Tooth loss in periodontal patients

OBJECTIVE: To compare tooth loss between patients who received surgical therapy for chronic periodontitis and those who received nonsurgical therapy alone. METHODS: A retrospective chart study was conducted at Dalhousie University. All patients who had periodontal treatment and were active cases for at least 10 years were included (n = 335). The sample consisted of 120 males (35.8%) and 215 females (64.2%). Ages ranged from 16 to 77 (mean = 46.1 +/- 12.0 years). All patients received nonsurgical therapy; 44.8% received periodontal surgery as well. Variables recorded were demographics, initial attachment loss, treatment type, recall frequency, patient compliance and history of extracted teeth. Independent t-tests or chi-squared tests were used to compare these for surgical and nonsurgical patients. ANOVA was used to test for interactions between initial attachment loss, age, gender, compliance and type of therapy a patient received as reasons for tooth loss. RESULTS: 521 teeth were lost in 69 patients (20.6% of sample). Of teeth lost, 61.8% were due to periodontal disease; 24.8% to caries; 13.2% to other reasons. Patients initially diagnosed with early attachment loss lost an average of 0.37 (+/- 1.33) teeth. Patients diagnosed with moderate attachment loss lost an average of 1.50 (+/- 2.54) teeth and those diagnosed with advanced attachment loss lost an average of 3.11 (+/- 3.01) teeth. Those who received surgical therapy lost more teeth (mean = 1.31 +/- 2.36) than those who received nonsurgical treatment (mean = 0.68 +/- 1.87; p = 0.001). However, initial attachment loss was the only factor that could predict tooth loss. The type of therapy (surgical or nonsurgical) was not statistically significant. CONCLUSIONS: Most periodontal patients (79.4%) who received treatment at this dental school clinic did not lose any teeth due to periodontal disease over at least 10 years. Although patients who had surgical therapy lost more teeth than those who had nonsurgical therapy alone, this was not an important predictor of tooth loss.     

Tooth loss in 100 treated patients with periodontal disease. A long-term study

A population of 100 patients with periodontal disease who had been treated and maintained for 15 years or longer was studied for tooth loss. The patients averaged 43.8 years of age and consisted of 59 females and 41 males. Patients were examined and their dental records were reviewed. On the basis of response to therapy and tooth loss, the patients were classified as Well-Maintained (77), Downhill (15), or Extreme Downhill (8). At the completion of initial treatment, 2,627 teeth were present. Of this number, during the maintenance period, 259 teeth (9.8%) were lost due to periodontal disease, while 40 teeth (1.5%) were lost due to other causes. Evaluation was made as to patterns of tooth loss, loss of questionable teeth, loss of teeth with furcations, surgical vs. nonsurgical therapy, and presence of fixed or removable prostheses. Considerable variation occurred between response groups. Periodontal disease appears to be bilaterally symmetrical and tooth loss response emulated this pattern with greatest loss of maxillary second molars and least loss of mandibular cuspids.     

Effect of periodontal therapy on patients maintained for 15 years or longer. A retrospective study

A retrospective study of tooth loss in 211 patients who were treated for periodontal disease in private practice and maintained for 15 to 34 years on 3- to 6-month recall schedules is reported. The average age of the patients was 42 years, and the average length of time in maintenance was 22 years. On the basis of response to therapy, the patients were classified as Well-Maintained (62%), Downhill (28%) and Extreme Downhill (10%). Seven hundred and seventy-one (771) teeth were lost (13.4%) due to all causes. Molar teeth are the most prone to loss and the mandibular cuspid is the most resistant. The importance of maintenance therapy is emphasized.     

A long-term survey of tooth loss in 600 treated periodontal patients.

1. Six hundred patients in a private periodontal practice were reexamined an average of 22 years after their active treatment and the patterns of tooth loss were observed. 2. During the post-treatment period, 300 patients had lost no teeth from periodontal disease, 199 had lost one to three teeth, 76 had lost 4 to 9 teeth and 25 had lost 10 to 23 teeth. 3. Of 2,139 teeth that originally had been considered of questionable prognosis, 666 were lost. Of these, 394 were lost by one sixth of the patients and only 272 by the other five-sixths. 4. Of 1,464 teeth which originally had furcation involvements, 460 were lost, 240 of them by one-sixth of the patients who deteriorated most. 5. The mortality of teeth which were treated with periodontal surgery was compared with that of teeth which did not have surgery. Tooth retention seemed more closely related to the case type than the surgery performed. 6. In general, periodontal disease is bilaterally symmetrical and there is a predictable order of likelihood of tooth loss according to position in the arch.     

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.     

