Residual Probing Depth and Periodontitis Grading Good Predictors of Tooth Loss Due to Periodontitis

Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined “threshold” at which a patient's profile is set to be at high risk for tooth loss due to periodontitis in the literature. Therefore, this study aimed to assess the influence of residual pockets on tooth loss due to periodontitis and determine the predictive performance of residual pockets compared to the staging and grading of periodontitis on tooth loss due to periodontitis risk. Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving supportive periodontal therapy for at least 10 years were evaluated in this retrospective study. Tooth loss due to periodontitis and the percentage of sites with residual pockets ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of residual pockets was compared to the staging and grading of the disease on tooth loss due to periodontitis using a multilevel Cox proportional hazard regression model. Results: Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with tooth loss due to periodontitis had ≥1 site with residual pockets ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with residual pockets ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for tooth loss due to periodontitis compared to residual pockets ≤4 mm/grade A. Grading exhibited the best discrimination and model fit. Patients with residual pockets ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and residual pockets ≥5 mm displayed excellent predictive capability of tooth loss due to periodontitis.

Reference: Saleh MHA, Dias DR, Mandil O, et al. Influence of residual pockets on periodontal tooth loss: a retrospective analysis. J Periodontol. 2023; 1-12. https://doi.org/10.1002/JPER.23-0448