Periodontitis phenotypes and clinical response patterns to non‐surgical periodontal therapy: reflections on the new periodontitis classification

• Published in: European journal of oral sciences Vol. 128; no. 1; pp. 55 - 65
• Main Authors: Nascimento, Gustavo G., Dahlén, Gunnar, López, Rodrigo, Baelum, Vibeke
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.02.2020
• Subjects: Classification; Data analysis; Dentistry; Diabetes mellitus; Disease control; Factor analysis; Gum disease; indicators; Levels; Medical treatment; number; Odontologi; Oral Surgery & Medicine; peri-implant diseases; Periodontal disease; Periodontal diseases; Periodontitis; Phenotypes; prognosis; Regression analysis; Regression models; root planing; Therapy; Trajectory analysis; periodontal diseases; prognosis; periodontitis; root planing
• ISSN: 0909-8836; 1600-0722
• DOI: 10.1111/eos.12670

We aimed to identify response patterns to non‐surgical periodontal therapy and to investigate whether the new classification system for periodontitis reflects response to treatment after 1 yr. At baseline, data on sociodemographic status, smoking, and diabetes were obtained from participants with periodontal disease. Clinical periodontal data and subgingival plaque were also collected. Participants underwent non‐surgical periodontal therapy, and after 3 and 12 months, clinical data were reassessed. Factor analyses, group‐based‐trajectory modeling, and mixed‐effects regression models were used for data analysis. Factor analysis of the baseline periodontal parameters revealed two different periodontitis dimensions: ‘moderate’ and ‘severe’. Two response patterns for each of these periodontitis dimensions were identified. Periodontal therapy had a beneficial effect on both ‘moderate’ and ‘severe’ periodontitis; however, individuals with higher levels of disease at baseline experienced greater treatment effect. Regarding the new classification system, while the staging component distinguished different levels of ‘moderate’ and ‘severe’ periodontitis before and after treatment, the grading component did not. This study shows the beneficial effect of non‐surgical periodontal therapy on both ‘moderate’ and ‘severe’ periodontitis. However, the benefit was limited among individuals with low levels of disease. The new classification system did not adequately reflect the periodontal response to therapy in this patient group.