Longitudinal comparison of the periodontal status of patients with moderate to severe periodontal disease receiving no treatment, non-surgical treatment, and surgical treatment utilizing individual sites for analysis

Background: The progression of periodontal disease without treatment and th e response of existing periodontal disease to various types of treatment ha ve been studied extensively. Many past studies have used the mean of the pa tient's probing depths or attachment levels to evaluate disease progression as opposed to following changes in individual sites or teeth. The purpose of the current study was to evaluate the response of individual teeth to tr eatment or non-treatment. Methods: The records from a private periodontal practice were reviewed to f ind patients with complete periodontal examinations that were recorded at l east 1 year apart. Patients who fit these criteria were divided into those who had none of the recommended treatment (untreated, n = 30); those who ha d only non-surgical treatment (partially treated, n = 20); and a control gr oup who had completed all recommended treatment (surgically treated, n = 41 ). The data for each tooth of each patient were placed in a database and an alyzed using the method of generalized estimating equations (GEE) to test f or associations between increase or decrease in probing depths and various initial clinical parameters while adjusting for significant confounders. Results: Teeth that received no treatment or non-surgical treatment showed significant increases in probing depths, worsening of prognosis, worsening of furcation involvement, and increases in mobility when compared to surgic ally treated teeth. Teeth that received surgical treatment showed significa nt decreases in probing depths. No significant difference was noted between teeth that had no treatment and teeth that had non-surgical treatment. Conclusions: When individual teeth are used as the basis for analysis, teet h that receive no treatment or non-surgical treatment show a significant wo rsening of probing depths, furcations, mobility, and prognosis when compare d to teeth that receive surgical treatment, while surgically treated teeth show significant improvement in probing depths.