Periodontal disease progression

Aim of the study

To attempt to measure the progression of periodontitis by non-invasive techniques and to model periodontal disease activity over time.

Materials and methods

Forty-four patients suffering from moderate to advanced periodontitis with a mean age of 45.8 years were studied for 18 months. The classical clinical parameters (Gingival Index GI, Plaque Index PI, Probing Depth PD) as well as the level of clinical attachment (measured using an electronic probe) were measured at the beginning and then monthly. Digitised radiographs were taken every 6 months.

A battery of statistical tests was applied to the data collected, in order to determine the type of progression of the disease.

Results

22.8 % of sites lost attachment, 5.4 % gained and 71.7 % remained the same. The mean time taken to lose 1 mm of attachment was 8.4 ± 0.6 months. Statistical analysis shows that the initial PI, GI and PP are relatively poor predictors of progression of the disease. A much more significant model is obtained by adding the rate of attachment loss over the first 6 months to the initial PI and GI. The same applies to the amount of bone loss over the first 6 months detected on radiographs which is related to the initial probing depth. When this model is applied to individual sites, the progression of the disease can be predicted with a sensitivity of 80 % and the specificity for ruling out progressive disease was 93.9 %.

Conclusion

This study shows that significant loss of attachment in the posterior segments is a frequent event in adult periodontitis and that the measures of loss of attachment and short term bone loss (6 months) improved the ability to predict disease progression in untreated patients.

Commentaries

Future studies must take into account demographic, systemic and genetic factors of the individuals.