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Wang M, Xu Y, Fang W, Pan W, Wang Q. Impact of COVID-19 on patient follow-up during supportive periodontal therapy: a retrospective study based on phone call survey. BMC Oral Health 2023; 23:811. [PMID: 37898758 PMCID: PMC10612285 DOI: 10.1186/s12903-023-03539-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/13/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND COVID-19 and the subsequent intermittent lockdown measures from 2020 to 2022 in China critically disrupted regular medical activities, including dental care. This study aimed to investigate the impact of COVID-19 on long-term follow-up at the Stomatology Hospital, Zhejiang University School of Medicine and to evaluate potential causes of loss to follow-up. METHODS A total of 1062 patients with periodontitis who visited the hospital from January 2019 to June 2022 were included in this study, and patient information was collected retrospectively in the form of a telephone questionnaire. The questionnaire consisted of 19 questions in four areas: demographic characteristics, clinical periodontal parameters, oral hygiene habits, and follow-up-related open-ended questions (specific reasons for loss to follow-up, attitudes toward follow-up and suggestions for increasing participation in future follow-ups). Regression analysis of factors influencing the follow-up of patients with periodontitis were analyzed by regression analysis using R (v4.2.3) software. RESULTS A total of 536 (50.47%) valid questionnaires were collected from 1062 patients. Personal factors (42.5%), instead of the COVID-19 epidemic (20.0%), were the main factors that impacted the loss to follow-up in long-term periodontal treatment, while work factors (19.8%), hospital factors (16.4%), and transportation or distance factors (14.7%) were all important factors. A family history of periodontitis [odds ratio (OR) = 0.567, 95% confidence interval (CI): 0.393, 0.817, p = 0.002], as well as frequent use of dental devices (OR = 0.540, 95% CI: 0.375, 0.777, p = 0.001), were significantly associated with a "negative" attitude toward follow-up visits. CONCLUSION This survey suggests that the COVID-19 epidemic factor was an important cause contributed to the loss to follow-up during supportive periodontal therapy (SPT) among a variety of potential factors. Majority of patients had negative attitudes toward subsequent continued participation in supportive care.
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Affiliation(s)
- Mengli Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Yuxin Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Wen Fang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Weiyi Pan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Qianting Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China.
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Gürbüz S, Altıkat M. The association between periodontitis patients' chief complaints and the stage of periodontitis: A clinical retrospective study. Clin Oral Investig 2023; 27:6261-6272. [PMID: 37704915 DOI: 10.1007/s00784-023-05258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES The purposes of this retrospective study were to investigate the prevalence of various periodontal chief complaints (pCCs) of patients, diagnosed with periodontitis, as well as to identify the association between pCCs and periodontal parameters or periodontitis staging according to AAP/EFP 2017 classification. MATERIALS AND METHODS Five hundred eighty-nine patients, applied to the clinic with pCCs, were screened. The demographic characteristics, smoking status, brushing behaviors, history of periodontal therapy, medical data, and periodontal parameters were obtained. A multinomial logistic regression analysis was performed to determine the most common pCCs and co-variables among the indicators of Stage III and IV periodontitis. RESULTS In Stage IV periodontitis, patients with pCC of mobility were observed the most (26.8%), and pCC of halitosis were the least (7.3%). Among all pCCs of patients, those with the pCC of gingival enlargement and tooth mobility had the highest percentage of sites with PPD ≥ 4 mm and CAL ≥ 5 mm, respectively (p < .001). According to regression analysis, those with pCC of gingival bleeding, recession and mobility were more likely to be in Stage IV than those in Stage I/II. CONCLUSION Among pCCs, only patients with pCCs of mobility, gingival recession and bleeding are related to periodontitis staging. Moreover, the extent of periodontal pockets in patients with pCC of gingival enlargement, and the extent of attachment loss in patients with pCC of mobility are greater than other patients. CLINICAL RELEVANCE New machine-learning technology models can be developed with the aim of classifying the patients based on their chief complaints, to support diagnosing the severity of periodontal diseases.
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Affiliation(s)
- Sühan Gürbüz
- Department of Periodontology, Gazi University Faculty of Dentistry, Bişkek Caddesi, 1.Sokak No. 4, 06490, Ankara, Türkiye.
