Longitudinal periodontal treatment outcomes in private practice

The majority of studies evaluating the efficacy of periodontal therapy have been conducted in university-based clinical trials under ideal and well-controlled conditions, where time (and cost) effectiveness was not an overriding factor. In Australia, where the larger proportion of dental treatment is provided by the private sector, there are no clinical studies which provide information on the efficacy of periodontal treatment in general or specialist private practice. The overall purpose of this study was to evaluate the efficacy of periodontal therapy in a specialist private practice over an initial period of 5.3 years in a group of 100 patients, and subsequently on the remaining 70 patients followed over a period 13.5 years. Hence the total observation period extended over nearly two decades. Using frequency distributions of site data, and statistical inferences based on the patient as the experimental unit, the results indicated an overall improvement and subsequent stability in clinical attachment in all categories of Initial Probing Depths, for both single- and multi-rooted teeth, for teeth treated with root planing alone and those that required adjunctive surgical intervention, and for younger and older patients. It was also noted that very few teeth were lost over the extended observation period. These positive results were achieved in a most favourable time in the initial phase of treatment (1.5-2.0 hours) as compared with the protracted time frame (5-8 hours) recorded in university-based clinical trials. Similarly, professional maintenance therapy took an average of around two appointments per year (1 hour) compared with an average of 3-4 hours per year in the university-based studies. The results therefore proved not only satisfactory from the standpoint of clinical parameters measured but also on the basis of time efficiency.