Initial extractions and tooth loss during supportive care in a periodontalpopulation seeking comprehensive care

Background/aims: This retrospective survey was aimed at determining the pre valence of tooth extractions and the dental pathologies associated with the m during both the active and maintenance phase of periodontal therapy in a periodontal population seeking comprehensive dental care. Methods: A total of 273 randomly selected subjects from the oral prophylaxi s clinic of the University of Berne were included. All subjects had receive d comprehensive care consisting of periodontal and restorative treatment an d participated in a supervised maintenance program for an average of 67+/-4 6 months (range 5 to 278 months). The population consisted of 39.6% current smokers and 27.8% previous smokers. 6.2% of the patients had gingivitis, 2 0.5% mild periodontitis, 48.4% moderate and 24.9% severe periodontitis. The average frequency of the recall visits was 4.4+/-1.5 appointments/year (ra nge 1.7-12 appointments/year). Results: Results indicated that 574 out of a total of 6503 teeth were extra cted; 311 teeth were extracted during active therapy and 263 during the sup portive periodontal care (SPC) phase of therapy. 46% of patients received t ooth extractions as part of their active treatment and 41% during their par ticipation in the secondary prevention program. In the subgroup whose treat ment plan included extractions the average number was 2.5+/-1.6 teeth per p atient. Likewise, the patients who received extractions during recall lost an average of 2.35+/-1.9 teeth per subject with an incidence of 0.4+/-0.37 teeth per patient per year. These data reinforce the concept that a minorit y of the population is responsible for the majority of tooth extractions, b oth during active therapy and SPC. Periodontal disease was the only patholo gy observed at 57% of the extracted teeth; while caries, endodontic patholo gy and technical problems in the absence of periodontitis were observed in 29% of cases. Conclusions: These observations indicate that the rendered treatment was ef fective in the long-term maintenance of the dentition of these subjects and suggest that advanced periodontal disease represented the major cause of t ooth loss in this population.