Distribution and influencing factors on residual pockets of the teeth in patients with periodontitis following non-surgical periodontal treatment: a retrospective observational study.

BACKGROUND: Periodontitis is a chronic and multi-factorial infectious disease. A notable difference exists in the prognosis of patients with severe periodontitis after non-surgical periodontal treatment. Thus, a retrospective study was conducted to identify common and specific factors that impact the prognosis of patients with periodontitis stage III-IV following non-surgical periodontal treatment at different tooth sites. METHODS: A total of 977 teeth were included in the study, comprising 266 patients diagnosed with periodontitis stage III-IV. This sample included 330 anterior teeth, 362 maxillary posterior teeth, and 285 mandibular posterior teeth. Following treatment, the teeth were categorized into two groups based on residual pocket depth [probing depth (PD) ≥ 5 mm] at 3 months post-treatment. The prognosis of periodontitis stage III-IV was assessed through multivariate analysis employing logistic regression to determine the association of various risk factors. RESULTS: The PD values of each site and the deepest PD values of each tooth significantly decreased at 3 months post-treatment. Residual pockets were predominantly found in the mesio/disto-buccal and mesio/disto-lingual regions. Multivariate analysis revealed that gender, PD, sulcus bleeding index (SBI) and plaque index (PLI) at baseline, and crown-root ratio in anterior teeth had a significant influence on periodontitis stage III-IV (P < 0.05). Smoking, PD, PLI and furcation involvement (FI) at baseline, PLI at 3 months post-treatment, grades of periodontitis, and crown-root ratio were prediction factors for maxillary posterior teeth. Factors such as PD, PLI and FI at baseline, PLI at 3 months post-treatment, and crown-root were significant in mandibular posterior teeth. CONCLUSIONS: The outcome of non-surgical treatment varies depending on the tooth positions for patients with periodontitis stage III-IV. Dentists must accurately identify the affected teeth that have periodontal pockets of more than 5 mm, taking into consideration the positions of the affected teeth, as well as various local and systemic factors. This comprehensive assessment will enable dentists to develop a customized and effective treatment plan.

Prognostic Factors of Grade 2-3 Endo-Periodontal Lesions Treated Nonsurgically in Patients with Periodontitis: A Retrospective Case-Control Study.

BACKGROUND: Endo-periodontal lesions are bacterial infectious diseases involving both the periodontal and pulp tissues with poor outcomes. It is hard for clinicians to predict their prognosis. The aim of this study is to investigate the factors affecting the prognosis of endo-periodontal lesions. METHODS: A total of 140 teeth diagnosed with grade 2-3 endo-periodontal lesions in patients with periodontitis were recruited in this study. They were divided into high and low responder groups, according to the clinical symptoms and parameters of the teeth involved after nonsurgical treatment of both the endodontic and periodontal components. Clinical parameters and symptoms were compared before and after treatment, and gender, age, smoking, and all clinical parameters were compared between high and low responder groups using univariate analyses. Logistic regression was applied to evaluate the independent effects on endo-periodontal lesion prognosis. RESULTS: Compared with the clinical parameters at baseline, the values of tooth mobility (TM), periapical index (PAI), and discomfort when chewing were decreased after endodontic therapy, and the values of periodontal probing depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), TM, simplified oral hygiene index (OHI-S), full-mouth periodontitis severity, PAI, and discomfort when chewing were decreased after periodontal therapy. Univariate analysis revealed that smoking, PD, CAL, TM, PAI, clinical crown-root ratio (CR), full-mouth periodontitis severities, and the number of root canals were significantly different between the high and low responder groups (P < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis (P < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis (. CONCLUSIONS: and Practical Implications. High PD and CAL, multirooted teeth, smoking, and serious full-mouth periodontitis indicated a poor prognosis for teeth with grade 2-3 endo-periodontal lesions.

Association between Periodontitis and Gene polymorphisms of hBD-1 and CD14: a meta-analysis.

OBJECTIVES: The aim of this meta-analysis was to analyze the association between periodontitis risk and gene polymorphisms of hBD-1 (rs11362, rs1799946 and rs1800972) and CD14 (rs2569190) by data synthesis. METHODS: This meta-analysis was performed using the PubMed and China National Knowledge Infrastructure databases and included 18 case-control studies. Statistical analyses were completed with Stata 12.0. RESULTS: In the overall analysis, there was no significant association between DEFB1 polymorphisms (rs11362, rs1799946 and rs1800972) and periodontitis risk. However, when examined by ethnicity, rs11362 (AG + AA vs GG: pooled OR = 3.561, 95% CI = 1.986-6.386, P = 0.000), rs1800972 (GC vs CC: pooled OR=0.391, 95% CI=0.216-0.708, P = 0.002; G vs C: pooled OR = 0.540, 95% CI = 0.337-0.867, P = 0.011) and rs1799946 (AG+AA vs GG: pooled OR=1.995, 95% CI=1.163-3.422, P = 0.012) polymorphisms were associated with periodontitis risk in Asian. Similarly, rs11362 and rs1799946 polymorphisms were related to periodontitis risk in Brazilian. In the stratified analysis by type of disease, rs1799946 polymorphism (AA vs GG: OR=1.444, 95% CI=1.051-1.983, P = 0.023; AG+AA vs GG: OR=1.374, 95% CI=1.021-1.849, P = 0.036; A vs G: OR=1.172, 95% CI=1.012-1.358, P = 0.034) and rs1800972 polymorphisms (GC vs CC: OR = 0.790, 95% CI = 0.638-0.979, P = 0.031; GG vs CC: OR=0.542, 95% CI=0.316-0.930, P = 0.026; GC+GG vs CC: OR=0.759, 95% CI=0.617-0.933, P = 0.009; G vs C: OR=0.773, 95% CI=0.649-0.921, P = 0.004) had significant associations with aggressive periodontitis (AP) risk. Nevertheless, in the overall and stratified analysis by the severity of periodontitis and ethnicity, no significant association was discovered between CD14 polymorphisms and periodontitis. CONCLUSIONS: This meta-analysis demonstrated that gene polymorphism of DEFB1 but not of CD14 might be involved in periodontitis risk.