Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (1): 39-44. doi: 10.19723/j.issn.1671-167X.2024.01.007

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A preliminary study on compliance of supportive treatment of patients with periodontitis after implant restoration therapy

Han ZHANG,Yixuan QIN,Diyuan WEI,Jie HAN*()   

  1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2023-10-10 Online:2024-02-18 Published:2024-02-06
  • Contact: Jie HAN E-mail:han_jie17@sina.com

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Abstract:

Objective: To find out factors influencing the compliance of supportive treatment of patients with periodontitis who have received implant restoration therapy. Methods: Patients who had completed periodontal and implant restoration treatment for more than 5 years in Department of Periodontology, Peking University Hospital of Stomatology were subjected to inclusion between March 2022 and August 2023.A questionnaire was compiled to gather the information including patients ' basic information (gender, age, and educational background etc.), smoking habits, general health conditions, oral hygiene habits, willingness to undertake periodontal and dental implant supportive treatment, actual fact on supportive treatment recorded in medical records, whether medical advices were correctly remembered, and reasons affected them to implement supportive therapy. The questionnaires were handed out to the above patients and filled during the process of follow-up treatment. Chi-square test, univariate and multivariate analysis of Logistic regression were employed to explore the correlations of these factors and the patients' compliance. Results: In the study, 92 patients and questionnaires were collected and analyzed. The results indicated that oral hygiene habits and whether medical advices were correctly remembered had significant correlation with compliance (P < 0.05). Time constraint (47.0%) and difficulty in appointment registration (24.8%) were the top 2 reasons obstructed them to undertake supportive treatment. Although the vast majority of the patients indicated willingness to perform follow-ups, 55.4% of them wouldn't come back until the dentist called them back. The results of our study also indicated that the patients placed significantly less importance on the health of natural teeth than implants. Conclusion: In order to improve the compliance of supportive treatment, we suggest that dentists should put more emphasis on oral hygiene instruction, and knowledge regarding periodontitis should also be added as part of patient education contents. In the early stages of treatment, the patient should develop the habit of regular follow-up checks, More attention and patience should be given to elderly patients and those with lower level of education; use language that is easy to understand and printed medical instructions to help them remember. Patients can memorize better from refined doctors' advice, reinforcing care knowledge and refining medical advices can promote better follow-up treatment results. Motivating patients based on their characteristics is critical to improving compliance.

Key words: Compliance, Dental implant, Maintenance, Periodontitis, Supportive periodontal therapy

CLC Number: 

  • R781.4

Table 1

Number and percentage of patients' demographic and behavioral characteristics in different compliance groups and univariate analysis of Logistic regression for factors affecting patients' compliance level"

Factor Good compliance Medium compliance Poor compliance χ2/F P
Gender, n/(%) 0.491 0.808
  Male 12 (46.1) 16 (55.2) 18 (48.6)
  Female 14 (53.9) 13 (44.8) 19 (51.4)
Age/years, ${\bar x}$±s 53.81±11.00 57.34±9. 76 55.84±11.38 0.740 0.480
Age groups/years, n(%) 1.571 0.482
  ≥60 7 (26.9) 12 (41.1) 15 (40.5)
   < 60 19 (73.1) 17 (58.6) 22 (59. 5)
Educational background, n(%) 1.684 0.830
  High school or below 1 (3.8) 3 (10.3) 4 (10.8)
  Junior college 4 (15.4) 6 (20.7) 7 (18.9)
  College or above 21 (80.8) 20 (69. 0) 26 (70.3)
Oral hygiene habits, n(%) 17.598 0.002
  Well 19 (73.1) 16 (55.2) 10 (27)
  Medium 3 (11.5) 3 (10.3) 3 (8.1)
  Poor 4 (15.4) 10 (34.5) 24 (64.9)
Periodontitis severity, n(%) 9. 499 0.067
  Minor 0 (0.0) 1 (3.4) 4 (10.8)
  Moderate 21 (80.8) 15 (51.7) 23 (62.2)
  Severe 5 (19.2) 13 (44.8) 10 (27.0)
Whether medical advices were correctly remembered, n(%) 13.033 0.002
  Correct 23 (88.5) 27 (93.1) 22 (59. 5)
  Incorrect 3 (11.5) 2 (6.9) 15 (40.5)
Willingness to undertake periodontal supportive treatment, n(%) 6.783 0.199
  High 18 (69. 2) 15 (51.7) 19 (51.4)
  Medium 8 (30.8) 12 (41.4) 13 (35.1)
  Low 0 (0.0) 2 (6.9) 5 (13.5)
Willingness to undertake dental implant supportive treatment, n(%) 7.781 0.033
  High 26 (100.0) 28 (96.6) 29 (78.4)
  Medium 0 (0.0) 1 (3.4) 5 (13.5)
  Low 0 (0.0) 0 (0.0) 3 (8.1)
The reason for the last follow-up, n(%) 10.839 0.039
  Active revisiting by patients 13 (50.0) 14 (48.3) 8 (21.6)
  Active follow-up appointments by doctors 12 (46.2) 14 (48.3) 25 (67.6)
  Presence of associated signs and symptoms 1 (3.8) 1 (3.4) 4 (10.8)

Table 2

Multivariate analysis of Logistic regression for factors affecting patients' compliance level"

Compliance Factor B SE Wald df P OR 95%CI
Medium Intercept -0.451 0.404 1.243 1 0.265
Oral hygiene habits=well 1.543 0.613 6.341 1 0.012 4.678 1.408-15.546
Oral hygiene habits=medium 0.714 0.943 0.574 1 0.449 2.043 0.322-12.968
Oral hygiene habits=poor
Medical advices were correctly remembered 2.398 0.847 8.012 1 0.005 11.007 2.091-57.931
Medical advices were incorrectly remembered
Good Intercept -1.399 0.559 6.266 1 0.012
Oral hygiene habits=well 2.611 0.712 13.450 1 < 0.001 13.615 3.373-54.960
Oral hygiene habits=medium 1.645 1.013 2.636 1 0.104 5.178 0.711-37.707
Oral hygiene habits=poor
Medical advices were correctly remembered 1.915 0.785 5.949 1 0.015 6.785 1.457-31.610
Medical advices were incorrectly remembered

Table 3

Coding rules of Logistic regression for factors affecting patients' compliance level"

Factor Mode
Oral hygiene habits Well=1, medium=2, poor=3
Periodontitis severity Minor=1, moderate=2, severe=3
Whether medical advices were correctly remembered Correct=1, incorrect=2
Willingness to undertake dental implant supportive treatment High=1, medium=2, low=3
The reason for the last follow-up Active revisiting by patients=1, active follow-up appointments by doctors=2, presence of associated signs and symptoms=3
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