Tooth loss and survival rate in chronic moderate to severe periodontitis. A synthetic search of non-surgical therapy studies.
Journal Title: Medicine in Evolution - Year 2017, Vol 0, Issue 3
Abstract
Introduction: in patients suffering of chronic severe generalized periodontitis, there are teeth at borderline, rising up the question of retaining or extracting. According to systems for assigning periodontal prognosis, these are classified as having questionable, unfavorable or hopeless prognosis. It has been shown, that the prognosis can be improved in most of the cases. Objective of this research was to review in a synthetic search the literature reporting the survival analysis (survival rate, tooth loss) of teeth with severe reduced attachment apparatus, and to assess, according to this literature, the ability of long term supportive periodontal care to modify the prognosis from hopeless to unfavorable or questionable. Methods: articles were electronically searched in PubMed and in relevant scientific journals. The filters used referred to full text articles and human studies. The query used in the advanced search offered 1,486 results. Studies were considered for inclusion if limited to patients with moderate to severe periodontitis, who underwent active periodontal therapy (APT) and followed a supportive periodontal care (SPT) program for at least 5 years. Also, they had to report data on tooth loss, diagnosis, prognosis, treatment approach, supportive periodontal treatment, treatment outcome. Results: from the electronic database search and the screening of the reference list of included publications, 18 articles were selected and grouped according to the treatment approach: non-surgical; surgical, non-regenerative therapy; surgical regenerative therapy. 3 articles were selected for the topic non-surgical therapy, and 15 for surgical therapy. In patients treated with non-surgical proceduers alone, the conclusions were: 1. patients highly susceptible to periodontitis exhibit a tooth loss rate almost 6 times higher than patients with normal susceptibility; 2. the decision for tooth extraction may also reflect the experience, knowledge, skills of the dentist and economical aspects of the treatment, and not only the factors related to the tooth or the patient; 3. even teeth initially classified as questionable or hopeless can be retained in the majority of patients; 4. prognostic factors for tooth loss in SPT remain confirmed: the patient’s age, the bone loss, the maximum PD after APT, multirooted teeth and the smoking habits. Studies in this first part of the paper were selected for the non-surgical treatment regimen, and data are synthetized and briefly commented.
Authors and Affiliations
Radulescu V. , Boariu M. , Rusu D. , Calniceanu H. , Stratul S. -I.
Keywords
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