A 12-year retrospective audit study of tooth loss in a general dental practice

OBJECTIVES: To determine the incidence of periodontal disease in a general dental practice, and to evaluate the effectiveness of treatment in preventing tooth loss over a period of 12 years. DESIGN: This was a single centre retrospective analysis. SETTING: A general dental practice in Bournemouth. SUBJECTS AND METHODS: Over a 6-month period from February 1997 to August 1997 records were made of all patients attending at the practice who had presented for dental examination between September 1985 and September 1986. A database was constructed to record the number of teeth present at the beginning of the study, those which at their initial exam had probing depths of between 5 and 6 mm, and those with 7 mm and greater. If teeth were lost, the date of the extraction was recorded. INTERVENTIONS: All patients were treated by conventional dental therapy. MAIN OUTCOME MEASURES: Tooth loss was chosen as the end-point. RESULTS: 13% of the patients presenting initially had periodontal problems, and conventional treatment resulted in very few teeth being lost over the study period. CONCLUSIONS: Periodontal disease affected only a small number of the patients in the general dental practice. Those patients affected responded well to conventional therapy, resulting in very few teeth being lost during the period of study.     

Postprocedural problems in an overdenture population: a longitudinal study

This study reports on endodontic and other post-procedural problems experienced by overdenture patients from 1973 to 1996. There were 395 subjects enrolled in the study; 273 fulfilled the recall criteria. At recall, all subjects were examined by a single examiner, and appropriate maintenance care was performed. The 273 subjects had 666 abutments and 626 endodontically treated teeth; of these, 51 subjects had postprocedural problems in 81 teeth. Thus, 87.1% of the endodontically treated teeth had no postprocedural problems, and 12.9% had postprocedural problems. Of the subpopulation with postprocedural problems, the most common problem was endodontically treated teeth developing periradicular lesions (37.0%) because of recurrent caries causing loss of the restoration sealing the root canal. Twenty of the 30 teeth were successfully retreated. The next most common problem was vertical root fractures (30.9%), followed by vital teeth developing periradicular lesions (19.8%).Most of the failures could have been prevented by better oral hygiene. Vertical root fractures were statistically associated with abutments in the maxilla and opposed by natural teeth; protection of these abutments with thimble crowns could prevent fractures.     

Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil

AIM: The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. MATERIAL AND METHODS: A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. RESULTS: Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). CONCLUSION: The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.     

Long-term evaluation of surgical periodontal treatment with and without maintenance care.

A study was conducted on the effectiveness of individual maintenance recalls and the long-term effects of surgical therapy on pocket depth and tooth loss in 43 patients with moderate to advanced periodontal disease. Sixteen of the patients had periodic control and 27 were uncontrolled. Intervals of periodic recall ranged from 3 to 6 months according to individual needs. Pocket depths were measured from four aspects of each tooth and initially classified as shallow (1-3 mm), moderate (4-6 mm) or deep (7 mm or more). Changes in each pocket depth level were determined after 10 years. Tenth-year comparisons showed that the uncontrolled group had significantly higher mean pocket depth values. Tooth loss rate was 3.6% in the controlled group, and 14.1% in the uncontrolled group, and the mean numbers of lost teeth were 0.69 and 3.63, respectively, in the ten-year period. It was concluded that periodic recalls were essential for long-term success of periodontal surgery.     

A survey of reasons for extraction of permanent teeth in Singapore

Abstract A survey was carried out to determine the reasons for tooth extractions of permanent teeth in Singapore. Data were obtained from 52 dentists practising general dentistry over a period of 12 months. At the end of the 12-month period, data were collected from 1276 patients, from whom a total 272 teeth were extracted. In this population group, the results showed that the percentage of teeth extracted due to periodontal reasons and caries were about the same, that is, 35.8% and 35.4%, respectively. There was an increase in teeth extracted due to periodontal reasons with age. In patients above 40 yr, an average of 76% of teeth were lost due to periodontal reasons. An average of 26.7% of teeth were lost due to periodontal reasons in patients under 40 yr old. However, the trend for loss of teeth due to caries is reversed. Posterior teeth were more frequently extracted compared to anterior teeth. Third molars accounted for 24.7% of all extractions carried out. whilst central incisors were 8.0% of all extractions. Molars were often lost due to caries and lower anterior teeth were most frequently lost due to periodontal reasons. The results of this study did not demonstrate one predominant reason for extraction. Both caries and periodontal reasons were equally common causes of tooth extraction.     

