periodontal parameters from 4 sites per tooth were assessed at the initial examination, at the time of reevaluation after initial therapy and at the re-examination after 8-years. Full sets of intraoral radiographs from the initial and the 8-year re-examination were analyzed with respect to changes in the radiographic alveolar bone height as a % of the total tooth length. As the result of the home care instructions, the mean plaque index (plaque control record) amounted to 21% at the end of initial periodontal therapy. 8 years later, the re-examination revealed a mean plaque index of 49% and a mean gingival bleeding index of 24%. At the initial examination, the 52 patients presented with an average of 18.7 teeth. During treatment. 26 teeth were sacrificed and 19 teeth were lost over the 8 years of supportive therapy. Bicuspids were the most frequent teeth to be lost over the observation period. As a result of initial therapy, the mean pocket probing depths decreased significantly. However, after 8 years, only minor differences were found when compared to the initial examination. At all examinations, the buccal and the oral aspects presented with shallower pockets compared to the interproximal sites. The comparison of the changes in the mean probing attachment levels over the observation period at mesial, buccal, distal and oral sites revealed a gain in clinical attachment after initial therapy and a mean loss of attachment ranging from 0.48 mm to 0.79 mm from the initial to the re-examination after 8 years. The buccal aspects demonstrated the highest mean clinical attachment loss followed by the oral sites. The radio-graphic assessment of the changes in the mean alveolar bone height revealed a statistically significant, but a clinically insignificant, loss of alveolar bone height of less than 2% of the tooth length. The patient population was grouped into 21 patients seeking supportive therapy less than once per year over 8 years. 14 patients having had one maintenance visit per year and 17 patients who were recalled more than once per year. With respect to the distribution of the number of sites with different changes in probing attachment level, no statistically significant difference between the groups was observed. When frequency analyses of the radiographically assessed changes in the alveolar bone height were performed, similar results were obtained. With the parameters and the statistical methods applied in this study, no significant influence of the age nor the recall frequency on the progression rate of periodontal disease could be detected in this group of patients presenting initially with mild to moderate adult periodontitis. Recall visits corresponding to conventional dental care did not prevent further loss of attachment, resulting in a deterioriation of the periodontal conditions compared to the results achieved after initial therapy and in 45 out of 52 patients compared to the baseline examination.     

Supportive periodontal therapy for high‐ and low‐risk patients

Aim: The validity of the risk assessment in predicting tooth loss due to periodontitis or disease progression was explored. Methods: Systemic factors, smoking status, bleeding on probing (BoP) percentage, number of residual pockets (probing pocket depth ≥6 mm), tooth loss, and alveolar bone loss in relation to age were the variables of the risk assessment. Based on an improving or deteriorating risk assessment in 2005 compared with 1999, 89 patients were divided into either a high‐ or low‐risk group. Findings were compared with the 2008 outcome. Results: Using BoP ≤ 20% as the cut‐off, the relationship between BoP and interleukin‐1 genotype status was neither significant in 2005 nor in 2008. Neither the high‐ nor low‐risk group was predictive for tooth loss. Patients displayed similar proportions of probing pocket depths ≥6 mm in 2005 and in 2008. Linear stepwise regression analysis demonstrated that only the number of supportive periodontal therapy visits explained the number of teeth lost due to periodontitis (P < 0.01). Conclusions: The categorization of patients into high‐ and low‐risk groups, according to the periodontal risk assessment model applied within a supportive periodontal therapy period of 3 years, had limitations in predicting future tooth loss.     

Compliance as a prognostic indicator: retrospective study of 505 patients treated and maintained for 15 years

