AIMS: The present study was performed to evaluate the impact of active periodontal therapy (AT) on subject-related factors with a prognostic value for periodontitis incidence and/or progression.
METHODS: Data from 109 patients (42 males; mean age: 42.2 ± 10.2 years, range 22-62 years; 5 former smokers and 32 smokers; 4 diabetics) undergone AT were retrospectively obtained from the record charts at 2 clinical centers, and used for analysis. According to the individual treatment plan, patients had undergone AT consisting of single or multiple sessions of non-surgical instrumentation and/or periodontaly surgery and/or extraction of teeth with a hopeless prognosis. Also information on the detrimental effects of smoking and uncontrolled diabetes on periodontal status as well as treatment outcomes had been provided to smoker and diabetic patients, respectively.
The following subject-related parameters, all included in a simplified method (UniFe; Farina et al. 2007, Trombelli et al. 2009) for periodontal risk assessment, were considered either before AT as well as at the completion of AT: smoking status (assessed as: current smoker, former smoker, never smoked) and number of cigarettes/day, diabetic status (assessed as: diabetic with serum HbA1c levels≥ 7.0%, diabetic with serum HbA1c levels< 7.0%, non-diabetic), number of sites with PPD≥ 5mm, Bleeding on Probing Index (BoP), and bone loss/age ratio.
RESULTS: The mean duration of AT was 1.4±0.8 years (range: 0.2 - 4.7). During AT, patients underwent 5.4 ± 2.9 sessions of non-surgical instrumentation and 2.9±1.7 sessions of osseous (resective or reconstructive) periodontal surgery. A mean of 1.1±1.5 teeth were lost during AT, with 51% of patients experiencing the loss of at least 1 tooth.
No significant differences in patient distribution according to smoking status were observed between pre-AT and post-AT observation intervals. The proportion of patients with 0-1, 2-4, 5-7, 8-10 and >10 sites with PPD≥ 5mm shifted from 3%, 3%, 3%, 3%, and 88%, respectively, before AT, to 20%, 23%, 23%, 8%, and 26%, respectively, at AT completion. The proportion of patients with BoP of 0-5%, 6-16%, 17-24%, 25-36% and >36% shifted from 1%, 7%, 10%, 23%, and 59%, respectively, before AT, to 64%, 17%, 11%, 4%, and 4%, respectively, at AT completion. Due to the limited number of diabetic patients, it was not possible to evaluate the impact of AT on diabetic status.
CONCLUSIONS: Within the limits of the present study, AT showed a significant impact on periodontal pockets and the prevalence of bleeding on probing, while a limited to null effect on smoking status.
