Maintenance visit regularity has a different impact on periodontitis‐related tooth loss depending on patient staging and grading

• Published in: Journal of clinical periodontology Vol. 48; no. 8; pp. 1008 - 1018
• Main Authors: Ravidà, Andrea, Galli, Matthew, Saleh, Muhammad H. A., Rodriguez, Maria Vera, Qazi, Musa, Troiano, Giuseppe, Chan, Hsun‐Liang, Wang, Hom‐Lay
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-08-2021
• Subjects: Aged; Gum disease; Humans; Periodontitis; Periodontitis - complications; Periodontitis - therapy; Retrospective Studies; staging and grading; supportive periodontal maintenance therapy; tooth loss; Tooth Loss - etiology; supportive periodontal maintenance therapy; tooth loss; staging and grading; periodontitis
• ISSN: 0303-6979; 1600-051X
• DOI: 10.1111/jcpe.13489

Aim
To assess whether maintenance variables have a differential effect on tooth loss due to periodontitis (TLP) based on staging and grading.
Materials and Methods
Patients treated for periodontitis for a minimum of ≥10 years follow‐up were included and categorized according to their stage and grade at baseline. Impact of number, regularity, and pattern of supportive periodontal therapy visits (SPT) on TLP was explored by dividing teeth into test (5 year time periods prior to TLP events) and control groups (random 5 year periods without tooth loss).
Results
The regularity of maintenance visits, but not the overall quantity, had a significant impact on risk of TLP and showed higher importance as staging and grading increased (larger impact for stages III/IV and grade C). The minimum threshold of visits below which the risk of TLP was equivalent to that of the control group was one visit every 7.4 months for stages I‐II, 6.7 months for stage III‐IV, 7.2 months for grade B and 6.7 months for grade C. This frequency should be increased for former and current smokers, diabetics and elderly patients. Stage III and IV patients who skip more than 1 year of maintenance in a 5 year period have an increased risk of TLP (OR = 2.55) compared to those only miss 1 year. A similar trend was noted for grade C patients, but not for stages I/II or grades A/B.
Conclusions
Lack of SPT regularity and missing multiple years of maintenance had a larger influence on risk of TLP for higher‐level staging and grading.