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Natural history of periodontitis: Disease progression and tooth loss over 40 years
Open accessAbstract
OBJECTIVES: To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years. MATERIAL AND METHODS: Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined. RESULTS: PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age. CONCLUSIONS: These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.
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“Manual dexterity difficulties in the latter and challenges with adherence decrease the effectiveness of guidelines conformed treatment in a large part of the affected population, who got the disease due to inadequate oral hygiene practices (Lang et al., 2009; Ramseier et al., 2017).”
From Enhanced control of periodontitis by an artificial intelligence‐enabled multimodal‐sensing toothbrush and targeted mHealth micromessages: A randomized trial (2024) · cites this paper as Ramseier et al., 2017
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Metadata
- Authors
- Ramseier, C. A., Anerud, A., Dulac, M., Lulic, M., Cullinan, M. P., Seymour, G. J., Faddy, M. J., Bürgin, W., Schätzle, M., & Lang, N. P.
- Affiliations
- University of Bern (CH)
- The University of Honk Kong Hong Kong China
- University of Hong Kong (HK)
- The University of Queensland (AU)
- Queensland University of Technology (AU)
- University of Zurich (CH)
- Corresponding author
- Lang, Niklaus P.
- ORCID
- Venue
- Journal of Clinical Periodontology
- Publisher
- Wiley
- Published
- 2017-09-22
- Volume
- 44
- Issue
- 12
- Pages
- 1182-1191
- ISSN
- 0303-6979 (ISSN-L)
- 1600-051X
- OpenAlex
- W2738605185
- Cited by
- 264
- References
- 24
- Citations by year
- 2026: 13 · 2025: 43 · 2024: 46 · 2023: 39 · 2022: 34 · 2021: 36 · 2020: 27 · 2019: 17 · 2018: 7 · 2017: 2
- FWCI
- 20.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal Of Clinical Periodontology (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Cancer Research Foundation
- Society of Surgical Oncology
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
- Health Sciences › Dentistry › Periodontics › Periodontal Regeneration and Treatments
- Keywords
- periodontitis, tooth loss, attachment loss, disease progression, smoking, dental calculus, dental plaque, gingivitis, edentulism, Markov chain analysis
- MeSH terms
- Adolescent, Adult, Areca, Dental Calculus, Dental Plaque, Gingivitis, Habits, Hong Kong, Humans, Jaw, Edentulous, Partially, Longitudinal Studies, Male, Markov Chains, Mouth, Edentulous, Periodontal Diseases, Periodontal Index, Periodontitis, Risk Factors, Sensitivity and Specificity, Smoking, Time Factors, Logistic Models, Tooth Loss, Smoking Cessation, Periodontal Attachment Loss, Disease Progression, Chronic Periodontitis, Young Adult
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