Email Alert | RSS

Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (5): 913-918. doi: 10.19723/j.issn.1671-167X.2019.05.020

Previous Articles     Next Articles

Tooth loss and multivariable analysis after 5-year non-surgical periodontal treatment on molars with furcation involvement

Shu-wen SHI1,Yang MENG2,Jian JIAO1,Wen-jing LI1,Huan-xin MENG1,△(),Qing-xian LUAN1,Wan-chun WANG2   

  1. 1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of Periodontology, Qingdao Stomatological Hospital, Qingdao 266001, Shandong, China
  • Received:2017-10-09 Online:2019-10-18 Published:2019-10-23
  • Contact: Huan-xin MENG E-mail:kqhxmeng@126.com

RICH HTML

   

PDF (PC)

Abstract:

Objective: To evaluate the tooth loss status of mandibular molars with furcation involvements after 5-year non-surgical periodontal treatment,and to analyze the factors that affected the tooth loss. Methods: A retrospective analysis was conducted in 79 patients with chronic periodontitis, who had received non-surgical periodontal treatment and 5 years of periodontal maintenance treatment in Department of Periodontology, Peking University School and Hospital of Stomatology from 1988 to 2012. Their clinical indexes, including probing depth (PD), bleeding index (BI), furcation index (FI) and tooth mobility were both evaluated before treatment and at the last time of the maintenance treatment. Bone resorption at furcation area was measured at the first visit by periapical radiographs taken by professional doctors of medical imaging. The status of tooth loss after 5-year non-surgical periodontal treatment on mandibular molars with furcation involvement, and the factors that affected the tooth loss were analyzed. Results: (1) Non-surgical treatment was significantly effective on the changes of PD in the patients of chronic periodontitis with furcation involvement, while the presence of furcation involvement could affect the improvement of PD here. (2) PD at the furcation area, tooth mobility, vertical bone resorption, and bone resorption area were all significant risk factors of mandibular molar missing (P<0.001), and the same with FI=3 and FI=4 (P=0.017, P=0.007),while age (P=0.703), gender (P=0.243) and smoking history (P=0.895) were not related to the tooth loss in this study. (3) The risk of tooth loss in mandibular molars with FI≥3 were significantly higher than those with FI≤2, and the survival rate of the former was less than 50%. Conclusion: The loss of mandibular molars with furcation involvement was related to the furcation involvement, meanwhile the degree of furcation involvement and bone resorption can significantly increase the risk of tooth loss.

Key words: Chronic periodontitis, Furcation defects, Tooth loss, Prognosis

CLC Number: 

  • R781.42

Figure 1

Fixed point and connection of apical photograph A, mesial cemento-enamel junction; B, distal cemento-enamel junction; C, midpoint of A and B; M, the bottom of the mesial bone defect; D, the bottom of the distal bone defect; P1,apical point of mesial root; P2: apical point of distal root; L, midpotint of P1 and P2; Fx, apex of furcation fornix; Fw1, the lowest point of bone loss in the mesial furcation area; Fw2, the lowest point of bone loss in the distal furcation area; J, foot of a perpendicular from Fx to Fw1Fw2."

Table 1

Baseline characteristics of the patients"

Characteristics Non-TL group
(n=216)		 TL group
(n=17)		 P
Age/years 41.51±9.92 42.53±5.60 0.677
Gender, n(%) 0.156
Female 102 (47.22) 5 (29.41)
Male 114 (52.78) 12 (70.59)
Smoking status, n(%) 0.466
Non-smoker 169 (78.24) 12 (70.59)
Smoker 47 (21.76) 5 (29.41)
PDmax/mm 4.26±1.57 6.65±2.37 <0.001
Plaque index, n(%)
≤2 46 (21.30) 1 (5.88)
=3 170 (78.70) 16 (94.12)
AL/mm 3.29±2.38 4.18±2.89 0.219
FImax, n(%) <0.001
0 59 (27.31) 4 (23.53)
Ⅰ 48 (22.22) 0
Ⅱ 100 (46.30) 7 (41.18)
Ⅲ 9 (4.17) 4 (23.53)
Ⅳ 0 2 (11.76)
BImax, n(%) 0.383
0 5 (2.31) 0
1 0 0
2 24 (11.11) 1 (5.88)
3 68 (31.48) 3 (17.65)
4 119 (55.09) 13 (76.47)
Mobility, n(%) <0.001
0 166 (76.85) 2 (11.76)
Ⅰ 28 (12.96) 5 (29.41)
Ⅱ 21 (9.72) 7 (41.18)
Ⅲ 1 (0.46) 3 (17.65)
Vertical bone resorption/% 11.48±11.28 29.79±16.20 <0.001
Bone resorption area/% 1.29±2.55 3.63±2.90 <0.001

