Prosthetic Outcomes in Stage III/IV Periodontitis Patients With 20–29 Years of Supportive Periodontal Care

Abstract

Objective: To assess (i) tooth loss (TL) in treated periodontitis (stage III/IV) patients undergoing supportive periodontal care without or with partial denture (PD) (removable [RPD], fixed PD [FPD], implant supported FPD [iFPD]) and (ii) 10-year prosthetic outcomes. Methods: From 1993 to 2023, comprehensive periodontal therapy including restorative treatment was rendered at the Bundeswehr Central Hospital periodontology outpatient clinic. Results: Two-hundred and thirty-three patients with generalised stage III/IV periodontitis were treated with a mean follow-up of 21.7 ± 2.7 years: 12 with 21 clasp-retained metal-based RPDs (TL/year 0.4 ± 0.39), 12 with 20 double crown–retained metal-based RPDs (0.35 ± 0.42), 50 with 80 ≥ 5-unit FPD (0.23 ± 0.33) and 27 with 218 implants (0.15 ± 0.22). One-hundred and thirty-two patients with < 5-unit FPDs, no RPDs or iFPDs served as control. The control group exhibited the lowest rate of TL (0.05 ± 0.08). Multivariate analyses revealed age (p < 0.001), smoking > 10 cigarettes/day (p < 0.001) and RPD (p = 0.002)/FPD (p < 0.001) but not iFPD (p = 0.134) to be significantly associated with TL. After 10 years, in 75% patients 67% of the metal-based clasp-retained RPDs; in 80% of patients 75% of double crown RPDs; in 90% of patients 93% of FPD; and in 76% of patients 83% of iFPDs were functional. Conclusion: Stage III/IV periodontitis patients treated with RPD and FPD have a higher long-term TL rate than controls and iFPD.