Avaliação longitudinal do efeito da terapia periodontal de suporte sobre o nível clínico de inserção em pacientes com periodontite

Abstract

Introduction: The ultimate goal of non-surgical periodontal therapy is to arrest further periodontal damage by controlling infection and inflammation. After active treatment, supportive periodontal therapy (SPT) is a key point to monitor periodontal health and modifying risk factors. Objective: The aim of this study was to evaluate longitudinal changes in clinical attachment level (CAL) in healthy or systemically compromised periodontal patients under SPT at different time intervals. Methods: A longitudinal cohort study was conducted at the University of Pittsburgh School of Dental Medicine. It was accessed the self reported medical history and periodontal charts of 100 patients with advanced periodontitis submitted to previous periodontal treatment and monitored in TPS with different intervals and follow-up from1 to 6 years. Periodontal status was determined by the difference between initial and final CAL measurements from baseline and the last visit. Results: The average follow-up was 3 years, being 73% of patients with systemic diseases and 27% systemically healthy. An average of 148.92 (+ 29.57) sites was evaluated for each patient. The mean clinical attachment gain was 23.24%, and 30.38% in healthy or systemic diseased group, respectively. A significant gain and stability of clinical insertion was observed in the group with systemic alteration (p = 0.004). Systemic impairments such as diabetes, hypertension, or smoking alone did not have a significant influence onCAL. The clinical attachment loss was higher in patients without systemic disease (p = 0.006), with a higher tendency of clinical attachment gain among systemic patients. In addition, there was no correlation (Spearman correlation = -0.144) between periodontal attachment gain and number of visits for both groups with and without systemic disease, with a statistically significant difference (p = 0.018) only for the group of systemic patients. The 30 interval of return to TPS was the most significant (p = 0.02) for attachment gain on t vestibular sitesand the 10 interval (p = 0.035) for the lingual sites; being both the lowest intervals during all TPS. Conclusion: The number of visits was not decisive for the sucessfull results of SPT, since they did not influence the clinical attachment gain regardless of the presence or absence of systemic impairment. However, shorter intervals between visits reflected better results of clinical attachment gain. The greater gain or stability of CAL in patients with systemic impairment reinforces that SPT offers satisfactory results, even in individuals with a greater susceptibility to periodontitis.