Tooth loss in periodontally compromised patients: Results 20 years after active periodontal therapy

Aim: To assess tooth loss in periodontally compromised patients 20 years after active periodontal therapy (APT) and to detect potential influencing factors for tooth loss on patient level.

Material and methods: From a total of 100 patients, who were re-evaluated ten years after APT, 70 could be re-examined 20 years ± 12 months after APT. Tooth loss during 20 years was detected and based on regression analyses the impact of patient-levelled factors was estimated.

Results: Of 1.639 teeth, 201 were lost (mean 2.87 teeth/patient, range 0-19 teeth, SD 3.49), resulting in a mean tooth loss rate of 0.14 teeth/patient/year during 20 years. Mean tooth loss per patient was higher during the second ten years of supportive periodontal therapy (SPT) compared to the first (1.20 vs. 1.67 teeth/patient). As influencing factors age (p < 0.001), smoking (p < 0.001), compliance to SPT (p < 0.001), marital status (p < 0.001), presence of diabetes (p < 0.001) and heart diseases (p = 0.001) could be detected.

Conclusion: Over 20 years of follow-up, a low number of teeth were lost in mostly severely compromised periodontal patients. Smoking, non-compliance to SPT, age, living as a single and systemic diseases like diabetes or cardiovascular diseases negatively influence tooth loss on the long run.