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Maintenance Therapy in Young Adults With Severe Generalized Periodontitis
Author(s) -
Gunsolley J.C.,
Zambon J.J.,
Mellott C.A.,
Brooks C.N.,
Kaugars C.C.
Publication year - 1994
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.1994.65.3.274
Subject(s) - medicine , periodontitis , dentistry , clinical attachment loss , debridement (dental) , actinobacillus , gingival and periodontal pocket , scaling and root planing , porphyromonas gingivalis , orthodontics , chronic periodontitis
T he purpose of this study was to evaluate one year of maintenance therapy in young adults with severe periodontitis (SP) who had previously received periodontal therapy consisting of root planing and scaling followed by open flap debridement. Subjects were evaluated with clinical and microbiological measurements at 3, 6, 9, and 12 months following the completion of active therapy. Subjects were included in the study if they completed a minimum of two evaluation appointments. Monitoring of these subjects during the maintenance phase was analyzed by three methods. First, changes in mean attachment level and mean probing depth were calculated at 3‐month intervals to determine if the subjects continued to lose or gain attachment and/or had periodontal pockets of increasing or decreasing depth. Second, the frequency of periodontal breakdown was determined and compared to breakdown rates of subjects in other patient populations. Third, future changes in attachment level were related to the presence or absence of two putative periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque. Mean attachment level remained constant in 13 subjects who completed one year of maintenance therapy. However, mean probing depth increased at a yearly rate of 0.19 mm and in periodontally‐involved sites pocket depth increased at a yearly rate of 0.65 mm both of which were statistically significantly different from 0 ( P <.05). The frequency of periodontal breakdown in this study was higher than reported in other similar studies of different periodontitis patient populations. The reminder of the data in the study was from 21 subjects who had completed at least two recall appointments. In these subjects sites infected with A. actinomycetemcomitans and P. gingivalis exhibited significantly greater probing depth than non‐infected sites. At 11 different sites in 6 subjects, P. gingivalis was detected in 16 samples and those sites had average additional attachment losses of 0.72 mm after 3 months. This additional attachment loss was significantly greater ( P <.05) than that at sites having no detectable P. gingivalis , which experienced little or no additional loss in attachment level (average = 0.0007 mm). A. actinomycetemcomitans was detected in 35 samples from 29 different sites in 12 subjects; however, no additional attachment loss was found 3 months later. These results indicate that P. gingivalis , but not A. actinomycetemcomitans , may be predictive of future attachment loss in young adults with severe generalized periodontitis and that the frequency of periodontal breakdown may be higher in SP patients than that in other patient populations. Consequently, microbiological monitoring of patients for P. gingivalis and more frequent clinical monitoring of SP patients may be appropriate during maintenance therapy. J Periodontol 1994;65:274–279 .