The Potential Prognostic Value of Some Periodontal Factors for Tooth Loss: A Retrospective Multilevel Analysis on Periodontal Patients Treated and Maintained Over 10 Years
Background: The great challenge in clinical periodontology is assigning a prognosis to a periodontally affected patient. Many different factors can affect the long‐term maintenance of periodontally compromised teeth. The main questions usually considered by the periodontist are: 1) Will a tooth lose...
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| creator | Muzzi, Leonardo Nieri, Michele Cattabriga, Marcello Rotundo, Roberto Cairo, Francesco Pini Prato, Giovan Paolo |
| description | Background: The great challenge in clinical periodontology is assigning a prognosis to a periodontally affected patient. Many different factors can affect the long‐term maintenance of periodontally compromised teeth. The main questions usually considered by the periodontist are: 1) Will a tooth lose more bone in the future? 2) Will the tooth itself be lost in the future? The purpose of this retrospective study was to evaluate the value of some clinical, genetic, and radiographic variables in predicting tooth loss in periodontal patients (aged 40 to 60 years) treated and maintained for 10 years.
Methods: Sixty consecutive non‐smoking patients (aged 46.77 ± 4.96 years) with moderate to severe chronic periodontitis (CP) were treated with scaling and root planing (SRP). Some patients also underwent additional surgical treatments. All patients were maintained in the same private practice for 10 years. The frequency of recall appointments was 3.4 ± 1.0 months. At baseline (T0) and 10 years later (T2) the following clinical variables were evaluated: the number of teeth, probing depths (PD), tooth mobility (TM), and presence of prosthetic restorations (PR). In addition, radiographic measurements were taken of the mesial and distal distances from the cemento‐enamel junction (CEJ) to the bottom of the defect (BD), to the bone crest (BC), and to the root apex (RA). At T2, a genetic test to determine the IL‐1 genotype and genetic susceptibility for severe periodontal disease was performed for all 60 patients, and they were classified as IL‐1 genotype positive (G+) or negative (G−) according to the test results. Tooth loss was used as the outcome variable. Different predictor variables were then tested using a two‐level statistical model (patient and tooth levels). At the patient level, these were: age, gender, mean bone loss (mean CEJ‐BD)T0, the interleukin‐1 (IL‐1) genotype, the interaction between mean bone loss, and IL‐1 genotype (mean CEJ‐BDT0 × IL‐1 genotype). At the tooth level, the variables were: TMT0, prosthetic restorations (PR)T0, molar teeth (MT)T0, the infrabony component of the defect (BC‐BD)T0, PDT0, bone level (CEJ‐BD)T0, and residual supporting bone (BD‐RA)T0.
Results: Among the considered predictor variables, the following were significantly associated with the outcome variable: 1) MTT0 (P |
| doi_str_mv | 10.1902/jop.2006.050227 |
| format | Article |
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Methods: Sixty consecutive non‐smoking patients (aged 46.77 ± 4.96 years) with moderate to severe chronic periodontitis (CP) were treated with scaling and root planing (SRP). Some patients also underwent additional surgical treatments. All patients were maintained in the same private practice for 10 years. The frequency of recall appointments was 3.4 ± 1.0 months. At baseline (T0) and 10 years later (T2) the following clinical variables were evaluated: the number of teeth, probing depths (PD), tooth mobility (TM), and presence of prosthetic restorations (PR). In addition, radiographic measurements were taken of the mesial and distal distances from the cemento‐enamel junction (CEJ) to the bottom of the defect (BD), to the bone crest (BC), and to the root apex (RA). At T2, a genetic test to determine the IL‐1 genotype and genetic susceptibility for severe periodontal disease was performed for all 60 patients, and they were classified as IL‐1 genotype positive (G+) or negative (G−) according to the test results. Tooth loss was used as the outcome variable. Different predictor variables were then tested using a two‐level statistical model (patient and tooth levels). At the patient level, these were: age, gender, mean bone loss (mean CEJ‐BD)T0, the interleukin‐1 (IL‐1) genotype, the interaction between mean bone loss, and IL‐1 genotype (mean CEJ‐BDT0 × IL‐1 genotype). At the tooth level, the variables were: TMT0, prosthetic restorations (PR)T0, molar teeth (MT)T0, the infrabony component of the defect (BC‐BD)T0, PDT0, bone level (CEJ‐BD)T0, and residual supporting bone (BD‐RA)T0.
