Tooth loss in aggressive periodontitis after active periodontal therapy: patient-related and tooth-related prognostic factors

Abstract Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

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Antibiotic Use in Periodontal Therapy among French Dentists and Factors Which Influence Prescribing Practices

Antibiotics ◽

10.3390/antibiotics10030303 ◽

2021 ◽

Vol 10 (3) ◽

pp. 303

Author(s):

Kevimy Agossa ◽

Kadiatou Sy ◽

Théo Mainville ◽

Marjolaine Gosset ◽

Sylvie Jeanne ◽

...

Keyword(s):

Antibiotic Use ◽

Aggressive Periodontitis ◽

Periodontal Therapy ◽

Research Network ◽

Prescribing Practices ◽

French Society ◽

Private Practitioners ◽

First Line Therapy ◽

Practice Based Research ◽

Systemic Antibiotics

The aim of the present survey is to investigate the use of antibiotics during periodontal therapy among French dentists with a focus on exploring potential differences between various groups of practitioners. A self-administered questionnaire was distributed to different groups of practitioners including members of (i) the French Society of Periodontology and Implantology; (ii) the College of University Teachers in Periodontology and, (iii) private practitioners participating in the French general dental practice-based research network. 272 questionnaires were included in the analysis. Prescription patterns were globally in line with the current recommendations. Systemic antibiotics are most frequently used as a first-line therapy in necrotizing periodontitis (92%) and aggressive periodontitis (53.3% to 66.1%). However, malpractice still exists, including in the management of periodontal abscesses. Antibiotics are prescribed (i) less frequently for periodontal abscesses and (ii) more frequently for generalized aggressive periodontitis by members of the periodontal society and University college (p < 0.05). Amoxicillin (59.9%) and the amoxicillin + metronidazole (59.6%) combination were the most frequently prescribed molecules. Providing a high number of periodontal treatments per week, being more recently graduated, having a post-graduate certificate in periodontology and holding or having held an academic position/hospital practice were all factors associated with a better knowledge of and/or more adequate antibiotic use.

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Risk factors for tooth loss with a mean follow-up period of 13.9 years in supportive periodontal therapy patients

BMC Oral Health ◽

10.1186/s12903-021-01573-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tomotaka Kato ◽

Natsuki Fujiwara ◽

Tomohisa Ogawa ◽

Yukihiro Numabe

Keyword(s):

Risk Factors ◽

Tooth Loss ◽

Periodontal Therapy ◽

Dental Hygienists ◽

Multiple Classification Analysis ◽

Hazard Ratios ◽

Dental Office ◽

Multiple Classification ◽

Supportive Periodontal Therapy

Abstract Background Clinical evidence indicates that there are various risk factors of tooth loss. However, the degree of this risk among other risk factors remains unclear. In this retrospective cohort study, the authors evaluated the hazard ratios of several risk factors for tooth loss. Methods Included patients had all been treated for dental disorders, were in the supportive phase of periodontal therapy by dental hygienists, and visited a Japanese dental office continually during a 10-year period. Periodontal parameters, tooth condition, and general status of all teeth (excluding third molars) at the initial visit and at least 10 years later were evaluated by using multiple classification analysis. Results The authors evaluated a total of 7584 teeth in 297 patients (average age: 45.3, mean follow-up time: 13.9 years) Non-vital pulp was the most significant predictor of tooth loss according to Cox hazards regression analysis (hazard ratio: 3.31). The 10-year survival rate was approximately 90% for teeth with non-vital pulp and 99% for teeth with vital pulp. Fracture was the most common reason for tooth loss. Conclusions Non-vital pulp had the most significant association with tooth loss among the parameters. Therefore, it is very important to minimize dental pulp extirpation.

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Aggregatibacter actinomycetemcomitans: The virulence factors and relation to persistence biofilm formation

Biomedicine ◽

10.51248/.v40i4.309 ◽

2021 ◽

Vol 40 (4) ◽

pp. 429-435

Author(s):

Syakir Syahiran ◽

Wan Rohani Wan Taib ◽

Norzawani Jaffar

Keyword(s):

Oral Cavity ◽

Virulence Factors ◽

Tooth Loss ◽

Periodontal Diseases ◽

Aggregatibacter Actinomycetemcomitans ◽

Aggressive Periodontitis ◽

Essential Factor ◽

Abiotic Surfaces ◽

Functional Biology ◽

Systemic Infections

Periodontitis is an infectious and inflammatory condition that is associated with subgingival biofilms in tooth-supporting tissues. Among the several hundred isolated organisms in the oral cavity, one of the most isolated bacteria from infected periodontal pockets are Aggregatibacter actinomycetemcomitans. It is a Gram-negative, facultative anaerobic bacillus that causes juvenile (localized aggressive periodontitis) and adolescent periodontal diseases. The development of biofilms is an essential factor in pathogenesis for A. actinomycetemcomitans. The early attachment of A. actinomycetemcomitans to abiotic surfaces relies on its protein-like fimbriae. This organism's ability to form tenacious biofilms can determine its survival and progression. A. actinomycetemcomitans, a pathogen not solely in periodontal but also involve in some systemic infections. This species has several virulence factors and genes that contribute to its oral cavity survival and, worst of all, cause bone resorption and tooth loss. Genetic diversity between the different A. actinomycetemcomitans isolates are great, and their ability to express and release virulence factors varies. In this review article, we discuss about the potential virulence factors and candidates genes for A. actinomycetemcomitans and their roles within periodontal disease by revealing their functional biology in facilitating attachment to oral surfaces, hindering protection of the host and causing inflammation and degradation of tissue.

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