The association between clinical and radiographic periodontitis measurements during periodontal maintenance.

BACKGROUND: The purpose of the present study is to examine the association between clinical and radiographic periodontitis measurements during 2 years of periodontal maintenance.

METHODS: Secondary analyses were performed from a 2-year, double-masked, placebo-controlled, randomized clinical trial evaluating the efficacy and safety of subantimicrobial dose doxycycline (SDD) in 128 postmenopausal osteopenic females with moderate-to-severe chronic periodontitis. Relative clinical attachment level (relative CAL) and probing depth (PD) measurements were made. Posterior vertical bitewings were taken for alveolar bone density (ABD) and alveolar bone height (ABH) measurements. Generalized estimating equations were used to model associations.

RESULTS: One-year ABD changes and 1-year relative CAL/PD changes did not predict 2-year ABH changes and ABH/ABD changes, respectively. Baseline relative CAL and PD were positively associated with baseline ABH loss (P <0.0001), and baseline PDs were associated with subsequent ABD and ABH loss (P <0.05 for each). Among placebo (but not SDD) participants, relative CAL changes were associated with concurrent ABD loss (P = 0.027) when considering 1- and 2-year changes combined. The odds of ABH loss were higher among sites with concurrent 1-year ABD loss versus no change (odds ratio [OR] = 3.15, P <0.0001) or concurrent PD increases versus no change (OR = 1.88, P = 0.0025) when considering 1- and 2-year changes combined.

CONCLUSIONS: In postmenopausal osteopenic females undergoing periodontal maintenance, baseline PD was associated with subsequent ABD and ABH loss. Although no longitudinal change preceded another measurement change, changes in PDs and relative CALs appeared to reflect changes in the underlying alveolar bone over time.