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Prognostic factors for the loss of molars – an 18‐years retrospective cohort study
Author(s) -
Graetz Christian,
Schützhold Svenja,
Plaumann Anna,
Kahl Maren,
Springer Claudia,
Sälzer Sonja,
Holtfreter Birte,
Kocher Thomas,
Dörfer Christof E.,
Schwendicke Falk
Publication year - 2015
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12460
Subject(s) - molar , medicine , dentistry , tooth loss , hazard ratio , proportional hazards model , retrospective cohort study , confidence interval , periodontitis , clinical attachment loss , mandibular second molar , orthodontics , oral health
Aim The aim of this study was to identify long‐term prognostic factors for the loss of molars with different degrees of furcation involvement ( FI ) during supportive periodontal therapy ( SPT ). Methods Three hundred and seventy‐nine compliant subjects with 2373 molars at baseline were retrospectively assessed. After nonsurgical ( n = 76) or surgical ( n = 303) non‐regenerative active periodontal therapy ( APT : T0–T1), patients remained under SPT (T1–T2) for 18.3 ± 5.5 (9–30.8) years. Association between tooth‐ and subject‐related factors with tooth loss was assessed using multilevel Cox regression‐analysis. Results During APT 159 and during SPT 438 molars were extracted in 256 subjects, respectively, yielding an overall survival of 74.8% (T2). Survival probabilities after 15‐years of SPT were 92.4% for molars with FI ‐0 compared to FI ‐1 = 85.6%, FI ‐2 = 74.9% and FI ‐3 = 62.3%. The risk of molar loss was significantly increased for teeth with FI ‐3 (hazard ratio: 2.39 [95% confidence interval: 1.54–3.70]), bone loss >50% (2.16 [1.36–3.42]), mobile teeth (2.07 [1.51–2.84]), maxillary molars (1.44 [1.12–1.85]) and endodontically treated teeth (1.89 [1.58–2.26]). For each mm of mean residual pocket probing depth, the hazard of tooth loss increased 1.89‐fold (1.58–2.26). On a subject level, for each year of age, HR was 1.03 (1.01–1.05). Conclusions Furcation involvement, bone loss, tooth mobility, mean pocket depth and age strongly predicted tooth loss during SPT . Long‐term retention of periodontally compromised molars was possible via conservative non‐regenerative active and supportive therapy.