Ten-year survival of posterior teeth in patients with periodontitis following systematic periodontal treatment: A systematic review and meta-analysis using only open-access evidence and analytic tools.

TITLE: Ten-Year Survival of Posterior Teeth in Patients with Periodontitis Following Systematic Periodontal Treatment: A Systematic Review and Meta-analysis Using Only Open-Access Evidence and Analytic Tools Background

OBJECTIVES

To determine whether conclusions drawn from open-access literature using freely available analytic tools on the long-term survival of posterior teeth following periodontal therapy are consistent with previously published comprehensive reviews.

METHODS-ELIGIBILITY CRITERIA: Human studies on patients with periodontitis who received systematic periodontal therapy (non-surgical and/or surgical) with supportive care, reporting 10-year posterior tooth survival in observational cohorts or RCTs, published between January 2015 and August 2025.Open-access full text only and no language restrictions.

INFORMATION SOURCES: PubMed (MEDLINE), Europe PMC, and Google Scholar Risk of bias: The Hoy Risk of Bias Tool for prevalence studies was used to assess the risk of bias SYNTHESIS OF

RESULTS

Two independent reviewers extracted data on study characteristics, interventions, outcomes, and risk of bias.

RESULTS INCLUDED STUDIES: The 11 included studies were mostly retrospective and predominantly from Germany, spanning diverse clinical settings and sample sizes, involving 90,089 teeth from patients with a median age of 54.9.

SYNTHESIS OF

RESULTS

The pooled 10-year survival percentage was 89.0% (95% CI: 85% to 93%) with very high heterogeneity (I² ≈ 98%). Premolars showed a higher survival (95.0%) than molars (85.0%), confirmed by meta-regression.

DISCUSSION: Despite low GRADE certainty, open-access evidence produced estimates consistent with prior published systematic reviews, indicating that posterior teeth-particularly premolars-commonly survive long-term under maintenance.

LIMITATIONS OF EVIDENCE: High heterogeneity and retrospective designs limit generalisability, highlighting the need for prospective, multicentre studies with standardised outcome reporting.

INTERPRETATION: Open-access data and free analytic tools can yield conclusions equivalent to those from subscription-based sources, supporting their use in valid secondary research.

FUNDING: No funding was obtained for this study REGISTRATION: PROSPERO CRD420251124114.