Purpose : Preservation of the periodontal health of the treated patient requires supportive periodontal therapy for the elimination of periodontal disease. After Phase I therapy is completed, patients are placed on a schedule of periodic recall visits for maintenance care to prevent recurrence of the disease. The amount of tooth loss would be the most relevant criterion in an evaluation of the effect of periodontal treatment, but this would require studies with extremely long follow-up periods. Thus the most commonly used outcome criteria in clinical research have been clinical attachment level change, reduction of pocket depth and bleeding frequency. The purpose of this case study is to identify the effect of supportive periodontal therapy after periodontal flap surgery. Materials & Methods : Following routine hygienic phase of treatment, patients with chronic periodontitis received surgical periodontal treatment. Bleeding on probing, pocket depth and clinical attachment level were measured at baseline, pre-operation and 1 year follow up. All procedures were performed by one operator. Results : One year a total of 28 patients (58sites) to recheck remained, when conducted maintenance program after periodontal flap surgery was observed reduction of bleeding frequency, pocket depth and improvement of clinical attachment level. Conclusion : The results from this study indicate that supportive periodontal therapy after periodontal flap surgery is effective for reduction of bleeding frequency, pocket depth and gain of clinical attachment level.
During the past decade, the use of osseointegrated implants as a foundation for prosthetic replacement of missing teeth has become highly predictable and successful. SPT(Supportive Periodontal Therapy) identified as regular visits to the therapist for periodontal control and maintenance in a well-organized scheme, the number of appointments per year following a pre-designed subject-tooth/implant-site risk assessment method. Peri-implant disease was a frequent finding in subjects having natural healthy dentition and in subjects without periodontitis. Supportive periodontal program were found to be strongly related to implant survival. This study demonstrates that regular maintenance reduces the risk for peri-implant inflammation significantly as compared with irregular maintenance. This underlines the value of the SPT in enhancing the long-term outcomes of implant therapy, particularly in subjects affected by periodontitis, in order to control reinfection and limit biological complications. It is highly recommended to maintain implant patients under a strict supportive periodontal treatment protocol that might contribute to implant survival, and regular maintenance reduces the risk for periimplant inflammation significantly as compared with irregular maintenance. Ideally, patients may be informed on the beneficial effect of a regular patient-related post-therapy care before implant insertion.
This study was performed to evaluate the relation between the interval of supportive periodontal therapy and the prevalence of the subgingival microflora. The subgingival plaques from 108 patients were used in the study. Control group were the patients with no periodontal treatment and test groups were assigned into 3 groups according to the period of recall check: group 1; 1-2 months, group 2; 3-4 months, group 3; 6months or more. The polymerase chain reaction (PCR) used for direct identification of periodontal pathogens (P. gingivalis, T. forsythensis, T. denticola) in subgingival plaque. The results of this study were as follows. 1. The prevalence of P. gingivalis, T. forsythensis, T. denticola in control group were 100%, 87%, 90%. 2. In clinical parameters such as plaque index, gingival index, bleeding on probing, control group was not significant different with group 1 but Significant different with group 2, group 3. 3. In group 1, the majority of P. gingivalis had type II fimA. 4. When group 3 were compared with group 1, the prevalence of P. gingivalis increased. But the prevalence of P. gingivalis with type II fimA, which have the virulence factor, decreased. 5. We were unable to find the correlation between P. gingivalis with type IV fimA and periodontal disease. 6. The prevalence of T. forsythensis, T. denticola in test group were 85%, 93% or more. From the above results, we were able to find the relation between the interval of supportive periodontal therapy and the prevalence of the subgingival microflora and the need of the strict supportive periodontal therapy to prevent recurrence of periodontal disease, because there were high prevalence of periodontal pathogens.
Schmalz, Gerhard;Kummer, Max Kristian;Kottmann, Tanja;Rinke, Sven;Haak, Rainer;Krause, Felix;Schmidt, Jana;Ziebolz, Dirk
Journal of Periodontal and Implant Science
/
제48권4호
/
pp.251-260
/
2018
Purpose: The aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT). Methods: A total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and ${\chi}^2$ test, as appropriate (P<0.05). Results: Only the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: $27.8%{\pm}20.9%$ vs. aMMP-8 negative: $18.0%{\pm}14.5%$; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05). Conclusions: Salivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.
Objectives : This study has made a comparison of the difference between the periodontal parameter before and after applying dental hygiene process on patients requiring supportive periodontal therapy at a private dental clinic. Methods : The entire process was conducted on 74 patients. As a result of analyzing the difference in periodontal parameters such as PPD>4mm, BOP, and O'Leary Index of 29 patients that has completed 1 circle of dental hygiene process. Results : All periodontal parameters in all subject patients had been significantly reduced(p<0.05). Furthermore, as a result of comparing the periodontal conditions of the smoking group and non-smoking group, complier and non-complier, all parameters were reduced with a significant difference in the non-smoking group and the complier, but the smoking group and the non-complier did not show difference in all parameters. As a result of making an assessment of before and after dental hygiene process according to PRA classifications, high risk group has been generally changed to moderate or low risk group. Conclusions : Accordingly, the supportive periodontal therapy applying dental hygiene process has been shown to be effective. The dental hygiene process in periodontal patients who require continuous management is anticipated to be a very efficient process.
The purpose of this study was to assess the clinical outcomes of active periodontal therapy (APT) and supportive periodontal therapy (SPT) through loss of teeth in the Korean patients with aggressive periodontitis. The number of missing and residual teeth, probing pocket depth were examined in 33 patients diagnosed with aggressive periodontitis at the baseline and who had participated in APT and SPT for 3 years or more. A 20 and 3 teeth were lost during the APT and SPT, respectively. The mean tooth loss rate of 0.13 per patient and year. There was no significant statistical difference in clinical improvement between the smoker and non-smoker groups. Within the limitation of this study, APT combined with supportive therapy could decrease the risk of tooth loss in patients suffering from aggressive periodontitis.
