Untreated periodontal disease: a longitudinal study.

Thirty diagnosed but untreated patients with moderate to advanced periodontal disease were examined a minimum of two times. The examination time intervals ranged between 18 and 115 months. 2. A total of 83 teeth were lost between examinations. 3. Excluding a patient who lost 25 teeth, a total of 58 teeth were lost. The adjusted tooth loss was 0.61 tooth per patient per year (or 0.36 with the elimination of 22 "hopeless" teeth). 4. The mandibular and maxillary molars had the greatest percentage of tooth loss between examinations. 5. All 29 patients completing the study had progessive increases in pocket depth during their time in the study. Increases in the mean annual pocket depths per tooth per patient varied from 0.24 millimeter per year to 2.46 millimeters per year. 6. The disto-lingual and mesio-lingual interproximal surfaces had the greatest increases in surface pocket depths. The lingual and buccal surfaces had the smallest increases in pocket depth. 7. The rate of increase in pocket depths was less in patients over 44 years of age. 8. The teeth which were lost had greater initial pocket depths and mobility scores than those which were present at both examinations. 9. There was no correlation between increases in pocket depth and changes in mobility. 10. All 29 patients showed radiographic evidence of progressive bone resorption between examinations. The posterior segments of the mouth had the largest amounts of bone loss between the first and last examinations.