Quintessence international (Berlin, Germany : 1985) · 2025
The impact of supportive periodontal therapy on the progression of molar furcation involvement: a time-to-event retrospective analysis.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chatzopoulos Georgios S, Wolff Larry F
Аннотация
OBJECTIVE: To determine the association between the frequency of supportive periodontal therapy (SPT) and the time to progression of initial Class I and Class II molar furcation involvements, using a time-to-event analysis that accounts for clustered data.
METHOD AND MATERIALS: This retrospective cohort study utilized electronic health records from the multi-center BigMouth network (2011 to 2022). The analysis was conducted at the tooth level. Molars with an initial Class I (N = 311) or Class II (N = 154) furcation were followed over time. The exposure was SPT frequency, categorized as regular (≥ 2 visits/year) or irregular ( 2 visits/year). The primary outcome was time to furcation progression (Class I to II, or Class II to III). Mixed-effects Cox proportional hazards models were used to analyze the data, accounting for the clustering of teeth within patients and variable follow-up times. Models were adjusted for baseline furcation grade, patient demographics, smoking, diabetes, hypertension, full-mouth plaque and bleeding scores, and tooth-level clinical parameters.
RESULTS: The incidence of progression for Class I furcations was 8.1 per 100 tooth-years in the irregular SPT group versus 5.9 in the regular SPT group. For Class II furcations, the incidence was 11.2 per 100 tooth-years (irregular) versus 6.8 (regular). After multivariable adjustment, regular SPT was significantly associated with a reduced hazard of progression for both Class I (hazard ratio [HR] = 0.51, 95% CI 0.28-0.92) and Class II (HR = 0.47, 95% CI 0.22-0.99) furcations.
CONCLUSIONS: In this time-to-event analysis, adherence to a regular SPT schedule of at least two visits per year is significantly associated with a longer time to progression for molars with initial Class I and Class II furcation involvement. These findings provide quantitative evidence that clinicians can use to emphasize the critical importance of consistent, biannual SPT for preserving the stability of these high-risk teeth.
METHOD AND MATERIALS: This retrospective cohort study utilized electronic health records from the multi-center BigMouth network (2011 to 2022). The analysis was conducted at the tooth level. Molars with an initial Class I (N = 311) or Class II (N = 154) furcation were followed over time. The exposure was SPT frequency, categorized as regular (≥ 2 visits/year) or irregular ( 2 visits/year). The primary outcome was time to furcation progression (Class I to II, or Class II to III). Mixed-effects Cox proportional hazards models were used to analyze the data, accounting for the clustering of teeth within patients and variable follow-up times. Models were adjusted for baseline furcation grade, patient demographics, smoking, diabetes, hypertension, full-mouth plaque and bleeding scores, and tooth-level clinical parameters.
RESULTS: The incidence of progression for Class I furcations was 8.1 per 100 tooth-years in the irregular SPT group versus 5.9 in the regular SPT group. For Class II furcations, the incidence was 11.2 per 100 tooth-years (irregular) versus 6.8 (regular). After multivariable adjustment, regular SPT was significantly associated with a reduced hazard of progression for both Class I (hazard ratio [HR] = 0.51, 95% CI 0.28-0.92) and Class II (HR = 0.47, 95% CI 0.22-0.99) furcations.
CONCLUSIONS: In this time-to-event analysis, adherence to a regular SPT schedule of at least two visits per year is significantly associated with a longer time to progression for molars with initial Class I and Class II furcation involvement. These findings provide quantitative evidence that clinicians can use to emphasize the critical importance of consistent, biannual SPT for preserving the stability of these high-risk teeth.