Results: Among the considered predictor variables, the following were significantly associated with the outcome variable: 1) MTT0 (P <0.0001); 2) BC‐BDT0 (P = 0.0377); and 3) BD‐RAT0 (P <0.0001). MTT0 were found to be more prone to loss and the amount of BD‐RAT0 prognostic for tooth loss: the lower the residual amount of supporting bone, the higher the probability of tooth loss. Conversely, the BC‐BDT0was associated with a reduced probability of future tooth loss: the greater the infrabony component, the lower the probability of tooth loss. None of the other considered predictors proved predictive for tooth loss.
Conclusions: Within the scope of this study, many traditional prognostic factors were ineffective in predicting future tooth loss and, therefore, were of no prognostic value. Conversely, a few specific factors at the tooth level emerged as viable prognostic factors. The use of these factors may be of great value to practitioners as predictors of tooth loss when assigning a prognosis.</description><identifier>ISSN: 0022-3492</identifier><identifier>EISSN: 1943-3670</identifier><identifier>DOI: 10.1902/jop.2006.050227</identifier><identifier>PMID: 17209795</identifier><language>eng</language><publisher>United States: American Academy of Periodontology</publisher><subject>Adult ; Aged ; Alveolar Process - physiopathology ; Cohort Studies ; Dentistry ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Interleukin-1 - genetics ; interleukin‐1 ; Longitudinal Studies ; Male ; Middle Aged ; Models, Statistical ; Molar - physiopathology ; periodontal disease ; Periodontal Index ; Periodontitis - complications ; Periodontitis - diagnosis ; Periodontitis - genetics ; Periodontitis - therapy ; Predictive Value of Tests ; Prognosis ; Radiography ; Retrospective Studies ; Root Planing ; Severity of Illness Index ; tooth loss ; Tooth Loss - diagnostic imaging ; Tooth Loss - etiology ; Tooth Loss - genetics ; Tooth Loss - prevention & control ; Tooth Mobility - complications ; Tooth Mobility - diagnosis ; Tooth Mobility - therapy</subject><ispartof>Journal of periodontology (1970), 2006-12, Vol.77 (12), p.2084-2089</ispartof><rights>2006 American Academy of Periodontology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4074-fbf0429f078ae5d8ecd376482c9200dd517724b4799d97542fad5c3b7b3ce1fc3</citedby><cites>FETCH-LOGICAL-c4074-fbf0429f078ae5d8ecd376482c9200dd517724b4799d97542fad5c3b7b3ce1fc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1902%2Fjop.2006.050227$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1902%2Fjop.2006.050227$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17209795$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muzzi, Leonardo</creatorcontrib><creatorcontrib>Nieri, Michele</creatorcontrib><creatorcontrib>Cattabriga, Marcello</creatorcontrib><creatorcontrib>Rotundo, Roberto</creatorcontrib><creatorcontrib>Cairo, Francesco</creatorcontrib><creatorcontrib>Pini Prato, Giovan Paolo</creatorcontrib><title>The Potential Prognostic Value of Some Periodontal Factors for Tooth Loss: A Retrospective Multilevel Analysis on Periodontal Patients Treated and Maintained Over 10 Years</title><title>Journal of periodontology (1970)</title><addtitle>J Periodontol</addtitle><description>Background: The great challenge in clinical periodontology is assigning a prognosis to a periodontally affected patient. Many different factors can affect the long‐term maintenance of periodontally compromised teeth. The main questions usually considered by the periodontist are: 1) Will a tooth lose more bone in the future? 2) Will the tooth itself be lost in the future? The purpose of this retrospective study was to evaluate the value of some clinical, genetic, and radiographic variables in predicting tooth loss in periodontal patients (aged 40 to 60 years) treated and maintained for 10 years.