| | - Merve Altıkat
- Vocational School of Health Care Services, İstinye University, İstanbul, Türkiye
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Michalowicz BS, Anderson JP, Kottke TE, Dehmer SP, Worley DC, Kane S, Basile S, Rindal DB. Periodontal treatment and subsequent clinical outcomes and medical care costs: A retrospective cohort study. PLoS One 2023; 18:e0290028. [PMID: 37578943 PMCID: PMC10424874 DOI: 10.1371/journal.pone.0290028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION Periodontitis is a common oral disease associated with coronary artery disease (CAD), cerebrovascular disease (CBVD) and type 2 diabetes (T2D). We studied if periodontitis treatment improves clinical outcomes and reduces medical care costs in patients with CAD, CBVD or T2D. METHODS We used clinic records and claims data from a health care system to identify patients with periodontitis and CAD, CBVD or T2D, and to assess periodontal treatments, hospitalizations, medical costs (total, inpatient, outpatient, pharmacy), glycated hemoglobin, cardiovascular events, and death following concurrent disease diagnoses. We compared clinical outcomes according to receipt of periodontal treatment and/or maintenance care in the follow-up period, and care costs according to treatment status within one year following concurrent disease diagnoses, while adjusting for covariates. The data were analyzed in 2019-21. RESULTS We identified 9,503 individuals, 4,057 of whom were in the CAD cohort; 3,247 in the CBVD cohort; and 4,879 in the T2D cohort. Patients who were selected and elected to receive treatment and maintenance care were less likely to be hospitalized than untreated individuals (CAD: OR = 0.71 (95% CI: 0.55, 0.92); CBVD: OR = 0.73 (0.56, 0.94); T2D: OR = 0.80 (0.64, 0.99)). Selection to treatment and/or maintenance care was not significantly associated with cardiovascular events, mortality, or glycated hemoglobin change. Total care costs did not differ significantly between treated and untreated groups over 4 years. Treated patients experienced lower inpatient costs but higher pharmacy costs. CONCLUSIONS Patients with periodontitis and CAD, CBVD or T2D who were selected and elected to undergo periodontal treatment or maintenance care had lower rates of hospitalizations, but did not differ significantly from untreated individuals in terms of clinical outcomes or total medical care costs.
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Affiliation(s)
| | | | - Thomas E. Kottke
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Steven P. Dehmer
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Donald C. Worley
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Sheryl Kane
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Sarah Basile
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - D. Brad Rindal
- HealthPartners Institute, Bloomington, Minnesota, United States of America
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Abdulkareem AA, Imran NK, Abdulraheam RH, Gul SS. Prevalence and factors influencing reporting of true periodontal chief complaints: A retrospective analysis. Clin Exp Dent Res 2021; 7:443-449. [PMID: 33354853 PMCID: PMC8404502 DOI: 10.1002/cre2.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of true periodontal chief complaints (CC) and the factors affecting their reporting by patients with periodontal diseases (PD). MATERIALS AND METHODS This cross-sectional study was based on retrospective analysis of available periodontal records. Different personal and demographic variables were obtained from these records including CC, age, gender, working status, past medical/dental history, smoking status and diagnosis. In addition, clinical parameters of plaque index, gingival index, probing pocket depth (PPD), and number of missing teeth. Periodontal CC were retrieved and divided either into true periodontal (bleeding, tooth mobility, and alteration in gingival color/shape) or others (emergency and esthetic-related) CC. RESULTS A total of 1161 records were included in the final analysis. Results showed that only 287 (24.7%) of patients reported true periodontal CC whereas the remaining 874 (75.3%) patients were not aware about symptoms of PD. Regression modeling indicated that reporting of true CC was positively associated with smoking and PPD but negatively associated with number of missing teeth and gender (male). CONCLUSIONS Results suggested that recognition of true periodontal CC by the patients was low. Reporting of true periodontal CC was significantly associated with smoking, PPD, female and lower number of missing teeth. These results shed light on the importance of increasing public knowledge about PD which is essential to aid people in recognizing these diseases at early stages.
