A retrospective study of vertical bone loss

Abstract

The aim of the present retrospective study was to comparatively evaluate the alterations of the alveolar bone level over a 10-year period at tooth sites with angular patterns of bone loss, between subjects undergoing scaling/root planing (SRP) or SRP and open flap debridement (SRP+OFD) with a maintenance program and those neither undergoing periodontal treatment nor enrolled in the maintenance program. The forty subjects with 100 deep intra-bony defects were treated by SRP or SRP+OFD, and maintained on a carefully managed plaque control program for 3 years (treatment group). ten subjects with 36 sites showing an angular pattern of bone loss neither underwent periodontal treatment nor were enrolled in the maintenance program (control group). Subjects with angular patterns of bone loss with furcation involvement were excluded from the study.
The subjects' age, sex, smoking status, treatment type, gingival index (GI), bleeding on probing (BOP), plaque control record (PCR), probing pocket depth (PPD)>=4mm, and tooth mobility were examined at the baseline and over 3 years after the treatment. The radiographic bone heights were assessed by measuring the distance between the cement-enamel junction and the bone crest at the baseline and for 3 years after treatment.
The mean duration of follow-up after treatment was 10.4±4.7 years. After periodontal treatment, the depths of the defects decreased and remained so during the maintenance program. The duration of follow-up of the control group after baseline was 4.5±1.2 years. The depths of the defects increased in this group.
There was no significant difference in the extent of decrease of bone resorption between the SRP group and the SRP+OFD group. The defects with an angle of less than 45°showed a gain of bone as compared with the defects with an angle of over 45°. The periodontal treatment improved the probing pocket depth even if there was BOP(+). However, a significant relationship between the remainder of the deep pocket depths and BOP(+) during the maintenance program was predictive of further disease progression. The present study results suggest that both SRP and SRP+OFD with a maintenance program are effective methods of treatment in patients with chronic periodontitis and vertical bone loss.
Nihon Shishubyo Gakkai Kaishi(J Jpn Soc Periodontol)52(2) : 161-169, 2010.