Influence of mobility on the long-term risk of tooth extraction/loss in periodontitis patients. A systematic review and meta-analysis.
long term
periodontitis
tooth loss
tooth mobility
tooth prognosis
Journal
Journal of periodontal research
ISSN: 1600-0765
Titre abrégé: J Periodontal Res
Pays: United States
ID NLM: 0055107
Informations de publication
Date de publication:
20 May 2024
20 May 2024
Historique:
revised:
23
04
2024
received:
21
02
2024
accepted:
24
04
2024
medline:
20
5
2024
pubmed:
20
5
2024
entrez:
20
5
2024
Statut:
aheadofprint
Résumé
The aim of this systematic review (SR) was to assess whether tooth mobility (TM) increases the risk of tooth extraction/loss. The protocol was registered in PROSPERO database (CRD42023485425). The focused PECO questions were as follows: (1) "In patients with periodontitis, undergoing periodontal treatment, are teeth affected by mobility at higher risk of being extracted/lost compared to non-mobile teeth, with a minimum follow-up of 10 years?" and (2) "In these patients, does varying degrees of tooth mobility increase the risk of tooth extraction/loss, with a minimum follow-up of 10 years?". Results were reported according to PRISMA statement. Electronic and manual searches were conducted to identify longitudinal studies. The different assessments of tooth mobility were pooled into three groups: TM0: Undetectable tooth mobility, TM1: Horizontal/Mesio-distal mobility ≤1 mm, TM2: Horizontal/Mesio-distal mobility >1 mm or vertical tooth mobility. Tooth loss was the primary outcome. Various meta-analyses were conducted, including subgroup analyses considering different follow-up lengths and the timing of TM assessment, along with sensitivity analyses. A trial sequential analysis was also performed. Eleven studies were included (1883 patients). The mean follow-up range was 10-25 years. The weighted total of included teeth, based on the sample size, was 18 918, with a total of 1604 (8.47%) extracted/lost teeth. The overall rate of tooth extraction/loss increased with increasing mobility: TM0 was associated with a 5.85% rate (866/14822), TM1 with the 11.8% (384/3255), TM2 with the 40.3% (339/841). Mobile teeth (TM1/TM2) were at an increased risk for tooth extraction/loss, compared to TM0 (HR: 2.85; [95% CI 1.88-4.32]; p < .00001). TM1 had a higher risk than TM0 (HR: 1.96; [95% CI 1.09-3.53]; p < .00001). TM2 had a higher risk than TM1 (HR: 2.85; [95% CI 2.19-3.70]; p < .00001) and TM0 (HR: 7.12; [95% CI 3.27-15.51]; p < .00001). The results of the tests for subgroup differences were not significant. Sensitivity meta-analyses yielded consistent results with other meta-analyses. Within the limits of the quality of the studies included in the meta-analyses, mobile teeth were at higher risk of being extracted/lost in the long-term and higher degrees of TM significantly influenced clinicians' decision to extract a tooth. However, most teeth can be retained in the long-term and thus TM should not be considered a reason for extraction or a risk factor for tooth loss, regardless of the degree of TM.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Papapanou P, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri‐implant diseases and conditions. J Clin Periodontol. 2018;45(Suppl 20):S162‐S170.
Hirotomi T, Yoshihara A, Ogawa H, Miyazaki H. Tooth‐related risk factors for tooth loss in community‐dwelling elderly people. Community Dent Oral Epidemiol. 2012;40(2):154‐163.
Hirschfeld L, Wasserman B. A long‐term survey of tooth loss in 600 treated periodontal patients. J Periodontol. 1978;49(5):225‐237.
McGuire M, Nunn M. Prognosis versus actual outcome. II. The effectiveness of clinical parameters in developing an accurate prognosis. J Periodontol. 1996;67(7):658‐665.
Mühlemann H. Tooth mobility. The measuring method. Initial and secondary tooth mobility. J Periodontol. 1954;25:22‐29.
Miller. Textbook of Periodontia. 3rd ed. The Blakiston Co. 1950.
Nyman S, Lindhe J, Lundgren D. The role of occlusion for the stability of fixed bridges in patients with reduced periodontal tissue support. J Clin Periodontol. 1975;2:53‐66.
Barbe A, Javadian S, Rott T, et al. Objective masticatory efficiency and subjective quality of masticatory function among patients with periodontal disease. J Clin Periodontol. 2020;47(11):1344‐1353.
Fleszar T, Knowles J, Morrison E, Burgett F, Nissle R, Ramfjord S. Tooth mobility and periodontal therapy. J Clin Periodontol. 1980;7:495‐505.
Wang H, Burgett F, Shyr Y, Ramfjord S. The influence of molar furcation involvement and mobility on future clinical periodontal attachment loss. J Periodontol. 1994;65:25‐29.
Burgett F, Ramfjord S, Nissle R, Morrison E, Charbeneau T, Caffesse R. A randomized trial of occlusal adjustment in the treatment of periodontitis patients. J Clin Periodontol. 1992;19(6):381‐387.
P. Cortellini, M. Tonetti, N. P. Lang, et al. The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects: clinical outcomes and postoperative morbidity.» J Periodontol, 72, 1701–1712, 2001.
Trejo P, Weltman R. Favorable periodontal regenerative outcomes from teeth with presurgical mobility: a retrospective study. J Periodontol. 2004;75(11):1532‐1538.
Cortellini P, Tonetti M. Clinical concepts for regenerative therapy in intrabony defects. Periodontol 2000. 2015;68(1):282‐307.
Dommisch H, Walter C, Difloe‐Geisert J, Gintaute A, Jepsen S, Zitzmann N. Efficacy of tooth splinting and occlusal adjustment in patients with periodontitis exhibiting masticatory dysfunction: a systematic review. J Clin Periodontol. 2022;49(Suppl 24:14):149‐166.
Muzzi L, Nieri M, Cattabriga M, Rotundo R, Cairo F, Pini Prato G. The potential prognostic value of some periodontal factors for tooth loss: a retrospective multilevel analysis on periodontal patients treated and maintained over 10 years. J Periodontol. 2006;77(12):2084‐2089.
Martínez‐Canut P. Predictors of tooth loss due to periodontal disease in patients following long‐term periodontal maintenance. J Clin Periodontol. 2015;42(12):1115‐1125.
Helal O, Göstemeyer G, Krois J, Fawzy El Sayed K, Graetz C, Schwendicke F. Predictors for tooth loss in periodontitis patients: systematic review and meta‐analysis. J Clin Periodontol. 2019;46(7):699‐712.
Page M, McKenzie J, Bossuyt P, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71.
Miller S, Forrest J. Enhancing your practice through evidence‐based decision making: PICO, learning how to ask good questions. J Evid Based Dent Prac. 2001;1:136‐141.
Stang A. Critical evaluation of the Newcastle‐Ottawa scale for the assessment of the quality of nonrandomized studies in meta‐analyses. Eur J Epidemiol. 2010;25(9):603‐605.
Sterne J, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.
Eldridge S, Ashby D, Kerry S. Sample size for cluster randomized trials: effect of coefficient of variation of cluster size and analysis method. Int J Epidemiol. 2006;35(5):1292‐1300.
Tierney J, Stewart L, Ghersi D, Sydes SB e M. Practical methods for incorporating summary time‐to‐event data into meta‐analysis. Trials. 2007;7(8):16.
Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration; 2011.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629‐634.
Petsos H, Ramich T, Nickles K, et al. Tooth loss in periodontally compromised patients: retrospective long‐term results 10 years after active periodontal therapy‐tooth‐related outcomes. J Periodontol. 2021;92(12):1761‐1775.
Shi S, Meng Y, Li W, Jiao J, Meng H, Feng X. A nomogram prediction for mandibular molar survival in Chinese patients with periodontitis: a 10‐year retrospective cohort study. J Clin Periodontol. 2020;47(9):1121‐1131.
Faggion C, Petersilka G, Lange D, Flemmig JGT. Prognostic model for tooth survival in patients treated for periodontitis. J Clin Periodontol. 2007;34(3):226‐231.
Graetz C, Schützhold S, Plaumann A, et al. Prognostic factors for the loss of molars‐an 18‐years retrospective cohort study. J Clin Periodontol. 2015;42(10):943‐950.
Graetz C, Ostermann F, Woeste S, Sälzer S, Dörfer C, Schwendicke F. Long‐term survival and maintenance efforts of splinted teeth in periodontitis patients. J Dent. 2019;80:49‐54.
Agudio G, Buti J, Bonaccini D, Pini Prato G, Cortellini P. Longevity of teeth in patients susceptible to periodontitis: clinical outcomes and risk factors associated with tooth loss after active therapy and 30 years of supportive periodontal care. J Clin Periodontol. 2023;50(4):520‐532.
Saleh M, Dias D, Mandil O, et al. Influence of residual pockets on periodontal tooth loss: a retrospective analysis. J Periodontol. 2023. Online ahead of print.
Graetz C, Sälzer S, Plaumann A, et al. Tooth loss in generalized aggressive periodontitis: prognostic factors after 17 years of supportive periodontal treatment. J Clin Periodontol. 2017;44(6):612‐619.
McGuire M, Nunn M. Prognosis versus actual outcome. IV. The effectiveness of clinical parameters and IL‐1 genotype in accurately predicting prognoses and tooth survival. J Periodontol. 1999;70(1):49‐56.
Miller P, McEntire M, Marlow N, Gellin R. An evidenced‐based scoring index to determine the periodontal prognosis on molars. J Periodontol. 2014;85(2):214‐225.
Siow D, Goh E, Ong M, Preshaw P. Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy. J Clin Periodontol. 2023;50(1):61‐70.
Nyman S, Lang N. Tooth mobility and the biological rationale for splinting teeth. Periodontol 2000. 1994;4:15‐22.
Fan J, Caton J. Occlusal trauma and excessive occlusal forces: narrative review, case definitions, and diagnostic considerations. J Clin Periodontol. 2018;45(Suppl 20):S199‐S206.
Persson R. Assessment of tooth mobility using small loads. II. Effect of oral hygiene procedures. J Clin Periodontol. 1980;76:506‐515.
Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I‐III periodontitis‐the EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47(Suppl 22):4‐60.
Axelsson P, Nyström B, Lindhe J. The long‐term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance. J Clin Periodontol. 2004;31(9):749‐757.
Becker W, Berg L, Becker B. The long‐term evaluation of periodontal treatment and maintenance in 95 patients. Int J Periodontics Restorative Dent. 1984;4:54‐71.
Becker W, Becker B, Berg L. Periodontal treatment without maintenance. A retrospective study in 44 patients. J Periodontol. 1984;55:505‐509.
König J, Plagmann H, Langenfeld N, Kocher T. Retrospective comparison of clinical variables between compliant and non‐compliant patients. J Clin Periodontol. 2001;28(3):227‐232.
Polson A. Trauma and progression of marginal periodontitis in squirrel monkeys. II. Co‐destructive factors of periodontitis and mechanically‐produced injury. J Periodontal Res. 1974;9:108‐113.
Ericsson I, Lindhe J. Lack of effect of trauma from occlusion on the recurrence of experimental periodontitis. J Clin Periodontol. 1977;4:114‐127.
Jepsen S, Caton J, Albandar J, et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the 2017 world workshop on the classification of periodontal and peri‐implant diseases and conditions. J Clin Periodontol. 2018;45(Suppl 20):S219‐S229.
American Academy of Periodontology. Glossary of periodontal terms. Retrieved from 2001 https://www.perio.org
Tonetti M, Christiansen A, Cortellini P. Vertical subclassification predicts survival of molars with class II furcation involvement during supportive periodontal care. J Clin Periodontol. 2017;44(11):1140‐1144.
Carnevale G, Cairo F, Tonetti M. Long‐term effects of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. II: tooth extractions during active and supportive therapy. J Clin Periodontol. 2007;34(4):342‐348.
Mani S, Mani A, Sachdeva S, Maniyar S, Anuraga S, Kale P. Indices to assess tooth mobility: a review. Int J Dent Sci Innov Res. 2019;2(2):630‐635.