The nonsurgical treatment of patients with periodontal disease: results after five years.
BACKGROUND
In a previous study involving patients seen at the dental clinic of the Detroit Receiving Hospital, the authors found that 87 percent of teeth initially recommended for surgery or extraction were spared those treatments by a combination of debridement and short-term usage of antimicrobial agents. The objective of the present study was to determine how long the surgery-sparing benefits of less invasive treatment would persist.


METHODS
Ninety of these patients were scheduled for maintenance therapy at three-month intervals over a five-year period. They were evaluated periodically for surgical needs by a clinician who was not aware of the nonsurgical periodontal treatment the patient had received.


RESULTS
The initial treatment benefits were sustained, as the number of teeth needing periodontal surgery or extraction was 0.06 teeth per patient after 1.1 year, 0.22 after 2.3 years, 0.51 after 3.6 years and 0.86 after 5.1 years.


CONCLUSIONS
A noninvasive treatment regimen for an anaerobic infection in teeth seriously compromised by periodontal disease resulted in a reduced need for surgery or tooth extraction for at least five years after completion of the initial treatment.
Loesche
Walter J
WJ
University of Michigan School of Dentistry, Ann Arbor 48109, USA. wloesche@umich.edu
Giordano
James R
JR
Soehren
Stephen
S
Kaciroti
Niko
N
D000367:Age Factors; D016301:Alveolar Bone Loss / Q000188:drug therapy / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001421:Bacteria, Anaerobic; D001424:Bacterial Infections / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D012534:Dental Scaling; D004311:Double-Blind Method; D004318:Doxycycline / Q000627:therapeutic use; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D016014:Linear Models; D008795:Metronidazole / Q000627:therapeutic use; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010510:Periodontal Diseases / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D010919:Placebos; D012008:Recurrence; D016745:Root Planing; D012907:Smoking; D014081:Tooth Extraction; D014086:Tooth Mobility / Q000188:drug therapy / Q000628:therapy
D000900:Anti-Bacterial Agents; D010919:Placebos; D008795:Metronidazole; D004318:Doxycycline