Investigation of the dynamics of the level of clinical attachment loss in patients with chronic periodontitis after conservative therapy

Abstract

Objective. To determine the effectiveness of non-surgical periodontal treatment depending on the localization of areas of loss of clinical attachment in patients with chronic generalized periodontitis of moderate severity. Materials and methods. 30 patients with moderate severity of chronic generalized periodontitis aged from 44 to 59 years were examined and treated. The patients underwent oral sanitation and conservative periodontal treatment. In accordance with the purpose of the study, the main task was to measure the degree of loss of clinical attachment (PKP) before treatment and 1 year after the start of therapy. The level of PKP was determined with a periodontal probe at six points near each tooth: distal-buccal (T1), buccal (T2), medial-buccal (T3), medial-palatine/lingual (T4), palatine/lingual (T5), distal-palatine/lingual (T6) points. A total of 5,052 points were examined in dynamics. Results. After 1 year, the worst results in conservative periodontal treatment in patients with chronic generalized periodontitis (moderate severity) were obtained in the distal sections (distal palatine and distal lingual points) of the molars of the upper and lower jaws. In the area of premolars and frontal teeth, conservative treatment in most cases leads to stabilization of the level of clinical attachment and improvement of the condition of the periodontal complex tissues. Conclusions. The unfavorable prognosis for the distal molars is most likely due to a combination of anatomical prerequisites (complex morphology of roots and furcations) and physical barriers (low ergonomics of access for both the doctor and the patient, asymmetry of hygiene measures on the right and left sides), which ultimately leads to the impossibility of complete elimination of microbial biofilm and creates conditions for recurrence of inflammation. The results obtained should be taken into account when planning periodontal treatment and, in order to avoid adverse treatment outcomes, include surgical methods in the complex of therapeutic measures. Unfavorable localization of periodontal lesions (distal palatine and distal lingual points of the molars of the upper and lower jaws) should be considered one of the predictors of disease progression.