Impact of active pariodontal therapy on subject-related periodontal prognosis as assessed with a simplified method for periodontal risk assessment

AIMS: The present study was performed to evaluate the amount of active periodontal therapy (AT) as well as AT outcomes in patients with different periodontal prognosis, as assessed with a simplified risk assessment method (UniFe; Farina et al. 2007, Trombelli et al. 2009),. 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 single or multiple sessions of non-surgical instrumentation and/or periodontaly surgery and/or extraction of teeth with a hopeless prognosis. Pre-AT, subject-related periodontal risk was calculated according to the UniFe method on the basis of 5 parameters (smoking status, diabetic status, number of sites with PPD≥ 5mm, Bleeding on Probing Index, and bone loss/age ratio) and scored at the subject level on a scale from 1 (low risk) to 5 (high risk). For each patient, AT outcomes were assessed in terms of mean PPD reduction. 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. Before AT, risk score was 1, 2, 3, 4 or 5 in 2%, 0%, 3%, 28% and 68% of patients, respectively. Patients with a risk score of 5 underwent more surgeries during AT compared to patients with a risk score of 4 (p< 0.01), while no differences were observed among risk categories for the number of sessions of non-surgical instrumentation and the number of teeth lost during AT. Mean PPD reduction was significantly different among groups, with risk-5 patients showing a significantly greater PPD reduction compared to risk-4 and risk-3 patients (p< 0.001). CONCLUSIONS: Subject-related periodontal prognosis, as evaluated with the UniFe method, seems to have a predictive value for the need for periodontal surgery during AT as well as the magnitude of PPD reduction following AT.