BACKGROUND: The relationship of patient compliance to overall tooth prognosis remains controversial. There are little data, often conflicting, that pertain to tooth loss as a function of patient compliance. METHODS: This retrospective study evaluates the impact of compliance (complete versus erratic) on common periodontal clinical variables, such as probing depth, bleeding index, plaque index, and tooth loss for 505 patients in a long-term period of observation (15 to 23 years) and maintenance therapy (at least 10 years). Compliance was defined in two ways for all analyses. Under the definition for compliance 1, patients who missed <30% of all prescribed maintenance visits were classified as complete compliers. Under the definition for compliance 2, patients who never went 2 years without a maintenance visit were classified as complete compliers. Change in clinical variables was dichotomized into reduction in plaque index versus no reduction, reduction in bleeding on probing versus no reduction, reduction in the percentage of periodontal pockets>3 mm versus no reduction, no increase in decayed, missing, or filled teeth (DMFT) versus increase, and no tooth loss versus tooth loss. The effects of both definitions of compliance were then evaluated in a series of multiple logistic regression models with adjustment for potential confounders. RESULTS: The analysis of the dichotomous change in clinical parameters over time revealed that complete compliers tended to show reduction in bleeding on probing and reduction in plaque index compared to erratic compliers for both definitions of compliance. In contrast, complete compliers under compliance 2 were less likely to have a reduction in the percentage of periodontal pockets >3 mm compared to erratic compliers, whereas complete compliers under compliance 1 had about the same likelihood of demonstrating a reduction in periodontal pockets compared to erratic compliers under this classification scheme. Under both definitions for compliance, complete compliers were more likely to exhibit tooth loss than erratic compliers, with the greatest tooth loss exhibited by complete compliers under the definition for compliance 1. CONCLUSIONS: Based on these results, complete compliers under both definitions tended to show a reduction in plaque and bleeding on probing over time. However, change in periodontal pockets and DMFT over time varied according to the definition of compliance that was used. In addition, the results seem to indicate that the decision for tooth extraction made by dental health professionals at maintenance visits may result in greater tooth loss.     

Long-term maintenance of patients treated for advanced periodontal disease

The aim of the present investigation was to evaluate the periodontal conditions of a group of patients who, following active treatment of extremely advanced periodontal disease, had been maintained for 14 years in a well-supervised maintenance care program. The present sample included 61 subjects out of an initial group of 75 individuals who in 1969 were referred to and treated by the authors. Following an initial examination, the patients were given detailed instructions in proper plaque control measures and were subjected to scaling and root planning and surgical elimination of pathologically deepened pockets. After the termination of the active treatment phase, the patients were placed in a maintenance care program including recall appointments every 3-6 months. At the initial examination, immediately after the completion of the active treatment phase and then once a year, all patients were examined regarding oral hygiene, gingival conditions, probing depths and clinical attachment levels. In addition, the interproximal alveolar bone height was determined from full mouth radiographs obtained before active treatment, at the completion of active therapy and 1, 3, 5, 8, 10, 12 and 14 years after treatment. The results from the repeated examinations demonstrated that treatment of advanced forms of periodontal disease resulted in clinically healthy periodontal conditions and that this state of "periodontal health" could be maintained in most patients and sites over a period of 14 years. It was also demonstrated that the treatment and maintenance programs described were equally effective in young and older patients. The individual mean values describing probing depths, attachment levels, and bone heights did not vary significantly over the 14 years of observation. A more detailed analysis of the data revealed, however, that a small number of sites in a few patients lost a substantial amount of attachment. This attachment loss occurred at different time intervals during the course of the maintenance period. Thus, 43 surfaces in 15 different patients were exposed to recurrent periodontal disease of a significant magnitude. This recurrent inflammatory periodontal disease caused the loss of 16 teeth in 7 different patients during the maintenance period. The data reported question the validity of using individual mean values to describe alterations of the periodontal conditions during maintenance following active periodontal therapy.     

Reliability of the CPITN in the epidemiological assessment of periodontal treatment needs at 13-15 years of age

The aim of this study was to assess the difference in the results obtained when using the two methods of recording the Community Periodontal Index of Treatment Needs (Ainamo et al., 1982) in teenaged children. A group of 240 13-15-year-old schoolchildren were clinically examined for pocketing, the presence of calculus and overhanging fillings, and gingival bleeding after gentle probing of the tooth surfaces. Pocket depths were also determined. False pockets around erupting teeth were recorded as gingivitis whenever bleeding was observed after probing. None of the children was found to exhibit deep pockets associated with true loss of tooth attachment. The presence of dental calculus was assessed equally well by examination of the index teeth in each sextant and by examination of all teeth for the determination of the sextant score. Gingival bleeding, however, was observed more often in the maxillary anterior sextant by full mouth examination than by examination of the gingiva around the right central incisor alone. Due to the high prevalence of gingival bleeding in young subjects, it is suggested that for the identification of treatment priorities, examination of the specified index teeth is of greater value than full mouth examinations. It is not appropriate to include false pockets around erupting teeth as indicators of moderate or advanced treatment need.     