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Affiliation(s)
- Ali A. Abdulkareem
- Department of Periodontics, College of DentistryUniversity of BaghdadBaghdadIraq
| | - Nada K. Imran
- Department of Periodontics, College of DentistryUniversity of BaghdadBaghdadIraq
| | | | - Sarhang S. Gul
- Periodontics Department, College of DentistryUniversity of SulaimaniSulaymaniyahIraq
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Ng E, Tay JRH, Ong MMA. Minimally Invasive Periodontology: A Treatment Philosophy and Suggested Approach. Int J Dent 2021; 2021:2810264. [PMID: 34257659 PMCID: PMC8245214 DOI: 10.1155/2021/2810264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 01/20/2023] Open
Abstract
Severe periodontitis is a highly prevalent dental disease. With the advent of implant dentistry, teeth are often extracted and replaced. Periodontal surgery, where indicated, could also result in increased trauma to the patient. This literature review discusses different treatment modalities for periodontitis and proposes a treatment approach emphasizing maximum preservation of teeth while minimizing morbidity to the patient. Scientific articles were retrieved from the MEDLINE/PubMed database up to January 2021 to identify appropriate articles that addressed the objectives of this review. This was supplemented with hand searching using reference lists from relevant articles. As tooth prognostication does not have a high predictive value, a more conservative approach in extracting teeth should be abided by. This may involve repeated rounds of nonsurgical periodontal therapy, and adjuncts such as locally delivered statin gels and subantimicrobial-dose doxycycline appear to be effective. Periodontal surgery should not be carried out at an early phase in therapy as improvements in nonsurgical therapy may be observed up to 12 months from initial treatment. Periodontal surgery, where indicated, should also be minimally invasive, with periodontal regeneration being shown to be effective over 20 years of follow-up. Biomarkers provide an opportunity for early detection of disease activity and personalised treatment. Quality of life is proposed as an alternative end point to the traditional biomedical paradigm focused on the disease state and clinical outcomes. In summary, minimally invasive therapy aims to preserve health and function of the natural dentition, thus improving the quality of life for patients with periodontitis.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - Marianne Meng Ann Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
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Brown LM, Bowman P, O’Rourke VJ, Mercado F, Marshall R, Parsons S. Periodontal Referral Patterns in Australia: 2000 Versus 2015. J Periodontol 2017; 88:869-875. [DOI: 10.1902/jop.2017.160774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Leah M. Brown
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Patrick Bowman
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Vincent J. O’Rourke
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Scott Parsons
- Private practice, Canberra, New South Wales, Australia
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Delatola C, Adonogianaki E, Ioannidou E. Non-surgical and supportive periodontal therapy: predictors of compliance. J Clin Periodontol 2014; 41:791-6. [PMID: 24813661 DOI: 10.1111/jcpe.12271] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 11/28/2022]
Abstract
AIM To identify predictors of compliance during non-surgical and supportive periodontal therapy (SPT). MATERIALS AND METHODS In this retrospective study, demographic, dental, medical data of 427 new patients in a private practice were collected. Data were analysed in statistical models with non-surgical therapy and SPT compliance used as dependent variables. RESULTS Of the 427 patients, 17.3% never agreed to initial therapy, 10.7% never completed therapy and 20.8% completed treatment, but never entered SPT. Of the 218 SPT patients, 56% became non-attenders after a period of 20 months, 33% were erratic attenders and 10.5% were regular attenders until the end of the observation period (5.5-6.5 years). Patients became erratic attenders after a mean period of regular attendance of 18.1 ± 16.2 months, whereas 49.6% of the patients, who abandoned SPT, were regular attenders until the time they stopped. In a univariate correlation model, periodontal disease severity emerged as a significant predictor of the completion of non-surgical periodontal therapy (p = 0.01). In a multivariate linear regression model, smoking was negatively associated with SPT compliance (p = 0.047). CONCLUSIONS A low compliance of the population was observed. Smoking and periodontal disease severity represented significant, but modest modifiers of a patient compliance with SPT and initial therapy respectively.
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The association of tooth scaling and decreased cardiovascular disease: a nationwide population-based study. Am J Med 2012; 125:568-75. [PMID: 22483056 DOI: 10.1016/j.amjmed.2011.10.034] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 10/21/2011] [Accepted: 10/21/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Poor oral hygiene has been associated with an increased risk for cardiovascular disease. However, the association between preventive dentistry and cardiovascular risk reduction has remained undetermined. The aim of this study is to investigate the association between tooth scaling and the risk of cardiovascular events by using a nationwide, population-based study and a prospective cohort design. METHODS Our analyses were conducted using information from a random sample of 1 million persons enrolled in the nationally representative Taiwan National Health Insurance Research Database. Exposed individuals consisted of all subjects who were aged ≥ 50 years and who received at least 1 tooth scaling in 2000. The comparison group of non-exposed persons consisted of persons who did not undergo tooth scaling and were matched to exposed individuals using propensity score matching by the time of enrollment, age, gender, history of coronary artery disease, diabetes, hypertension, and hyperlipidemia. RESULTS During an average follow-up period of 7 years, 10,887 subjects who had ever received tooth scaling (exposed group) and 10,989 age-, gender-, and comorbidity-matched subjects who had not received tooth scaling (non-exposed group) were enrolled. The exposed group had a lower incidence of acute myocardial infarction (1.6% vs 2.2%, P<.001), stroke (8.9% vs 10%, P=.03), and total cardiovascular events (10% vs 11.6%, P<.001) when compared with the non-exposed group. After multivariate analysis, tooth scaling was an independent factor associated with less risk of developing future myocardial infarction (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.57-0.85), stroke (HR, 0.85; 95% CI, 0.78-0.93), and total cardiovascular events (HR, 0.84; 95% CI, 0.77-0.91). Furthermore, when compared with the non-exposed group, increasing frequency of tooth scaling correlated with a higher risk reduction of acute myocardial infarction, stroke, and total cardiovascular events (P for trend<.001). CONCLUSION Tooth scaling was associated with a decreased risk for future cardiovascular events.
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