Alhazmi Shahad, Abu-Reyal Sawsan, Chiang Yi-Chen, Saleh Muhammad H A, Wang Hom-Lay
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Department of Periodontics, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA.
J Periodontol. 2025 Sep;96(9):1035-1043. doi: 10.1002/JPER.24-0474. Epub 2025 Feb 10.
Supportive periodontal therapy (SPT) reduces the probability of infection reoccurrence further disease progression. Despite that, several patient/tooth related variables have been linked to tooth loss during SPT. This longitudinal study examines the correlation between periodontal staging, grading, initial therapy, and frequency, cost, and time-to-re-treatment following active periodontal therapy (APT).
Patients who received scaling and root planing (SRP) or surgery (SUR) were included. Demographics, annual SPT visits, and medical history were collected. Radiographic bone loss (RBL), probing depths (PD), and clinical attachment loss were collected at six sites/tooth. A simple binary logistic regression model assessed the probability of re-treatment. Multiple models were constructed while adjusting for confounding factors: sex, age, number of SPT visits, and baseline data.
Three hundred patients underwent SRP, and 142 underwent SUR as their APT. 191 patients (63.7%) required a second intervention over 24 ± 8.2-year follow-up. The second intervention type was correlated with the first (p = 0.035). The likelihood of a second intervention was higher in SUR patients (p < 0.001). Significant differences in time to first intervention based on stage (p = 0.019) and compliance (p < 0.001). Similar patterns were observed for time-to-recurrence based on stage (p = 0.03) and compliance (p = 0.017) but not grade (p = 0.144). Mean teeth "free of intervention time" was 16.3 years before the first additional therapy. However, SSD was found between stages (p = 0.028) and grades (p = 0.043) for SUR interventions, but not for SRP.
In this long-term study, higher stage patients and those who had surgical treatments received more frequent retreatments. The first intervention affected the likelihood and type of the second intervention. 12.4% of patients were responsible for 64% of the entire retreatment spending.
Patients with more severe periodontitis who initially underwent surgery needed more frequent therapy. Patients who had surgery as their intervention during active periodontal therapy were more prone to have surgery as their additional therapy during follow-up.
支持性牙周治疗（SPT）可降低感染复发及疾病进一步进展的可能性。尽管如此，在SPT期间，一些患者/牙齿相关变量与牙齿脱落有关。这项纵向研究探讨了牙周分期、分级、初始治疗与积极牙周治疗（APT）后的再治疗频率、成本和时间之间的相关性。
纳入接受龈上洁治和根面平整（SRP）或手术（SUR）的患者。收集人口统计学资料、每年的SPT就诊次数和病史。在每个牙齿的六个位点收集影像学骨丧失（RBL）、探诊深度（PD）和临床附着丧失情况。采用简单二元逻辑回归模型评估再治疗的概率。在调整混杂因素（性别、年龄、SPT就诊次数和基线数据）的同时构建多个模型。
300例患者接受了SRP治疗，142例患者接受了SUR作为其APT。在24±8.2年的随访中，191例患者（63.7%）需要第二次干预。第二次干预类型与第一次相关（p = 0.035）。SUR患者第二次干预的可能性更高（p < 0.001）。基于分期（p = 0.019）和依从性（p < 0.001），首次干预时间存在显著差异。基于分期（p = 0.03）和依从性（p = 0.017），但不是分级（p = 0.144），复发时间观察到类似模式。在首次额外治疗前，平均牙齿“无干预时间”为16.3年。然而，对于SUR干预，在分期（p = 0.028）和分级（p = 0.043）之间发现了SSD，但对于SRP则没有。
在这项长期研究中，分期较高的患者和接受手术治疗的患者接受再治疗的频率更高。首次干预影响了第二次干预的可能性和类型。12.4%的患者承担了全部再治疗费用的64%。
最初接受手术的牙周炎更严重的患者需要更频繁的治疗。在积极牙周治疗期间接受手术作为干预的患者在随访期间更倾向于接受手术作为额外治疗。
