1-Year chronic periodontitis non-surgical treatment: comparison of upper and lower sites clinical attachment loss recovery

Introduction: Periodontitis presents complex bacterial biofilms and multifactorial mechanisms, being its management a major challenge [1–3 Darveau RP. Periodontitis: a polymicrobial disruption of host homeostasis. Nat Rev Microbiol Nature Publishing Group. 2010;8(7):481–490. Arweiler NB, Auschill TM, Sculean A. Patient self-care of periodontal pocket infections. Periodontol 2000. 2018;76(1):164–179. Bosshardt DD. The periodontal pocket: pathogenesis, histopathology and consequences. Periodontol 2000. 2018;76(1):43–50. ]. Our recent observational study exposed smoking and aging as risk indicators for clinical attachment loss (CAL), but it would be significant to study how CAL levels variate after periodontal treatment. The aim of this study was to assess CAL variation at 3, 6 and 12 months’ follow-up in patients that underwent non-surgical periodontal treatment.Materials and methods: 24 patients, from the Periodontology Department of the Egas Moniz Dental Clinic, were retrospectively analyzed during the period of 2013-2017. The patients had moderate to severe periodontitis according to Page and Eke’s case definitions [4 Eke PI, Page RC, Wei L, et al. Update of the Case Definitions for Population-Based Surveillance of Periodontitis. J Periodontol. 2012;83(12):1449–1454.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]], and were treated by dentists at various levels in their specialist training. All patients received non-surgical periodontal treatments and follow-up visits at 3, 6 and 12 months. Six sites per tooth were measured (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, distolingual) and recorded, excluding third molars. CAL was measured with a CP-12 SE (Hu-Friedy, Chicago, IL, USA). This study was approved by the Egas Moniz Ethics Committee (IRB approval number: 595).Results: The upper and lower teeth initial mean PD were 5.91 (±2.18) and 5.7 (±1.93), respectively, and they were not statistically different (p = 0.2501, independent t-test). Overall, upper teeth had significantly less recovery that lower teeth. Figure 1 presents CAL recovery levels at 3, 6 and 12 months’ follow-up of non-surgical periodontal treatment.1-Year chronic periodontitis non-surgical treatment: comparison of upper and lower sites clinical attachment loss recoveryAll authorsVanessa Machado, João Botelho, Paulo Mascarenhas, Ricardo Alves, Maria Alzira Cavacas & José João Mendeshttps://doi.org/10.1080/07853890.2018.1561974Published online:28 May 2019Figure 1. CAL levels variation at 3, 6 and 12 months' follow-up of non-surgical periodontal treatment. *P < 0.05, **P < 0.01, ***P < 0.001. SD: Standard Deviation; 3M: 3 months; 6M: 6 months; 12M: 12 months.Display full sizeFigure 1. CAL levels variation at 3, 6 and 12 months' follow-up of non-surgical periodontal treatment. *P < 0.05, **P < 0.01, ***P < 0.001. SD: Standard Deviation; 3M: 3 months; 6M: 6 months; 12M: 12 months.Discussion and conclusions: Overall, lower teeth presented increased CAL healing than upper teeth. Besides, lower teeth appear to present firm prospective healing levels after non-surgical periodontal therapy and, oppositely, upper teeth apparently present a slight recurrence. Future research is necessary to unveil the reasons for this difference.