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Natural history of periodontitis: disease progression and tooth loss over 40 years


Ramseier, Christoph A; Anerud, Age; Dulac, Mary; Lulic, Martina; Cullinan, Mary P; Seymour, Gregory J; Faddy, Malcolm J; Bürgin, Walter; Schätzle, Marc; Lang, Niklaus P (2017). Natural history of periodontitis: disease progression and tooth loss over 40 years. Journal of Clinical Periodontology, 44(12):1182-1191.

Abstract

OBJECTIVES: To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years.
MATERIAL AND METHODS: Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined.
RESULTS: PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age.
CONCLUSIONS: These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.

Abstract

OBJECTIVES: To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years.
MATERIAL AND METHODS: Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined.
RESULTS: PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age.
CONCLUSIONS: These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Orthodontics and Pediatric Dentistry
04 Faculty of Medicine > Center for Dental Medicine > Clinic for Fixed and Removable Prosthodontics
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:clinical attachment loss; longitudinal; natural history; periodontal disease progression; prediction; tooth loss
Language:English
Date:22 July 2017
Deposited On:30 Nov 2017 16:54
Last Modified:09 Dec 2017 03:51
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0303-6979
Additional Information:This is the peer reviewed version of the following article: Ramseier CA, Anerud A, Dulac M, et al. Natural history of periodontitis: Disease progression and tooth loss over 40 years. J Clin Periodontol. 2017;00:1–10, which has been published in final form at https://doi.org/10.1111/jcpe.12782
Publisher DOI:https://doi.org/10.1111/jcpe.12782
PubMed ID:28733997

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Language: English
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Embargo till: 2018-09-22