Purpose: The purpose of this study was to evaluate the compliance to maintenance schedules recommended supportive periodontal therapy(SPT) and to determine differences in the characteristics of compliant and non-compliant patients. Methods: 414 patients commencing SPT after active periodontal treatment from 2003 to 2005 were included in this study. Based on their compliance with the suggested maintenance schedule, patients were classified as compliant and non-compliant groups. Also patients classified by gender, age, degree of alveolar bone loss and treatment rendered. The association between compliance and patient characteristics was assessed by odds ratio in logistic regression analyses. Results: Only 47% of the initial patient was found to be compliant at the end of August 2008 and 20.8% patients were lost in the first year of SPT. There were significant differences between compliant and non-compliant regard to age, degree of alveolar bone loss and treatment rendered. Conclusions: In conclusion, compliance with SPT generally poor and patients who were older, treated surgical therapy and with mild alveolar bone loss are more compliant to SPT.
Purpose: This study aimed to examine the prevalence and abundance of 9 representative periodontal pathogens in the saliva samples of periodontally healthy subjects (PH) and patients with periodontitis who underwent supportive periodontal therapy (SPT). The age-specific distribution of these pathogens in periodontally healthy individuals was also analyzed. Methods: One hundred subjects (aged >35 years) were recruited (50 each in the PH and SPT groups) between August 2016 and April 2019. The prevalence and abundance of periodontal pathogens in the PH group were compared with those in periodontally healthy young subjects (94 subjects; aged <35 years), who were included in our previous study. DNA copy numbers of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Campylobacter rectus (Cr), Peptostreptococcus anaerobius (Pa), and Eikenella corrodens (Ec) were analyzed using real-time polymerase chain reaction. Results: The detection frequencies of all pathogens, except Aa, were high in the PH and SPT groups. The ranking order of pathogen DNA copy numbers was similar in both groups. In both groups, Fn had the highest abundance, Aa had the lowest abundance. Additionally, Td was significantly more abundant in men than in women in both groups (P<0.05). Compared with the PH group, the SPT group exhibited significantly lower total bacteria and Fn abundance and higher Pg abundance (P<0.05). The age-specific pathogen distribution analysis revealed a significantly low Aa abundance and high Tf and Cr abundance in the PH group. Conclusions: The clinical parameters and microbial profiles were similar between the SPT and PH groups. However, patients with periodontitis require supportive care to prevent recurrence. As the abundance of some bacteria varied with age, future studies must elucidate the correlation between age-related physiological changes and periodontal bacterial composition.
Supportive periodontal therapy(SPT) is essential for the long-term success of periodontal treatment. A patient's compliance with SPT is one of the most important factors affecting periodontal status. There are few studies quantifying compliance with SPT. The aim of this study is to quantify patient's compliance using new method and evaluate tooth loss depending on patient's supportive periodontal treatment compliance index(SPTCI) with SPT. This study included subjects diagnosed with generalized moderate to severe chronic periodontitis, who had completed active periodontal treatment and had SPT over 5 years in Wonkwang university dental hospital. Chart review and radiography analysis were performed. To quantify compliance, SPTCI representing average of gap between recommended schedules and actual visits has been used and evaluated with tooth loss. Mean period of SPT was 8.9 years and mean SPTCI was about 120. In statical analysis, patients who have higher SPTCI with SPT are more likely to have higher rate of tooth loss. Under SPTCI of 120, there were no significant co-relation between SPTCI and tooth loss. Patients diagnosed with moderate chronic periodontitis have significant co-relation between SPTCI and tooth loss, whereas patients diagnosed with severe chronic periodontitis have no co-relation. SPTCI, new method of quantifying compliance in this study, affected to tooth loss. This study suggests that using SPTCI could be helpful for prediction of tooth loss and be used to determine the interval of visit.
Purpose: The purpose of this study was to investigate the degree of compliance with supportive periodontal therapy(SPT), to determine if any significant differences existed in the characteristics of compliant, erratically compliant and non-compliant patients and to identify reasons for poor compliance. Materials and methods: Four hundred five patients who initially visited between July 2003 and December 2004 and were treated until June 2005 were retrospectively evaluated for their compliance with SPT in terms of attendance for a recommended schedule of visits. Patients' compliance was classified as complete compliance(attended more than 80% of the recommended appointments), erratic compliance(attended less than 80% of the recommended appointments or discontinued) and non-compliance(did not return for SPT). Analysis was made for each group to correlate the degree of compliance with gender, age, smoking, distance between their houses and the hospital, disease severity, type of therapy, implant, plaque control instruction and systemic diseases. Tele research of erratically compliant and non-compliant patients was carried out to identify reasons for their poor compliance. Results: Only 24.7% of the patients were in complete compliance. The highest drop-out rate(32.4%) occurred in the first year. A significantly greater percentage of non-smokers and patients who finished plaque control instruction were in complete compliance. A significantly greater percentage of patients without implant and patients who had been treated by only scaling and root planing were in non-compliance. More males were found to be compliant with SPT, although this was marginally significant. There were no significant differences between compliant, erratically compliant and non-compliant patients with regard to age, distance, disease severity and systemic disease. The survey revealed that the main reasons for poor compliance with SPT were inconvenient location and insufficient time. Conclusion: Patients' compliance with SPT was poor and the highest drop-out rate(32.4%) occurred in the first year. Significant relationships were found between the degree of compliance and smoking, type of therapy, implant, plaque control instruction and gender.
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