Gingival inflammation and subgingival calculus as determinants of disease progression in early-onset periodontitis

. This study was undertaken to test the hypothesis that gingival inflammation and dental calculus are important determinants of the development and progression of early‐onset periodontitis. The study sample included 156 individuals who were 13–20 years old at baseline and who were examined 2× during 6 years to assess the attachment loss, gingival state and the presence of dental calculus. 33 (21%), 62 (40%), and 61 (39%) individuals were classified as having localized, generalized, or incidental EOP, respectively. The results showed an increase in the % of teeth with overt gingivitis and subgingival calculus, and also an increase in the % of teeth showing attachment loss during the 6‐year period in ail classification groups. Of teeth with 0–2 mm attachment loss at the beginning of the study and which developed ≥3 mm attachment loss during the following 6 years, there were 2× as many teeth with overt gingival inflammation, and 4× more teeth with subgingival calculus at baseline than teeth without. Gingivitis and subgingival calculus when present at both examinations resulted in a stronger association with the development of new lesions than presence of these variables at baseline. Teeth with gingivitis at baseline had a significantly higher mean attachment loss during 6 years than teeth without gingivitis (p