Patient Related Risk Factors for Bone Loss During Periodontal Maintenance

Objectives: To analyze patient-related risk factors from radiographic evidence of progressive mild-moderate periodontitis during periodontal maintenance (PM).
Methods: Bitewing radiographs of periodontal maintenance patients were taken before and after at least two years of periodontal maintenance. Progressive periodontitis (PP) patients (with at least one site of posterior interproximal bone loss ≥2mm) and periodontitis stable (PS) patients (no sites with bone loss) were matched by age and gender and compared for measurements including: 1.Systemic conditions from medical history: diabetes mellitus, osteoporosis, rheumatoid arthritis, menopause; 2.Smoking: Current smoker, former smoker or never smoker; 3.Awareness of periodontal and oral disease: loose teeth, food or floss caught between teeth, diagnosed with gum disease, treated for gum disease, gums bleed when brush, and dry mouth; 4.Oral hygiene habits: brushing frequency per week and flossing frequency per week; 5.Compliance with periodontal recalls: numbers of maintenance appointments within 2 years and average visits per year for 2 years. 71 individuals were in each group. Fisher's exact test and Wilcoxon Rank Sums test were used to compare groups.
Results: While PM patients with mild-moderate periodontitis are generally stable, 71 of 442 patients followed in this study showed at least one site with ≥2mm interproximal bone loss. However, no significant differences were observed at baseline with regard to systemic conditions, smoking, awareness of periodontal and oral disease, oral hygiene habits, and compliance with periodontal recalls. There was a trend toward more PP in diabetic patients (p=0.1277).
Conclusions: Even mild-moderate periodontitis patients on PM should be followed closely for evidence of bone loss, but systemic factors are of little value in identifying patients at increased short-term risk.