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

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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

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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"

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