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

The aim of this retrospective study was to assess the effect of regular supportive periodontal treatment on disease progression in patients with moderate to advanced periodontitis.

We compared radiographic change of interdental bone level and number 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 therapy; group B, non-compliant patients (n=26), who discontinued supportive periodontal therapy after ca. 2 years of maintenance; group C, compliant patients (n=27), who regularly attended the maintenance program for 7 years. Periodontal treatment was performed as scaling and root planing or flap surgery in groups B and C. All 3 groups were re-examined ca. 7 years after the initial examination.

Patients in group A lost 3.8 teeth (0.5 teeth/year), those in group B 3.2 (0.4 teeth/year), and in group C, patients lost 2.0 teeth (0.2 teeth/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 increase 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).

Systematic periodontal treatment stops interdental bone loss and decreases the rate of tooth loss in most cases. Periodontal surgery without regular follow-up care cannot prevent further periodontal destruction, but it can delay it.