Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study

Abstract The aim of the present study was to evaluate the incidence and causes of tooth loss in periodontal subjects from a private practice in Brazil. Two trained examiners extracted data from the records of subjects who sought periodontal treatment from 1980 to 2013. Only records of patients who completed the non-surgical periodontal treatment and had at least one visit for maintenance were included. Data were analyzed by chi-square test, Student's t-test, Kaplan-Meier survival curve and Cox regression. A total of 3,319 records were reviewed and 737 records included (58.6% women, mean age of 46.6±13.0 years at the beginning of the treatment). Maintenance period ranged from 1 to 33 years (7.4±6 years). During this period, 202 individuals (27.4%) lost 360 teeth, 47.5% of losses within the first five years (n=171). Non-compliers lost more teeth than compliers (p<0.001), respectively 211 and 149 teeth. Regarding reasons of tooth loss, 84 individuals lost 38% of the teeth from periodontal disease progression (n=137). Survival analysis showed that most patients lost only one tooth from periodontal disease, and differences in the survival rates between compliers and non-compliers were observed following the second tooth loss. Approximately one-third of tooth losses was related to periodontal disease progression, and there was stability in time of the proportion of losses from disease progression and other reasons. Therefore, it is possible to conclude that compliant patients in a private practice lose fewer teeth than do non-compliers. Among compliers, periodontal disease progression was not the main cause of tooth loss.

Resumo O objetivo do presente estudo foi avaliar a incidência e causas de perda dentária em pacientes em manutenção periódica preventiva (MPP) de uma clínica privada. Dois examinadores extraíram os dados de registros de pacientes que procuraram tratamento periodontal entre 1980 a 2013. Os registros de pacientes que completaram o tratamento periodontal não cirúrgico e tiveram ao menos uma visita de MPP foram incluídos. Os dados foram avaliados utilizando os testes chi-quadrado, T de Student, curva de sobrevida de Kaplan-Meier e regressão de Cox. Dos 3.319 prontuários, 737 foram incluídos (58,6% mulheres, 46,6±13,0 anos). O período de MPP variou de 1 a 33 anos (7,4±6 anos). Durante este período, 202 indivíduos (27,4%) perderam 360 dentes, 47,5% das perdas durante os primeiros 5 anos de manutenção (n=171). Indivíduos irregulares nas consultas de MPP perderam mais dentes (p<0.001) do que indivíduos com regularidade, 211 e 149 dentes respectivamente. Oitenta e quatro indivíduos perderam 38% de dentes por progressão de doença periodontal (n=137). A maioria dos indivíduos perdeu 1 dente por doença periodontal, e foram observadas diferenças na sobrevida a partir da segunda perda dentária quando comparados indivíduos regulares e irregulares na MPP. Aproximadamente um terço dos dentes perdidos estava relacionado à progressão de doença periodontal. Foi observada uma estabilidade na proporção de perdas por progressão de doença e outras razões ao longo do tempo. Desta forma, conclui-se que indivíduos com uma frequência regular de MPP perdem menos dentes e a progressão de doença nesses indivíduos não é a principal razão para perda dentária.

Microbiological outcomes from different periodontal maintenance interventions: a systematic review

Abstract This study aimed to investigate the differences in the subgingival microbiological outcomes between periodontal patients submitted to a supragingival control (SPG) regimen as compared to subgingival scaling and root planing performed combined with supragingival debridement (SPG + SBG) intervention during the periodontal maintenance period (PMP). A systematic literature search using electronic databases (MEDLINE and EMBASE) was conducted looking for articles published up to August 2016 and independent of language. Two independent reviewers performed the study selection, quality assessment and data collection. Only human randomized or non-randomized clinical trials with at least 6-months-follow-up after periodontal treatment and presenting subgingival microbiological outcomes related to SPG and/or SPG+SBG therapies were included. Search strategy found 2,250 titles. Among these, 148 (after title analysis) and 39 (after abstract analysis) papers were considered to be relevant. Finally, 19 studies were selected after full-text analysis. No article had a direct comparison between the therapies. Five SPG and 14 SPG+SBG studies presented experimental groups with these respective regimens and were descriptively analyzed while most of the results were only presented graphically. The results showed that both SPG and SPG+SBG protocols of PMP determined stability in the microbiological results along time. Nevertheless, new studies comparing these interventions in PMP are needed, especially if the limitations herein discussed could be better controlled.

A map of Brazilian dental research in the last decade

The aim of the present study was to analyze dental research trends in Brazil over the past nine years. All abstracts presented at the 26th Annual Meeting of the Brazilian Society for Dental Research in 2009 (n = 2648) were classified based on field of knowledge, home institution and geographic region. Data were compared with those previously published based on abstracts presented at various meetings. Between 2001 and 2006, five fields of knowledge had a greater than 10 percent representation among the total number of studies. These fields included restorative dentistry/dental materials (RD/DM), periodontics, endodontics, pediatric dentistry and population-based oral health. In 2009, only RD/DM maintained a greater than 10 percent proportion of meeting abstracts, and basic fields comprised the second position among those fields with greater representation (9.8 percent). The majority of research studies were performed at public institutions, and the number of abstracts per state increased significantly in 2009 (Wilcoxon test, p < 0.001). The southeastern region of Brazil submitted the greatest number of abstracts; however, other regions also demonstrated increased participation in research (11 percent). The percentage distribution of abstracts between states remained constant (Wilcoxon test, p = 0.255; r s = 0.873). The results of the present study suggest a slight shift in the scientific research profile in Brazilian dentistry: fields related to professional disciplines have declined in relative research participation, while increasing interest has been observed in basic fields and new specialties.