Table 2

Univariate and multivariable analysis of tooth loss after initial therapy of periodontal disease"

Non-TL group
(n=216)		 TL group
(n=17)		 Univariate analysis Multivariable analysis
P HR (95%CI) P HR (95%CI)
PDmax/mm 4.26±1.57 6.65±2.37 <0.001 1.63 (1.34, 1.98) <0.001 1.63 (1.33, 1.99)
FImax, n(%)
0 59 (27.31) 4 (23.53)
Ⅰ 48 (22.22) 0 0.997 0.00 (0.00, Inf) 0.010 0.00 (0.00, Inf)
Ⅱ 100 (46.30) 7 (41.18) 0.990 1.01 (0.29, 3.44) 0.867 1.11 (0.00, Inf)
Ⅲ 9 (4.17) 4 (23.53) 0.017 5,47 (1.36, 22.01) 0.002 12.80 (2.57, 63.72)
Ⅳ 0 2 (11.76) 0.007 10.59 (1.92,58.46) 0.002 22.85 (3.23, 161.68)
BImax, n(%)
<4 97 (44.91) 4 (23.53)
=4 119 (55.09) 13 (76.47) 0.042 3.22 (1.04, 9.93)
Mobility, n(%)
0 166 (76.85) 2 (11.76)
Ⅰ 28 (12.96) 5 (29.41) 0.006 9.99 (1.93, 51.62) 0.002 15.70 (2.71, 91.1)
Ⅱ 21 (9,72) 7 (41.18) <0.001 28.50 (5.85, 138.74) <0.001 38.91 (7.16, 211.46)
Ⅲ 1 (0.46) 3 (17.65) <0.001 66.51 (11.10, 398.57) <0.001 76.12 (10.77, 537.97)
Vertical bone resorption/% 11.48±11.28 29.79±16.20 <0.001 1.08 (1.05, 1.11) <0.001 1.09 (1.06, 1.12)
Bone resorption area/% 1.29±2.55 3.63±2.90 <0.001 1.22 (1.10, 1.35) <0.001 1.29 (1.14, 1.46)

Figure 2

Kaplan-Meier estimated for the tooth survival curves"

