Table 3. Periodontal disease progression as reported in the different studies.
| Publication | SPT | PD | CAL | Frequency distributions |
|---|---|---|---|---|
| Axelsson & Lindhe (1981) [38] | One-third patients received maintenance by dentist (NRG). Two-third university program with 1 appointment per 2 mon the first 2 yr and then 1 appointment per 3 mon after (RG). | NRG: 1.8±0.24 (BS) to 2.9±0.51 (6 yr). | NRG: 3.7±1.11 (BS) to 5.5±1.11 (6 yr). | PD: 18% increase of 4–6 mm at 6 yr in NRG. |
| RG: 1.9±0.32 (BS) to 1.6±0.35 (6 yr). | RG: 4.2±0.90 (BS) to 4.0±0.93 (6 yr). | Among sites with CAL loss: NRG; 44% ≤1 mm, 55% 2–5 mm, and 1% ≥6 mm. RG; 99% ≤1 mm, 1% 2–5 mm. | ||
| Crespi et al. (2011) [35] | Patients were recalled every 2 wk for 3 mon and twice a yr thereafter. | Change BS-15 yr | Change BS-15 yr | NR |
| i) 1–4 mm; MWF: 0.61 mm, LT: 0.35 mm. | i) 1–4 mm; MWF: −0.39 mm, LT: −0.38 mm. | |||
| ii) 5–6 mm; MWF: 0.03 mm, LT: 0.3 mm. | ii) 5–6 mm; MWF: −0.24 mm, LT: 0.3 mm. | |||
| iii) ≥7 mm; MWF: 0.95 mm, LT: 0.4 mm. | iii) ≥7 mm; MWF: −0.94 mm, LT: 0.37 mm. | |||
| Gaspirc & Skaleric (2007) [57] | SPT 1/mon for 3 mon and at mon 6 post-surgery, then 1/6 mon during the remainder of the study. | MW: 2.92±0.7 mm (BS) to 2.91±0.55 mm (5 yr) | MW: 3.81±1.06 mm (BS) to 4.05±0.85 mm (5 yr) | NR |
| LT: 2.82±0.70 mm (BS) to 2.84±0.43 mm (5 yr) | LT: 3.66±0.81 mm (BS) to 3.97±0.89 mm (5 yr) | |||
| Isidor & Karring (1986) [39] | First yr 1 professional cleaning every 2 wk. | MWF: 2.3 mm (BS), 3.1 mm (5 yr). | Change BS-5 yr | Eighteen surfaces (7.1%) in MWF and 7 surfaces in SRP (2.9%) showed ≥2 mm loss of CAL. Overall 48 surfaces (4.9%) showed an attachment loss of ≥2 mm after 5 yr. |
| During 2nd yr 1/3 mon from then every 6 mon. | SRP: 3.1 mm (BS), 3.2 mm (5 yr). | MWF: −0.2mm, SRP: 0.4 mm | ||
| Kaldahl et al. (1996) [43] | 1/3 mon after surgery, plaque control, OHI, CSC, SRP if necessary. | Change BS-7 yr | Change BS-7 yr | Tooth loss: 19 originally treated with CSC, 21 with SRP, 20 with MWF, and 5 teeth treated with FOS were extracted due to probing depth progressing past the apex. |
| i) 1–4 mm; SRP: 0 mm, MWF: 0.2 mm, FOS: 0.5 mm. | i) 1–4 mm; SRP: −0.3 mm, MWF: −0.5 mm, FOS: 0.1 mm. | |||
| ii) 5–6 mm; SRP: 0.2 mm, MWF: 0.2 mm, FOS: 0.6 mm. | ii) 5–6 mm; SRP: 0 mm, MWF: −0.1 mm, FOS: 0.1 mm. | |||
| iii) ≥7 mm; SRP: −0.4 mm, MWF: 0.1 mm, FOS: 0.5 mm. | iii) ≥7 mm; SRP: 0.3 mm, MWF: 0.1 mm, FOS: 0.1 mm. | |||
| Kaldahl et al. (1996) [31] | One-third mon after surgery, plaque control, OHI, CSC, SRP if necessary. | Reported in Kaldahl et al. (1996) [43] | Reported in Kaldahl et al. (1996) [43] | Breakdown defined ≥3 mm CAL loss. 35 patients had ≤0.99% sites with breakdown, 34 patients 1%–3% sites, 8 patients 3%–6% sites. Patients having an incidence of a >3.00% were smokers at BS. |