"Critical probing depths" in periodontal therapy

Abstract The present investigation was carried out on 15 individuals who were referred for treatment of moderately advanced periodontal disease. All patients were first subjected to a Baseline examination comprising assessment of oral hygiene and gingival conditions, probing depths and attachment levels. Following case presentation and instructions in oral hygiene measures, the patients were given periodontal treatment utilizing a split mouth design. In one side of the jaw scaling and root planing were performed in conjunction with a modified Widman flap procedure while in the contralateral jaw quadrants the treatment was restricted to scaling and root planing only. The period from initial treatment to 6 months after treatment was considered to be the Healing phase and from 6–24 months after treatment the maintenance phase. During the healing phase the patients were recalled for professional tooth cleaning once every 2 weeks. During the maintenance phase the interval between the recall appointments was extended to 3 months. Reexaminations were carried out 6, 12 and 24 months after the completion of active treatment. The results revealed that treatment resulted in loss of clinical attachment in sites with initially shallow pockets, while sites with initially deep pockets gained clinical attachment. With the use of regression analysis “critical probing depths” were calculated for the two methods of treatment used. It was found that the critical probing depth value for scaling and root planing was significantly smaller than the corresponding value for scaling and root planing used in combination with modified Widman flap surgery (2.9 vs 4.2 mm). In addition, the surgical modality of therapy resulted in more attachment loss than the non-surgical approach when used in sites with initially shallow pockets. On the other hand, in sites with initial probing depths above the critical probing depth value more gain of clinical attachment occurred following Widman flap surgery than following scaling and root planing. The data obtained from the reexaminations 12 and 24 months after active treatment demonstrated that the probing depths and the attachment levels obtained following active therapy and healing were maintained more or less unchanged during a maintenance care period which involved careful prophylaxis once every 3 months. However, the data also disclosed that the level of oral hygiene maintained by the patients during healing and maintenance was more critical for the resulting probing depths and attachment levels than the mode of initial therapy used. Thus, sites which during the maintenance period were found to be free from supragingival plaque were associated with shallow pockets and maintained attachment levels. In contrast, sites which harboured plaque exhibited increasing probing depths and further attachment loss.     

Clinical effects of root instrumentation using conventional steel or non-tooth substance removing plastic curettes during supportive periodontal therapy (SPT)

Although root instrumentation has been accepted as the most important cause-related treatment of periodontal diseases, repeated scaling and root planing may over time result in substantive loss of tooth substance and increased sensitivity of the teeth. In an effort to minimize these side effects of therapy, non-root substance removing curettes have been developed. However, the clinical effects of such plastic curettes with regard to the control of the periodontal infection has not yet been established. The aims of this study were, therefore, to compare the effects of root instrumentation using plastic curettes (Universal Perio Soft Scaler, Hawe-Neos Dental, Bioggio, TI, Switzerland) versus conventional steel curettes on the periodontal conditions during supportive periodontal therapy. 40 subjects participated in this parallel, randomized, double blind, prospective longitudinal clinical study following active peridontal therapy. 20 subjects served as a control group and were treated with conventional steel curettes during a supportive periodontal care visit (SPT). The other 20 subjects, the experimental group, were treated using plastic curettes during a similar SPT visit. Clinical parameters, such as bleeding on probing (BOP) and probing pocket depth (PPD), were assessed at baseline and 3-6 months later at the next regular SPT visit. In addition, the BOP percentage was determined 10 days following baseline. The results showed that there were no statistically significant differences between the 2 treatment modalities regarding BOP and PPD at any observation time. Both treatments were effective in reducing the BOP percentage which ranged from 17-42% at baseline by about 40% after 10 days (mean BOP baseline: 26%, mean BOP after 10 days: 16%). This clinical study suggests that non-root substance removing curettes may be valuable instruments for periodontally treated patients during maintenance care, thus minimizing trauma on the hard structures of the teeth.     

Significance of frequency of professional tooth cleaning for healing following periodontal surgery