[1] 孟焕新 . 临床牙周病学[M]. 2版. 北京: 北京大学医学出版社, 2014: 216-219.
[2] 孟洋, 王万春, 栾庆先 . 根分叉病变发生、发展与治疗研究进展[J]. 中国实用口腔医学杂志, 2016,4(9):237-242.
[3] Grover V, Malhotra R, Kapoor A , et al. Correlation of the interdental and the interradicular bone loss: A radiovisuographic analysis[J]. J Indian Soc Periodontol, 2014,18(4):482-487.
[4] Dannewitz B, Krieger JK, Hüsing J , et al. Loss of molars in periodontally treated patients: A retrospective analysis five years or more after active periodontal treatment[J]. J Clin Periodontol, 2006,33(1):53-61.
[5] Do Vale HF, Del Peloso Ribeiro E, Bittencourt S, et al. Radiographic characteristics of furcation involvements in mandibular molars as prognostic indicators of healing after nonsurgical periodontal therapy[J]. J Am Dent Assoc, 2009,140(4):434-440.
[6] Mazza JE, Newman MG, Sims TN . Clinical and antimicrobial effect of stannous fluoride on periodontitis[J]. J Clin Periodontol, 1981,8(3):203-212.
[7] Jiao J, Shi D, Cao ZQ , et al. Effectiveness of non-surgical periodontal therapy in a large Chinese population with chronic periodontitis[J]. J Clin Periodontol, 2017,44(1):42-50.
[8] Hou GL, Hung CC, Tsai CC , et al. Topographic study of root trunk type on Chinese molars with Class Ⅲ furcation involvements: Molar type and furcation site[J]. Int J Periodontics Restorative Dent, 2005,25(2):173-179.
[9] Bowers GM, Schallhorn RG, McClain PK, et al. Factors influen-cing the outcome of regenerative therapy in mandibular class Ⅱ furcations: Part Ⅰ[J]. J Periodontol, 2003,74(9):1255-1268.
[10] James JR, Arun KV, Talwar A , et al. Mathematical analysis of furcation angle in extracted mandibular molars[J]. J Indian Soc Periodontol, 2013,17(1):68-71.
[11] Faggion CM Jr, Petersilka G, Lange DE , et al. Prognostic model for tooth survival in patients treated for periodontitis[J]. J Clin Periodontol, 2007,34(3):226-231.
[12] Checchi L, Montevecchi M, Gatto MR , et al. Retrospective study of tooth loss in 92 treated periodontal patients[J]. J Clin Perio-dontol, 2002,29(7):651-656.
[13] Graetz C, Schützhold S, Plaumann A , et al. Prognostic factors for the loss of molars: An 18-years retrospective cohort study[J]. J Clin Periodontol, 2015,42(10):943-950.
[14] Onabolu O, Donos N, Tu YK , et al. Periodontal progression based on radiographic records: An observational study in chronic and aggressive periodontitis[J]. J Dent, 2015,43(6):673-682.
[15] 沈潇, 施捷, 徐莉 , 等. 伴错牙合畸形的侵袭性牙周炎患者牙周-正畸联合治疗的临床评价[J]. 北京大学学报(医学版), 2017,49(1):60-66.
[1] Junyong OU,Kunming NI,Lulin MA,Guoliang WANG,Ye YAN,Bin YANG,Gengwu LI,Haodong SONG,Min LU,Jianfei YE,Shudong ZHANG. Prognostic factors of patients with muscle invasive bladder cancer with intermediate-to-high risk prostate cancer [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 582-588.
[2] Shuai LIU,Lei LIU,Zhuo LIU,Fan ZHANG,Lulin MA,Xiaojun TIAN,Xiaofei HOU,Guoliang WANG,Lei ZHAO,Shudong ZHANG. Clinical treatment and prognosis of adrenocortical carcinoma with venous tumor thrombus [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 624-630.
[3] Le YU,Shaohui DENG,Fan ZHANG,Ye YAN,Jianfei YE,Shudong ZHANG. Clinicopathological characteristics and prognosis of multilocular cystic renal neoplasm of low malignant potential [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 661-666.
[4] Zezhen ZHOU,Shaohui DENG,Ye YAN,Fan ZHANG,Yichang HAO,Liyuan GE,Hongxian ZHANG,Guoliang WANG,Shudong ZHANG. Predicting the 3-year tumor-specific survival in patients with T3a non-metastatic renal cell carcinoma [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 673-679.
[5] Yangyi FANG,Qiang LI,Zhigao HUANG,Min LU,Kai HONG,Shudong ZHANG. Well-differentiated papillary mesothelial tumour of the tunica vaginalis: A case report [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 741-744.
[6] Yuanyuan ZENG,Yun XIE,Daonan CHEN,Ruilan WANG. Related factors of euthyroid sick syndrome in patients with sepsis [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 526-532.
[7] Jian-bin LI,Meng-na LYU,Qiang CHI,Yi-lin PENG,Peng-cheng LIU,Rui WU. Early prediction of severe COVID-19 in patients with Sjögren’s syndrome [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 1007-1012.
[8] Huan-rui LIU,Xiang PENG,Sen-lin LI,Xin GOU. Risk modeling based on HER-2 related genes for bladder cancer survival prognosis assessment [J]. Journal of Peking University (Health Sciences), 2023, 55(5): 793-801.
[9] Zi-xuan XUE,Shi-ying TANG,Min QIU,Cheng LIU,Xiao-jun TIAN,Min LU,Jing-han DONG,Lu-lin MA,Shu-dong ZHANG. Clinicopathologic features and prognosis of young renal tumors with tumor thrombus [J]. Journal of Peking University (Health Sciences), 2023, 55(5): 802-811.
[10] Han LU,Jian-yun ZHANG,Rong YANG,Le XU,Qing-xiang LI,Yu-xing GUO,Chuan-bin GUO. Clinical factors affecting the prognosis of lower gingival squamous cell carcinoma [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 702-707.
[11] Xi-yan PEI,Wen YANG,Xiang-ying OUYANG,Feng SUN. Comparison of clinical effects between periodontal endoscopy aiding subgingival debridement and flap surgery [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 716-720.
[12] Yun-fei SHI,Hao-jie WANG,Wei-ping LIU,Lan MI,Meng-ping LONG,Yan-fei LIU,Yu-mei LAI,Li-xin ZHOU,Xin-ting DIAO,Xiang-hong LI. Analysis of clinicopathological and molecular abnormalities of angioimmunoblastic T-cell lymphoma [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 521-529.
[13] Xiao-juan ZHU,Hong ZHANG,Shuang ZHANG,Dong LI,Xin LI,Ling XU,Ting LI. Clinicopathological features and prognosis of breast cancer with human epidermal growth factor receptor 2 low expression [J]. Journal of Peking University (Health Sciences), 2023, 55(2): 243-253.
[14] Yu-mei LAI,Zhong-wu LI,Huan LI,Yan WU,Yun-fei SHI,Li-xin ZHOU,Yu-tong LOU,Chuan-liang CUI. Clinicopathological features and prognosis of anorectal melanoma: A report of 68 cases [J]. Journal of Peking University (Health Sciences), 2023, 55(2): 262-269.
[15] Qi SHEN,Yi-xiao LIU,Qun HE. Mucinous tubular and spindle cell carcinoma of kidney: Clinicopathology and prognosis [J]. Journal of Peking University (Health Sciences), 2023, 55(2): 276-282.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd