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=3 mm). The majority of pockets at T2 showed PDs of 4-5 mm (83.4% of pockets). At the same time, the total number of pockets >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.

[1]  M. Tonetti,et al.  Long-term effects of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. II: tooth extractions during active and supportive therapy. , 2007, Journal of clinical periodontology.

[2]  G. Carnevale.  Fibre retention osseous resective surgery: a novel conservative approach for pocket elimination. , 2007, Journal of clinical periodontology.

[3]  J. Lindhe,et al.  Host response to microbial challenge following resective/non-resective periodontal therapy. , 2005, Journal of clinical periodontology.

[4]  G. Greenstein.  The use of surrogate variables to reflect long-term tooth survivability. , 2005, Journal of periodontology.

[5]  G. Linden,et al.  Re-treatment profiles during long-term maintenance therapy in a periodontal practice in Norway. , 2005, Journal of clinical periodontology.

[6]  J. Lindhe,et al.  Inflammatory lesions in the gingiva following resective/non-resective periodontal therapy. , 2005, Journal of clinical periodontology.

[7]  P. Hujoel.  Endpoints in periodontal trials: the need for an evidence-based research approach. , 2004, Periodontology 2000.

[8]  P Axelsson,et al.  The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance. , 2004, Journal of clinical periodontology.

[9]  A. C. Johannessen,et al.  Tooth loss during maintenance following periodontal treatment in a periodontal practice in Norway. , 2004, Journal of clinical periodontology.

[10]  C. Scapoli,et al.  Modulation of clinical expression of plaque-induced gingivitis. II. Identification of "high-responder" and "low-responder" subjects. , 2004, Journal of clinical periodontology.

[11]  T. Kocher,et al.  Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis. , 2002, Journal of clinical periodontology.

[12]  M. Nieri,et al.  Retrospective Evaluation of the Influence the Interleukin-1 Genotype on Radiographic Bone Levels in Treated Periodontal Patients Over 10 Years. , 2001, Journal of periodontology.

[13]  R. Caffesse,et al.  A longitudinal study comparing scaling, osseous surgery, and modified Widman procedures: results after 5 years. , 1988, Journal of periodontology.

[14]  N. Lang,et al.  Initial extractions and tooth loss during supportive care in a periodontal population seeking comprehensive care. , 2000, Journal of clinical periodontology.

[15]  N. Lang,et al.  Changes in the prevalence of residual pockets and tooth loss in treated periodontal patients during a supportive maintenance care program. , 1998, Journal of clinical periodontology.

[16]  N. Lang,et al.  Generalizability of the added benefits of guided tissue regeneration in the treatment of deep intrabony defects. Evaluation in a multi-center randomized controlled clinical trial. , 1998 .

[17]  G. Armitage,et al.  Periodontal diseases: diagnosis. , 1996, Annals of periodontology.

[18]  N. Lang,et al.  Periodontal diagnosis in treated periodontitis. Why, when and how to use clinical parameters. , 1996, Journal of clinical periodontology.

[19]  K. Patil,et al.  Long-term evaluation of periodontal therapy: I. Response to 4 therapeutic modalities. , 1996, Journal of periodontology.

[20]  K. Kalkwarf,et al.  Long-term evaluation of periodontal therapy: II. Incidence of sites breaking down. , 1996, Journal of periodontology.

[21]  N. Claffey,et al.  Clinical indicators of probing attachment loss following initial periodontal treatment in advanced periodontitis patients. , 1995, Journal of clinical periodontology.

[22]  I. Lamster,et al.  Risk indicators for future clinical attachment loss in adult periodontitis. Tooth and site variables. , 1992, Journal of periodontology.

[23]  K. C. Nixon,et al.  Compliance with supportive periodontal therapy. , 1991, Journal of periodontology.

[24]  N. Lang,et al.  Absence of bleeding on probing. An indicator of periodontal stability. , 1990, Journal of clinical periodontology.

[25]  N. Claffey,et al.  Diagnostic predictability of scores of plaque, bleeding, suppuration and probing depth for probing attachment loss. 3 1/2 years of observation following initial periodontal therapy. , 1990, Journal of clinical periodontology.

[26]  K. Kalkwarf,et al.  Evaluation of four modalities of periodontal therapy. Mean probing depth, probing attachment level and recession changes. , 1988, Journal of periodontology.

[27]  T. Wilson,et al.  Tooth loss in maintenance patients in a private periodontal practice. , 1987, Journal of periodontology.

[28]  J. Egelberg,et al.  Effect of nonsurgical periodontal therapy. VII. Bleeding, suppuration and probing depth in sites with probing attachment loss. , 1985, Journal of clinical periodontology.

[29]  S. Socransky,et al.  Improved periodontal conditions following therapy. , 1985, Journal of clinical periodontology.

[30]  J. Lindhe,et al.  Long-term maintenance of patients treated for advanced periodontal disease. , 1984, Journal of clinical periodontology.

[31]  P Axelsson,et al.  Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. Results after 6 years. , 1981, Journal of clinical periodontology.

[32]  G. van Belle,et al.  A longitudinal study of peridontal status comparing osseous recontouring with flap curettage. I. Results after 6 months. , 1980, Journal of periodontology.

[33]  S. Ramfjord,et al.  Results of periodontal treatment related to pocket depth and attachment level. Eight years. , 1979, Journal of periodontology.

[34]  J. Lindhe,et al.  Periodontal surgery in plaque-infected dentitions. , 1977, Journal of clinical periodontology.

[35]  J. Lindhe,et al.  The healing potential of the periodontal tissues following different techniques of periodontal surgery in plaque-free dentitions. A 2-year clinical study. , 1976, Journal of clinical periodontology.