RISK INDICATORS FOR FUTURE CLINICAL ATTACHMENT LOSS IN ADULT PERIODONTITIS - PATIENT VARIABLES

WE STUDIED PATIENT-DERIVED VARIABLES to identify individuals at risk for future clinical attachment loss (CAL). Seventy-five patients with chronic adult periodontitis were followed for 6 months and clinical and epidemiological parameters collected at baseline were related to CAL. Clinical parameters were obtained from 6 sites per tooth and whole-mouth averages were calculated. Epidemiologic parameters were obtained by questionnaire and interview. After the baseline examination, patients were treated with root planing and scaling. Thirty-one patients (41.3%) demonstrated greater-than-or-equal-to 1 site with CAL of greater-than-or-equal-to 2.5 mm, while 16 patients (21.3%) demonstrated CAL at greater-than-or-equal-to 2 sites. Epidemiological factors such as gender, health status, marital status, education, and occupation were not associated with CAL. In contrast, baseline mean attachment level, age, baseline mean probing depth, baseline mean recession, percentage of sites exhibiting bleeding on probing, and the number of missing teeth were related to CAL. Using logistic modelling, we found that baseline attachment level was the primary risk indicator for post-treatment CAL. Nineteen percent of the patients with baseline attachment levels < 4.0 mm, 50% of the patients with 4.0 to 4.9 mm, and 85% (P < .005) of the patients with greater-than-or-equal-to 5.0 mm exhibited CAL. The age of the patient was also a major risk indicator for CAL, and was independent of baseline attachment levels. Eighty-nine percent of the 60 to 69 year old patients demonstrated CAL, compared to only 35% of patients between the ages of 30 and 59 (P less-than-or-equal-to .005). In summary, patients with existing severe periodontal disease and patients over the age of 60 years were at greatest risk for periodontal breakdown after root planing and scaling.