Disease progression in periodontally treated and untreated patients - a retrospective study

Background, aims: The aim of this retrospective study was to assess the eff ect of regular supportive periodontal treatment on disease progression in p atients with moderate to advanced periodontitis. Method: We compared radiographic change of interdental bone level and numbe r of teeth at 2 time points in 3 patient groups (mean age 46 years): group A, periodontally untreated patients (n=14) who dropped out during initial t herapy; group B, non-compliant patients (n=26), who discontinued supportive periodontal therapy after ca. 2 years of maintenance; group C, compliant p atients (n=27), who regularly attended the maintenance program for 7 years. Periodontal treatment was performed as scaling and root planing or flap su rgery in groups B and C. All 3 groups were re-examined ca. 7 years after th e initial examination. Results: Patients in group A lost 3.8 teeth (0.5 teeth/year), those in grou p B 3.2 (0.4 teeth/year), and in group C, patients lost 2.0 teeth (0.2 teet h/year). About half of the patients lost no teeth (group A 43%, B 42%, C 55 %), and only 17 subjects lost more than 3. At the 2nd examination, an incre ase in interdental bone was found only in group C (+0.13 mm), while groups A and B lost 0.57 mm and 0.31 mm of alveolar bone level, respectively (p<0. 05 group C versus A and B). Conclusions: Systematic periodontal treatment stops interdental bone loss a nd decreases the rate of tooth loss in most cases. Periodontal surgery with out regular follow-up care cannot prevent further periodontal destruction, but it can delay it.