Periodontal risk assessment model in a sample of regular and irregular compliers under maintenance therapy: a 3-year prospective study

Background: The purpose of this study is to investigate the association of the periodontal risk assessment (PRA) model with the recurrence of periodontitis and tooth loss during periodontal maintenance therapy (PMT). Methods: In a prospective PMT program, 75 regular complier (RC) and 89 erratic complier (EC) patients were selected. A periodontal examination and PRA were performed after active periodontal therapy and after 3 years of PMT. Risk profiles (low, moderate, or high) of participants were evaluated, and the recurrence of periodontitis and tooth loss were analyzed using univariate and multivariate analyses. Results: RCs showed less recurrence of periodontitis and tooth loss than ECs (P <0.05). Rates of periodontitis recurrence in RCs and ECs were 2.7% and 3.4%, respectively, for the moderate‐risk profile and 6.7% and 11.2%, respectively, for the high‐risk profile. During PMT, 49 teeth (0.65 ± 1.4 teeth per participant) were lost in the RC group, and 70 teeth (0.78 ± 2.1 teeth per participant) were lost in the EC group. High‐risk profile participants showed more recurrence of periodontitis and lost significantly more teeth than did participants with moderate‐ or low‐risk profiles in RC and EC groups (P <0.05). Conclusion: The risk profile influenced the recurrence of periodontitis and tooth loss. RCs had less recurrence of periodontitis and less tooth loss. The PRA model can be useful in particularizing the risk of patients and adjusting recall intervals.     

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.     

Untreated periodontal disease: a follow-up on 30 cases

BACKGROUND: Many studies have shown that periodontal disease can be successfully treated. However, there is limited documentation as to what happens when periodontal disease is left untreated. This study examined patients in a private practice who were diagnosed with periodontal disease and did not complete any treatment. The goal was to see what happened to this group of untreated patients. METHODS: Thirty patients with periodontal disease were included in this study. After a mean period of 2.1 years without periodontal treatment, the patients were re-examined and the changes which occurred evaluated. RESULTS: There was a statistically significant increase in probing depth (3.43 mm to 3.95 mm) and attachment loss (4.19 mm to 4.77 mm) and a statistically significant decrease in the number of teeth present (23.37 to 22.67). Twenty-one teeth were lost, which was 3.0% of the teeth present at the time of initial diagnosis. The rate of tooth loss was 0.32 teeth/patient/year. The teeth that were lost had deeper recession, probing depths, and attachment loss than the teeth that were retained. Patient factors evaluated could not be associated with statistically significant changes in the clinical parameters, except that smokers had a greater number of sites gaining > or = 2 mm of attachment and patients with the poorest oral hygiene had a greater percent of sites breaking down. However, certain site specific variables could be associated with statistically significant changes in the clinical parameters. These included sites: with bleeding on probing, associated with molar furcations, on interproximal surfaces, at posterior teeth, with probing depths > or = 3.43 mm, with probing depths > or = 7 mm, attachment loss > or = 7 mm, and teeth with increased mobility. CONCLUSIONS: This group of patients with untreated periodontal disease had greater breakdown and tooth loss than one would expect to see in a group of patients if their periodontal disease was treated.     

Pattern of tooth loss in recipients of free dental treatment at the University Hospital of Amman, Jordan

The aim of this study is to document reasons for tooth loss in disadvantaged Jordanians who seek free dental care at the University Hospital/Dental Clinics. A 4-year (1998-2001) prospective study was undertaken involving 2200 randomly selected patients from this subpopulation. Of their 3069 lost teeth, 46.9% were lost due to caries and its sequel; 18% were lost because of periodontal disease; 8% were lost for a combination of caries and periodontal disease; 19.4% for pre-prosthetic reasons; 4% for orthodontic reasons; 2.8% for eruption problems and 0.7% due to trauma. Logistic regression analysis for reasons of tooth loss in this sector revealed that caries and its sequel was the predominant cause of tooth loss in patients 相似文献   

Tooth loss during maintenance following periodontal treatment in a periodontal practice in Norway

BACKGROUND: Periodontal therapy coupled with careful maintenance has been shown to be effective in maintaining periodontal health; however, a small number of teeth are still lost because of progressive periodontitis. AIM: To investigate factors associated with tooth loss due to periodontal reasons during maintenance following periodontal treatment in patients in a Norwegian specialist periodontal practice. The study also examined how initial prognosis related to actual outcome as measured by periodontal tooth loss. METHODS: Hundred consecutive patients (68 females, 32 males) who had comprehensive periodontal treatment and attended for 9.8 (SD: 0.7), range: 9-11 years of maintenance care, were studied. All teeth classified as being lost due to periodontal disease over the period were identified. RESULTS: Only 36 (1.5%) of the 2436 teeth present at baseline were subsequently lost due to periodontal disease. There were 26 patients who lost at least one tooth. Logistic regression analysis showed that tooth loss was significantly related to male gender (p=0.049; adjusted odds ratio: 2.8; confidence interval (c.i.): 1.0-8.1), older age, i.e.>60 years (p=0.012; adjusted odds ratio: 4.0; c.i.: 1.3-12.0) and smoking (p=0.019; adjusted odds ratio: 4.2; c.i.: 1.4-13.8). The majority 27 (75%) of the teeth lost due to periodontal disease had been assigned an uncertain, poor or hopeless initial prognosis; however, nine teeth (25%) lost had been assigned a good prognosis at baseline. The prognosis for 202 teeth was judged to have worsened over the period of the study. CONCLUSION: Compliance with maintenance following periodontal treatment was associated with very low levels of tooth loss in a referral practice in rural Norway. Male gender, older age (>60 years) and smoking were predictors of tooth loss due to progressive periodontitis.     

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.     

Patterns of and reasons for tooth extractions in general dental practice in Ontario, Canada

Abstract While substantial proportions of the population of Ontario, Canada continue to have teeth extracted, little is known about the reasons for this loss. In this survey of Ontario general dental practitioners. 128 dentists provided information on 6143 patients they saw during a reference week. Approximately one-in-seven of these patients had or were going to have one or more extractions as part of their current course of treatment. The mean number of extractions for patients having at least one tooth taken out was 2.3 (SD=2.5). Emergency patients were more likely than regular patients to have at least one extraction but, on average, had fewer teeth taken out. Orthodontic considerations were the main reason for tooth loss in childhood, caries continued to be an important cause of tooth loss at all ages and periodontal disease accounted for more teeth lost after 40 years of age than caries. This study differs from almost all others in finding that, overall, more permanent teeth were extracted because of periodontal disease than because of caries. The former accounted for 35.9% of teeth lost and the latter for 28.9%. While this may be due to methodological differences between this and other studies, it is consistent with epidemiological data on periodontal disease in the Ontario population and data showing that Ontarians receive little in the way of periodontal care.     

Effect of periodontal therapy in smokers and non-smokers with advanced periodontal disease: results after maintenance therapy for a minimum of 5 years

BACKGROUND: Longitudinal clinical studies show smoking is a risk factor for periodontal disease progression. It has also been documented that smoking impairs healing after periodontal therapy. However, the longitudinal effect of smoking on treatment results in patients who undergo long-term maintenance therapy has not been extensively investigated. This study clinically and radiographically compared smoking and non-smoking patients who had been treated for advanced periodontal disease and who received maintenance therapy for a minimum of 5 years. METHODS: Twenty-nine patients were selected over a 6-month period when they presented for a regularly scheduled visit in a private office. Patients were selected on the basis of initially having lost 50% of bone support on 50% of their teeth; had received follow-up therapy for at least 5 years; were compliant at 75% of the appointments; and had plaque scores < 20% in 75% of the visits. All patients had received non-surgical and surgical therapy as required for pocket elimination. Fourteen were active smokers during the entire maintenance period. Clinical measurements of probing depths and presence of plaque and gingivitis and a new set of standardized radiographs were taken. RESULTS: Smokers had higher mean radiographic bone loss values prior to treatment (7.52 +/- 1.39 versus 6.65 +/- 1.39) and at the final examination (7.32 +/- 1.42 versus 6.29 +/- 1.29) mean radiographic bone loss as well as initial, immediate post-therapy, and final percent of pockets > or = 6 mm (1.42% +/- 1.87% versus 0.60% +/- 1.11%). Differences were not statistically significant. Over 5 to 8 years, seven sites in four non-smokers and 11 sites in six smokers exhibited radiographic bone loss > or = 2 mm. One tooth in a non-smoker and three teeth in two smokers were lost. In a logistic regression analysis, smoking increased the odds ratio 10.7 times of having > or = 1 site with bone loss > or = 2 mm. CONCLUSION: The present study on a small group of patients treated for advanced periodontal disease and well maintained over 5 to 8 years showed no statistically significant differences between smokers and non-smokers in clinical probing depth and radiographic bone loss measurements.     

Periodontal destruction and loss of the remaining natural teeth

Interproximal bone levels were measured from orthopantograms of a consecutive group of 373 patients who had all their remaining teeth extracted in a dental teaching hospital. There was little periodontal destruction below the age of 40. In older patients (those aged 40 or over) 77% of the teeth had lost at least 25% of their supporting bone. 64% of the older patients had at least one tooth with advanced (more than 50%) bone loss. Only 15% of the patients had generalised advanced periodontal destruction (more than 50% of their teeth with advanced bone loss) at clearance. Men had more periodontal destruction than women. It was concluded that severe periodontal disease was limited to a small proportion of the patients in which it was a major factor in the loss of their dentition. However, in many cases it was doubtful whether the periodontal condition was of any consequence when the decision was taken to remove the remaining natural teeth.     

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.