Influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis and malocclusion

Abstract

Objective: To investigate the influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP). Methods: A retrospective analysis was conducted in 25 AgP patients, who have received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology. Changes in the ratio of the residual alveolar bone height (RBH) was measured at three time points: baseline (T0), post orthodontic treatment (T1), and the last re-visit 3 years after orthodontic treatment (T2). Root abnormity was evaluated by observing periapical radiographs, and its relationship with alveolar bone loss after orthodontic treatment was analyzed. A multi-level analysis on factors related to the clinical outcome (alveolar bone height change) was performed. Results: Totally 693 teeth of 25 patients at T0 and T1 and 368 teeth of 14 patients at T2 were investigated. During the periodontal-orthodontic treatment, the RBH was mainly influenced by root abnormity (estimation value -2.392), tooth position (estimation value for upper teeth vs. lower teeth 3.139, and anterior teeth vs. posterior teeth -3.469) and the baseline RBH at T0 (estimation value -0.391) (P<0.05). Teeth with root abnormity, teeth in mandibular and anterior area, and teeth with higher RBH showed less change in T1-T0 RBH values. In the long-term follow-up, RBH was mainly influenced by tooth position (estimation value for upper teeth vs. lower teeth 3.735, and anterior teeth vs. posterior teeth -5.318), the baseline RBH and probing depth (PD) at T0. Teeth in mandibular and anterior area, teeth with higher RBH (estimation value -0.498) and PD (estimation value -1.594) (P<0.05) showed less change in T0-T2 RBH values. Conclusions: During orthodontic treatment, teeth with abnormal root, lower teeth, anterior teeth, and teeth with high RBH were unfavorable factors for bone gain. In the long-term observation, lower teeth, anterior teeth, teeth with high RBH and PD at first visit were unfavorable factors for bone gain.