| Lindhe et al. (1984) [42] | For first 6 months professional tooth cleaning once/2 wk, next 18 mon once/3 mon. After this SRP was avoided and SPT were every 4–6 mon. | MWF: ±1 mm, 76% sites; +2 mm, 14%; −2 mm, 7%. | MWF: ±1 mm, 84% sites; −2 mm, 9%; −2 mm, 5%. | CAL gains of ≥2 mm in 2% sites. CAL loss ≥2 mm in 10%–12% of sites. Patients with poor oral hygiene had 20% of sites loss ≥2 mm while in good oral hygiene only 2%–3% sites. |
| SRP: ±1 mm, 84% sites; −2 mm, 9%; +2 mm, 5%. | SRP: ±1 mm, 85% sites; −2 mm, 7%; +2 mm, 7%. | |||
| Pihlstrom et al. (1983) [32] | Three to 4 times per year. OHI, CSC and SRP for 1 hr. | MWF: 1–3 mm, 0.3mm; 4–6 mm, 0.4 mm; >7 mm, 0.7 mm. | MWF: 1–3 mm, 0.1 mm; 4–6 mm, 0.2 mm; >7 mm, −0.2 mm. | NR |
| SRP: 1–3 mm, 0.2 mm; 4–6 mm, 0.05 mm; >7 mm, 0.2 mm. | SRP: 1–3 mm, 0.1 mm; 4–6 mm, 0.3 mm; >7 mm, 0.3 mm. | |||
| Pihlstrom et al. (1984) [33] | Three to 4 times per yr. OHI, CSC and SRP for 1 hr. | Change BS-6.5 yr | Change BS-6.5 yr | NR |
| i) 4–6 mm: MWF: Mol: 0.7, non-Mol: −0.31. SRP: Mol: −0.21, non-Mol: 0.3. | 4–6 mm: MWF: Mol: −0.06, non-Mol: 0.41. SRP: Mol: 0.21, non-Mol: 0.29. | |||
| ii) >7 mm: MWF: Mol: 0.48, non-Mol: −0.3. SRP: Mol: 0.74, non-Mol: −0.45 | >7 mm: MWF: Mol: −0.38, non-Mol: −0.3. SRP: Mol: −0.13, non-Mol: 0.5 | |||
| Preus et al. (2017) [36] | SPT at 3, 6, and 12 mon after therapy, and every 6 mon after that. SPT consisted of CSC and SRP and sites that required it. | Change BS-5 yr | Change BS-5 yr | Trend for increase in the number of teeth with PPD ≥5 mm noted, occurrence of PPD ≥5 mm remained stable. |
| FMDIS-MET: 0.2 mm, FDIS: 0.15 mm, SRP+MET: 0.17 mm, SRP: 0.21 mm. | FMDIS-MET: −0.53 mm, FDIS: −0.47 mm, SRP+MET: −0.74 mm, SRP: −0.44 mm. | TL: None, 45%; 1 TL, 24%; 2 TL, 14%; 3 TL, 9%; ≥4 TL, 8%. | ||
| Ramberg et al. (2001) [37] | SPT 3–4 times per yr. | Change BS-13 yr | Change BS-13Y: TTR: −1mm, SRP: −1.1mm | PD; BS |
| TTR(test): 0.4 mm, SRP(control): 0.3mm | ≤3 mm: test, 43%; control, 49%; 4–6 mm: test, 42%; control, 39%; ≥7 mm: test, 15%; control, 12%. | |||
| 13 yr | ||||
| ≤3 mm: test, 57%; control, 61%; 4–6 mm: test, 35%; control, 32%; ≥7 mm: test, 8%; control, 7%. | ||||
| Ramfjord et al. (1975) [56] | SPT every 3 mon. | Change in interproximal mean PPD: CUR, −0.3mm; MWF, −0.4 mm; PEL, −0.58 mm. | Change in mean interproximal CAL: CUR, 0.38 mm; MWF, −0.02 mm; PEL, −0.06 mm. | NR |
| Knowles et al. (1979) [30] | SPT every 3 mon. | Overall change in PD: 1–3 mm, −0.35 mm; 4–6 mm, −0.3 mm; ≥7 mm, −0.2 mm. | Overall change in CAL: 1–3 mm, −0.3 mm; 4–6 mm, 0.25 mm; ≥7 mm, −0.4 mm. | NR |
| Ramfjord et al. (1987) [41] | Once per wk for 4 wk post-surgically, and later once 1/3 mon for 5 yr. | BS-5 yr | Change BS-5 yr in mm | % Sites CAL loss ≥2 mm |
| i) 1–3 mm; PEL: 0.43, CUR: 0.1, MWF: 0.17, SRP: 0.03. | i) 1–3 mm; PEL: −0.53, CUR: −0.64, MWF: −0.56, SRP: 0.62. | i) 1–3 mm, PEL: 38.1, CUR: 33.6, MWF: 35.4, SRP: 30.3. | ||
| ii) 4–6 mm; PEL: −0.52, CUR: −0.65, MWF: 0.39, SRP: 0.18. | ii) 4–6 mm; PEL: −0.49, CUR: −0.42, MWF: −0.43, SRP: −0.57. | ii) 4–6 mm; PEL: 29.3, CUR: 22.6, MWF: 27.9, SRP: 21.1. | ||
| iii) ≥7 mm; PEL: −0.64, CUR: 1.29, MWF: 0.28, SRP: −0.07. | iii) ≥7 mm; PEL: 0.26, CUR: 0.4, MWF: 0.5, SRP: 0.4. | iii) ≥7 mm; PEL: 10.8, CUR: 10.9, MWF: 8.1, SRP: 14.8. | ||
| Renvert et al. (1996) [55] | One-third mon for 3 yr and thereafter every 6 mon. Plaque scores, OHI, CSC, no SRP. | PD change BS-5 yr: 1.4 mm | CAL change BS-5 yr: −0.5 mm | NR |
| Rosling et al. (2001) [34] | Three to 4 times per year, according to individual needs. OHI, BOP, PD. | % of molar sites exhibiting an increase in PD ≥2 mm | CAL change: NG: 0.45 mm, HSG: 0.8 mm | NG 10% of subjects had 8 teeth exhibiting ≥2 mm CAL loss. 70% of HSG subjects had >8 teeth with ≥2 mm CAL change. |
| i) 0–3 mm; NG: 4.6%, HSG: 34.3%. | ||||
| ii) 4–5 mm; NG: 2.4%, HSG: 25.6%. | ||||
| iii) ≥6 mm; NG: 16.1%, HSG: 18.1%. | ||||
| Serino et al. (2001) [40] | SPT 4 times per year. Plaque control. Additional SRP at sites ≥5 mm. | PD change BS-13 yr | Mean annual CAL loss | Annual % of sites ≥2 mm CAL loss stratified by PD CAL loss in PD ≥6 mm |
| SRP: 0.6 mm, MWF: 0.6 mm. | i) SRP: 0.08 mm (1–3 yr), 0.11 mm (3–5 yr), and 0.07 mm (5–13 yr). | i) SRP: 7.5% (1–3 yr), 7.8% (3–5 yr), 2.9% (5–13 yr). | ||
| ii) MWF: 0.11 mm (1–3 yr), 0.07mm (3–5 yr), 0.07mm (5–13 yr). | ii) MWF: 5% (1–3 yr), 4% (3–5 yr), 2.3% (5–13 yr). |
Baseline was considered to be the first examination after the completion of active therapy.
Aa: Actinobacillus actinomycetemcomitans, BOP: bleeding on probing, BS: baseline, CAL: clinical attachment level, CSC: coronal scaling, CUR: curettage, FMDIS: full mouth disinfection, FOS: flap osseous surgery, FU: follow-up, HSG: high susceptibility group, LT: laser therapy, MET: metronidazole, Micro: microbiology, Mol: molar, MWF: modified Widman flap, NG: normal group, NR: not reported, NRG: non-recall group, OHI: oral hygiene instructions, PD: probing depth, PEL: pocket elimination surgery, PG: Porphyromonas gingivalis, RG: recall group, SPT: supportive periodontal therapy, SRP: scaling and root planing, TL: tooth loss, TTR: tetracycline.