Methods: Sixty consecutive non‐smoking patients (aged 46.77 ± 4.96 years) with moderate to severe chronic periodontitis (CP) were treated with scaling and root planing (SRP). Some patients also underwent additional surgical treatments. All patients were maintained in the same private practice for 10 years. The frequency of recall appointments was 3.4 ± 1.0 months. At baseline (T0) and 10 years later (T2) the following clinical variables were evaluated: the number of teeth, probing depths (PD), tooth mobility (TM), and presence of prosthetic restorations (PR). In addition, radiographic measurements were taken of the mesial and distal distances from the cemento‐enamel junction (CEJ) to the bottom of the defect (BD), to the bone crest (BC), and to the root apex (RA). At T2, a genetic test to determine the IL‐1 genotype and genetic susceptibility for severe periodontal disease was performed for all 60 patients, and they were classified as IL‐1 genotype positive (G+) or negative (G−) according to the test results. Tooth loss was used as the outcome variable. Different predictor variables were then tested using a two‐level statistical model (patient and tooth levels). At the patient level, these were: age, gender, mean bone loss (mean CEJ‐BD)T0, the interleukin‐1 (IL‐1) genotype, the interaction between mean bone loss, and IL‐1 genotype (mean CEJ‐BDT0 × IL‐1 genotype). At the tooth level, the variables were: TMT0, prosthetic restorations (PR)T0, molar teeth (MT)T0, the infrabony component of the defect (BC‐BD)T0, PDT0, bone level (CEJ‐BD)T0, and residual supporting bone (BD‐RA)T0.
Results: Among the considered predictor variables, the following were significantly associated with the outcome variable: 1) MTT0 (P <0.0001); 2) BC‐BDT0 (P = 0.0377); and 3) BD‐RAT0 (P <0.0001). MTT0 were found to be more prone to loss and the amount of BD‐RAT0 prognostic for tooth loss: the lower the residual amount of supporting bone, the higher the probability of tooth loss. Conversely, the BC‐BDT0was associated with a reduced probability of future tooth loss: the greater the infrabony component, the lower the probability of tooth loss. None of the other considered predictors proved predictive for tooth loss.
Conclusions: Within the scope of this study, many traditional prognostic factors were ineffective in predicting future tooth loss and, therefore, were of no prognostic value. Conversely, a few specific factors at the tooth level emerged as viable prognostic factors. The use of these factors may be of great value to practitioners as predictors of tooth loss when assigning a prognosis.</description><subject>Adult</subject><subject>Aged</subject><subject>Alveolar Process - physiopathology</subject><subject>Cohort Studies</subject><subject>Dentistry</subject><subject>Female</subject><subject>Genetic Predisposition to Disease</subject><subject>Genotype</subject><subject>Humans</subject><subject>Interleukin-1 - genetics</subject><subject>interleukin‐1</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Statistical</subject><subject>Molar - physiopathology</subject><subject>periodontal disease</subject><subject>Periodontal Index</subject><subject>Periodontitis - complications</subject><subject>Periodontitis - diagnosis</subject><subject>Periodontitis - genetics</subject><subject>Periodontitis - therapy</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Root Planing</subject><subject>Severity of Illness Index</subject><subject>tooth loss</subject><subject>Tooth Loss - diagnostic imaging</subject><subject>Tooth Loss - etiology</subject><subject>Tooth Loss - genetics</subject><subject>Tooth Loss - prevention & control</subject><subject>Tooth Mobility - complications</subject><subject>Tooth Mobility - diagnosis</subject><subject>Tooth Mobility - therapy</subject><issn>0022-3492</issn><issn>1943-3670</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1vGyEQhlHVqHGTnnurOPW2DrDssvRmRUk_5ChW4lbqCbEwNETrxQHWlX9T_2SJbKnKqSc08PCOZh6E3lMyp5Kwi8ewnTNC2jlpCGPiFZpRyeuqbgV5jWak3FU1l-wUvU3psZSU1-QNOqWCESlkM0N_1g-AVyHDmL0e8CqGX2NI2Rv8Qw8T4ODwfdgUBKIPNoy5QNfa5BATdiHidQj5AS9DSp_wAt9BjiFtwWS_A3wzDdkPsIMBL0Y97JNPOIwvolY6-9I64XUEncFiPVp8o3159GMpb3cQMSX4J-iYztGJ00OCd8fzDH2_vlpffqmWt5-_Xi6WleFE8Mr1jnAmHRGdhsZ2YGwtWt4xI8uqrG2oEIz3XEhppWg4c9o2pu5FXxugztRn6OMhdxvD0wQpq41PBoZBjxCmpNqOdW3XNQW8OICmTJ0iOLWNfqPjXlGinv2o4kc9-1EHP-XHh2P01G_A_uOPQgrQHIDfZXP7_-Wpb6urO0Y6Xv8FZMaeyA</recordid><startdate>200612</startdate><enddate>200612</enddate><creator>Muzzi, Leonardo</creator><creator>Nieri, Michele</creator><creator>Cattabriga, Marcello</creator><creator>Rotundo, Roberto</creator><creator>Cairo, Francesco</creator><creator>Pini Prato, Giovan Paolo</creator><general>American Academy of Periodontology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200612</creationdate><title>The Potential Prognostic Value of Some Periodontal Factors for Tooth Loss: A Retrospective Multilevel Analysis on Periodontal Patients Treated and Maintained Over 10 Years</title><author>Muzzi, Leonardo ; Nieri, Michele ; Cattabriga, Marcello ; Rotundo, Roberto ; Cairo, Francesco ; Pini Prato, Giovan Paolo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4074-fbf0429f078ae5d8ecd376482c9200dd517724b4799d97542fad5c3b7b3ce1fc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alveolar Process - physiopathology</topic><topic>Cohort Studies</topic><topic>Dentistry</topic><topic>Female</topic><topic>Genetic Predisposition to Disease</topic><topic>Genotype</topic><topic>Humans</topic><topic>Interleukin-1 - genetics</topic><topic>interleukin‐1</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Statistical</topic><topic>Molar - physiopathology</topic><topic>periodontal disease</topic><topic>Periodontal Index</topic><topic>Periodontitis - complications</topic><topic>Periodontitis - diagnosis</topic><topic>Periodontitis - genetics</topic><topic>Periodontitis - therapy</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Root Planing</topic><topic>Severity of Illness Index</topic><topic>tooth loss</topic><topic>Tooth Loss - diagnostic imaging</topic><topic>Tooth Loss - etiology</topic><topic>Tooth Loss - genetics</topic><topic>Tooth Loss - prevention & control</topic><topic>Tooth Mobility - complications</topic><topic>Tooth Mobility - diagnosis</topic><topic>Tooth Mobility - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muzzi, Leonardo</creatorcontrib><creatorcontrib>Nieri, Michele</creatorcontrib><creatorcontrib>Cattabriga, Marcello</creatorcontrib><creatorcontrib>Rotundo, Roberto</creatorcontrib><creatorcontrib>Cairo, Francesco</creatorcontrib><creatorcontrib>Pini Prato, Giovan Paolo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of periodontology (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muzzi, Leonardo</au><au>Nieri, Michele</au><au>Cattabriga, Marcello</au><au>Rotundo, Roberto</au><au>Cairo, Francesco</au><au>Pini Prato, Giovan Paolo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Potential Prognostic Value of Some Periodontal Factors for Tooth Loss: A Retrospective Multilevel Analysis on Periodontal Patients Treated and Maintained Over 10 Years</atitle><jtitle>Journal of periodontology (1970)</jtitle><addtitle>J Periodontol</addtitle><date>2006-12</date><risdate>2006</risdate><volume>77</volume><issue>12</issue><spage>2084</spage><epage>2089</epage><pages>2084-2089</pages><issn>0022-3492</issn><eissn>1943-3670</eissn><abstract>Background: The great challenge in clinical periodontology is assigning a prognosis to a periodontally affected patient. Many different factors can affect the long‐term maintenance of periodontally compromised teeth. The main questions usually considered by the periodontist are: 1) Will a tooth lose more bone in the future? 2) Will the tooth itself be lost in the future? The purpose of this retrospective study was to evaluate the value of some clinical, genetic, and radiographic variables in predicting tooth loss in periodontal patients (aged 40 to 60 years) treated and maintained for 10 years.
