ABSTRACT
AIM: The validity of the risk assessment in predicting tooth loss due to periodontitis or disease progression was explored. METHODS: Systemic factors, smoking status, bleeding on probing (BoP) percentage, number of residual pockets (probing pocket depth ≥6 mm), tooth loss, and alveolar bone loss in relation to age were the variables of the risk assessment. Based on an improving or deteriorating risk assessment in 2005 compared with 1999, 89 patients were divided into either a high- or low-risk group. Findings were compared with the 2008 outcome. RESULTS: Using BoP≤20% as the cut-off, the relationship between BoP and interleukin-1 genotype status was neither significant in 2005 nor in 2008. Neither the high- nor low-risk group was predictive for tooth loss. Patients displayed similar proportions of probing pocket depths ≥6mm in 2005 and in 2008. Linear stepwise regression analysis demonstrated that only the number of supportive periodontal therapy visits explained the number of teeth lost due to periodontitis (P<0.01). CONCLUSIONS: The categorization of patients into high- and low-risk groups, according to the periodontal risk assessment model applied within a supportive periodontal therapy period of 3 years, had limitations in predicting future tooth loss.
Subject(s)
Chronic Periodontitis/prevention & control , Age Factors , Aged , Alveolar Bone Loss/classification , Chronic Disease , Chronic Periodontitis/classification , Cohort Studies , Disease Progression , Disease Susceptibility , Female , Follow-Up Studies , Humans , Interleukin-1alpha/genetics , Interleukin-1beta/genetics , Male , Middle Aged , Periodontal Index , Periodontal Pocket/classification , Polymorphism, Genetic/genetics , Risk Assessment , Smoking , Tooth Loss/classification , Tooth Loss/prevention & controlABSTRACT
OBJECTIVES: To review the evidence for the association between diabetes and periodontal and peri-implant conditions and the impact of periodontal therapy in subjects with diabetes. MATERIAL AND METHODS: A search of MEDLINE-PubMed was performed up to and including December 2007. The search was limited to clinical studies published in English. Publications on animal studies were excluded. The selection criteria included all levels of available evidence. RESULTS: Evidence on the association between diabetes and periodontitis supports the concept of increased severity but not extent of periodontitis in subjects with poorly controlled diabetes. Subjects with controlled diabetes do not show an increase in extent and severity of periodontitis. Periodontitis is associated with poor glycaemic control and diabetes-related complications. It is inconclusive that periodontal therapy with or without the use of antibiotics results in improvements of glycaemic control and of markers of systemic inflammation. Evidence is lacking to indicate that implant therapy in subjects with diabetes yields long-term outcomes comparable with those of non-diabetic subjects. CONCLUSIONS: Poorly controlled diabetes may be considered a risk factor for increased severity of periodontitis. The effects of periodontal therapy on glycaemic control and systemic inflammation is not proven beyond doubt and need to be confirmed in large-scale randomized-controlled clinical trials.