Abstract. The present investigation was undertaken to study the significance of frequently repeated professional tooth cleaning for healing results following periodontal surgery. 24 patients suffering from moderately advanced periodontal disease were selected for the study. Following a Baseline examination comprising assessment of oral hygiene status, gingival conditions, probing depths and attachment levels, all patients were given detailed instruction in proper oral hygiene measures. They were then subjected to periodontal surgery using the modified Widman flap procedure. During the initial 6 months after surgery all patients were enrolled in a maintenance care program which included measures such as scaling and professional tooth cleaning. The patients were randomly distributed into 3 different maintenance care groups. 8 patients (Group 1) received maintenance care once every 2 weeks, another 8 patients (Group 2) received a similar treatment once every 4 weeks while the remaining 8 patients (Group 3) were recalled once every 12 weeks. Following a reexamination at the termination of this 6month period the recall program was changed. Thus, during the subsequent 18 months of maintenance (the maintenance phase) all 24 patients were recalled for prophylaxis once every 3 months. A final reexamination was performed 24 months after completion of active therapy. The reexamination performed 6 months after surgery revealed that while patients who had been recalled for professional tooth cleaning once every 2 weeks had low numbers of inflamed gingival units and deep (>3 mm) periodontal pockets, test subjects recalled less frequently exhibited an increasing number of inflamed gingival units and deep pockets. In addition, the frequency of sites exhibiting attachment loss of > 1 mm was closely related to the frequency of maintenance care. Patients recalled once every 12 weeks for maintenance therapy had 3 times the number of sites with attachment loss (>1 mm) as compared to those who were recalled once every 2 weeks. With the use of regression analysis critical probing depth values were calculated. This analysis showed that while the critical probing depth value was Sow in patients frequently recalled during the healing phase, this parameter adopted gradually increasing values in patients recalled with less frequent intervals. Between the 6- and 24-month reexaminations there were no significant alterations of the oral hygiene status, the gingival condition or the probing depth and attachment level data in any of the 3 groups of patients.     

Follow-up study of periodontal tissues around the abutment teeth in Konus telescope denture

The purpose of this study was to evaluate the periodontal tissues around the 47 abutment teeth in patients with advanced periodontitis for 5 years maintenance periods. The periodontal and prosthetic treatment were carried out and 16 Konus telescope dentures were applied for 11 patients. During 5 years maintenance therapy, periodontal conditions were observed once a year assessing probing depth, attachment level, tooth mobility index, gingival index, marginal alveolar bone height, width of periodontal ligament and loss of lamina dura. The results showed that increase of probing depth in 0.61 mm and attachment loss in 0.78 mm were observed for 5 years. A slight gingival inflammation occurred and tooth mobility increased in some extent. Enlargement of periodontal ligament space and loss of lamina dura in 40% of abutment teeth were observed for 5 years. There were six decayed teeth, six teeth, from which a intracoronal crown was removed, and two extracted teeth in 47 abutment teeth. In conclusion, the periodontal tissues around abutment teeth in Konus telescope denture changed slightly at one year after denture placement, after which, the periodontal tissues were well maintained.     

Diagnostic discrimination of bleeding on probing during maintenance periodontal therapy

The purpose of this study was to test the diagnostic discrimination of bleeding on probing in a group of 71 patients who have been treated for periodontitis. They have been maintained over 5 years receiving prophylaxis every 3 months and clinical evaluation once a year. 1,746 teeth were used and extracted and retreated teeth were not included. The presence or absence of bleeding on probing was recorded for each tooth over the five yearly examinations. After recording the site variations between the 1st and the 5th year maintenance values, the highest value of attachment loss per tooth was selected. Teeth were considered diseased when they presented at least one site with 4 mm of probing pocket depth at the baseline (year 1) and 2 mm of attachment loss after 5 years (Criterion 1), or showed 3 mm of attachment loss after 5 years (Criterion 2). The prevalence of disease was 8.19% (143 teeth) for Criterion 1 and 19.7% (344 teeth) for Criterion 2. Bleeding on probing 2 times presented the highest sensitivity (86% Criterion 1 and 64.5% Criterion 2) and the lowest predictability (11.9% Criterion 1 and 21.4% Criterion 2). Bleeding on probing frequency = 5 times showed the highest specificity (93.6% Criterion 1 and 93.4% Criterion 2) and predictability (93.4% Criterion 1 and 81.5% Criterion 2). These results demonstrated that bleeding on probing may not be substituted for clinical attachment levels when evaluating the periodontal attachment loss over time. However, the high specificity and predictability of these tests as a negative one suggests that absence of bleeding after probing may be a good indicator of maintenance of periodontal attachment levels over time.     

Periodontal status of 14–16-year-old Danish schoolchildren

Abstract – The purpose of this study was to determine the prevalence of periodontal disease in teenagers. The survey was conducted on 325 children aged 14,15 and 16 years, living in Aarhus, Denmark. Pocket depth and loss of attachment were measured in mm at the maxillary and mandibular first molars and incisors. Plaque, calculus and gingival bleeding on probing were recorded. A total of 221 children (68%) had 4–5 mm deep pockets and 19 children (5.8%) had pockets deeper than 5 mm on at least one tooth Approximately 11% of the subjects showed loss of attachment on at least on tooth. The frequency of surfaces with plaque and gingivitis was high in all three age groups. Plaque, gingivitis, deepened pockets and loss of attachment were most frequently observed on interproximal surfaces. No significant differences were observed between the sexes with regard to periodontal disease.