Methods: Sixty consecutive non‐smoking patients (aged 46.77 ± 4.96 years) with moderate to severe chronic periodontitis (CP) were treated with scaling and root planing (SRP). Some patients also underwent additional surgical treatments. All patients were maintained in the same private practice for 10 years. The frequency of recall appointments was 3.4 ± 1.0 months. At baseline (T0) and 10 years later (T2) the following clinical variables were evaluated: the number of teeth, probing depths (PD), tooth mobility (TM), and presence of prosthetic restorations (PR). In addition, radiographic measurements were taken of the mesial and distal distances from the cemento‐enamel junction (CEJ) to the bottom of the defect (BD), to the bone crest (BC), and to the root apex (RA). At T2, a genetic test to determine the IL‐1 genotype and genetic susceptibility for severe periodontal disease was performed for all 60 patients, and they were classified as IL‐1 genotype positive (G+) or negative (G−) according to the test results. Tooth loss was used as the outcome variable. Different predictor variables were then tested using a two‐level statistical model (patient and tooth levels). At the patient level, these were: age, gender, mean bone loss (mean CEJ‐BD)T0, the interleukin‐1 (IL‐1) genotype, the interaction between mean bone loss, and IL‐1 genotype (mean CEJ‐BDT0 × IL‐1 genotype). At the tooth level, the variables were: TMT0, prosthetic restorations (PR)T0, molar teeth (MT)T0, the infrabony component of the defect (BC‐BD)T0, PDT0, bone level (CEJ‐BD)T0, and residual supporting bone (BD‐RA)T0.
Results: Among the considered predictor variables, the following were significantly associated with the outcome variable: 1) MTT0 (P <0.0001); 2) BC‐BDT0 (P = 0.0377); and 3) BD‐RAT0 (P <0.0001). MTT0 were found to be more prone to loss and the amount of BD‐RAT0 prognostic for tooth loss: the lower the residual amount of supporting bone, the higher the probability of tooth loss. Conversely, the BC‐BDT0was associated with a reduced probability of future tooth loss: the greater the infrabony component, the lower the probability of tooth loss. None of the other considered predictors proved predictive for tooth loss.
Conclusions: Within the scope of this study, many traditional prognostic factors were ineffective in predicting future tooth loss and, therefore, were of no prognostic value. Conversely, a few specific factors at the tooth level emerged as viable prognostic factors. The use of these factors may be of great value to practitioners as predictors of tooth loss when assigning a prognosis.</abstract><cop>United States</cop><pub>American Academy of Periodontology</pub><pmid>17209795</pmid><doi>10.1902/jop.2006.050227</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Alveolar Process - physiopathology Cohort Studies Dentistry Female Genetic Predisposition to Disease Genotype Humans Interleukin-1 - genetics interleukin‐1 Longitudinal Studies Male Middle Aged Models, Statistical Molar - physiopathology periodontal disease Periodontal Index Periodontitis - complications Periodontitis - diagnosis Periodontitis - genetics Periodontitis - therapy Predictive Value of Tests Prognosis Radiography Retrospective Studies Root Planing Severity of Illness Index tooth loss Tooth Loss - diagnostic imaging Tooth Loss - etiology Tooth Loss - genetics Tooth Loss - prevention & control Tooth Mobility - complications Tooth Mobility - diagnosis Tooth Mobility - therapy |
| title | The Potential Prognostic Value of Some Periodontal Factors for Tooth Loss: A Retrospective Multilevel Analysis on Periodontal Patients Treated and Maintained Over 10 Years |
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