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Assessment of Residual Periodontal Maintenance Populations S.L. Campbell*, A.R. Biesbrock, R.W. Gerlach
Procter & Gamble Co., Cincinnati, OH, USA
ABSTRACT
Patients undergoing routine periodontal maintenance may Patients with moderate-to-severe disease often complete present with residual disease. To evaluate residual disease initial care (scaling and root planing with or without surgery) rates within a dental education setting, a random dental and then begin SPT with residual pocket depth. During SPT, chart review was conducted involving a sample of patients in the overall clinical presentation is one of relative stability with a dental hygiene and a post graduate periodontal recall little gain or reduction in either pocket depths or attachment maintenance program. Residual disease was characterized levels. However, some patients may continue to experience • most recent periodontal therapy (date) as the presence of one or more teeth (excluding third breakdown at individual sites (McFall 1982, Lindhe 1984, molars) with at least one 6 mm pocket that bled on probing. Renvert 1990). • disease severity (teeth with 5+ or 6+ mm pockets In the post graduate periodontal maintenance (PPM) sample, 29% of the patients (17/59) exhibited residual Because of this potential for residual and recurrent periodontal disease. In contrast, 59% of the dental hygiene periodontitis, maintenance patients are at elevated risk for All abstracted data were entered directly into a spreadsheet periodontal maintenance (DHPM) sample (13/22) had further breakdown, and as such, represent a "key group" for via laptop computer. Following data collection, cases were residual disease. Patients with residual disease in both targeting care (Newman 1994). In this research, we categorized as to their probability of successfully passing populations were similar with respect to mean age and evaluated dental maintenance behaviors and clinical status periodontal clinical trials entrance criteria at screening. gender balance: mean age was 63.5 and 73.7 years in the of patients undergoing SPT within an academic dental PPM and DHPM groups, respectively, while gender center. Specifically, the research was designed to compare composition was 53% and 46% female in the PPM and status among patients receiving SPT from the school's post DHPM groups, respectively. Mean interval between graduate periodontics program versus those managed in the maintenance visits was similar in both groups, with 4.5 dental hygiene program. A total of 81 patient charts were reviewed and abstracted: 59 months for PPM and 4.8 months for DHPM; however a selected at random from the post graduate SPT program, higher percentage of the PPM sample was seen on a shorter and 22 selected at random from the dental hygiene SPT maintenance interval ( >4 months ): 65% versus 45% in the MATERIALS AND METHODS
program. Residual disease was characterized as the DHPM group. These findings suggest that despite
presence of one or more teeth (excluding third molars) with regular periodontal maintenance care, a significant To evaluate residual disease rates within a dental school at least one 6 mm pocket that bled on probing.
percentage of patients in a dental education setting still setting, a random dental chart review was conducted
presented with residual disease.
involving a sample of patients in a dental hygiene and a post The mean age of the collective sample was 67.1 years, graduate SPT program. After obtaining permission from the ranging from 37 years to 88 years. Gender composition of OBJECTIVE
school's institutional review board, the investigator the collective sample was evenly distributed, at 50.0% assembled a random sample of patient charts from the two female. Patients with residual disease in both the post The initial phase of periodontal care (surgical or non- graduate (PPM) and dental hygiene (DHPM) populations surgical) is typically followed by a maintenance phase of were similar with respect to mean age and gender: mean treatment, wherein supportive care including local scaling, Key data relevant to protocol eligibility criteria were age was 63.5 and 73.7 years respectively, while gender root planing and plaque removal is provided on a regular abstracted relating to demographics, clinical status and composition was 53% and 46% female in the PPM and basis, typically every 2-4 months (McFall 1989). This phase, dental utilization. No specific identifying information was DHPM groups, respectively. referred to as supportive periodontal therapy (SPT), collected (e.g., patient name). Where appropriate, dental represents an extension of the active phase of treatment radiographs were used to establish clinical status. In the PPM sample, 29% of the patients (17/59) exhibited (McFall, 1989) where the primary objective is to achieve Abstracted variables included: residual disease. In contrast, 59% of the DHPM sample optimal patient plaque control by encouraging patient oral hygiene and delivering frequent professional removal of plaque and calculus deposits (Ramjford 1987). Research Presented at the 75th General Session of the IADR; Orlando, Florida March 19-23, 1997 Assessment of Residual Periodontal Maintenance Populations S.L. Campbell*, A.R. Biesbrock, R.W. Gerlach
Procter & Gamble Co., Cincinnati, OH, USA
Table 1: Frequency Distribution of SPT Patients by
Table 2: Frequency Distribution of SPT Patients by
REFERENCES
Number of Teeth With at Least One Periodontal Pocket
Maintenance Interval
1. Lindhe J, Nyman S Long term maintenance of patients treated for advanced periodontal disease. J Clin Periodontol 1984; 11:504-514. 2. McFall WT Tooth loss in 100 treated patients with periodontal disease. A long-term study. J Periodontol 1982; 53:539-549. 3. McFall, WT Supportive treatment. from "American Academy of Periodontology. Proceedings of the World Workshop in Clinical Periodontics." If these reported outcomes are representative, patients Newman MG, Kornman KS, Doherty FM A 6-month multi-center evaluation of adjunctive tetracycline undergoing periodontal maintenance in academic settings may present with residual periodontal disease. Importantly, fiber therapy used in conjunction with scaling and residual disease was more common among older patients, root planing in maintenance patients: Clinical The mean number of years since initial periodontal therapy especially those over age 60 years, and in some patients, results. J Periodontol 1994, 65:685-691. in the collective PPM and DHPM sample of 81 patients was involved most retained teeth. 5. Ramfjord SP Maintenance care for treated 9.5 years. Considering only patients with residual disease, periodontitis patients. J Clin Periodontol the mean number of years since initial therapy was 10.8 years and 6.7 years for the PPM and DHPM groups, CONCLUSION
6. Renvert S, Nilvéus R, Dahlén G, Slots J, Egelberg Regarding periodontal maintenance within dental J. 5-year follow up of periodontal intraosseous Mean interval between maintenance visits was similar in school settings, these findings suggest: defects treated by root planing or flap surgery. J both groups, with 4.5 months for PPM and 4.8 months for Clin Periodontol 1990;17:356-363. DHPM; however a higher percentage of the PPM sample -Dental school maintenance programs may include a with residual disease were seen on a shorter maintenance significant proportion of patients with residual interval (< 4 months): 65% versus 45% in the DHPM group -Differences may exist within dental schools as to disease severity and maintenance schedules for patients in post graduate programs versus those in hygiene programs -This pilot exercise using a convenience sample may be a useful model for identifying patient types within academic maintenance programs, and could potentially target enrollment and reduce overall clinical cycle time. Research Presented at the 75th General Session of the IADR; Orlando, Florida March 19-23, 1997

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