Análise comparativa de coortes prospectivas pública e privada em terapia periodontal de manutenção: análise de variáveis de risco biológicas, sociais e comportamentais na progressão da periodontite e perda dentária

Abstract

Objectives: evaluate and compare the periodontal condition, periodontitis progression, tooth loss and the influence of risk predictors variables in two programs of periodontal maintenancetherapy for a period of 12 months. Materials and methods: 288 subjects complete compliers, diagnosed with moderate to advanced chronic periodontitis and who have completed active periodontal therapy wereevaluated in na academic environment (PMTA group, n=138), in Faculty of Dentistry, Federal University of Minas Gerais, and in a private clinic (PMTP group, n=150), both located in Belo Horizonte, Minas Gerais, Brazil. Periodontal examination was performed at baseline and 3-month recalls, evaluating: plaque index (PI), bleeding on probing (BOP), clinical attachment level (CAL), suppuration and furcation involvement. Data about individuals social, demographic and biological characteristics and compliance to the program was also collected. The effect variables of interest and confounders was tested by univariate logistic regression analysis and multivariate analysis.Results: the sample characterization was observed a predominance of female subjects (65.2%), aged between 31 and 50 years (65.2%), non smokers (55.7%) and with companion (60.1%). Significant differences between PMTA and PMTP were observed only for the presenceof diabetes (p=0.023). During periodontal evaluation performed at baseline, the groups presented similar results for PS, NIC, SU, BOP, PI. In the subsequent evaluations, was observed a major improvement in the PMTP group compared to the PMTA group, in these same periodontal parameters, from the PMT1 to PMT4 period. The PMTP group also presented low rates of periodontitis progression and tooth loss compared to the PMTA group, with significative differences between groups (p<0.012). After multivariate logistic regression analysis for periodontitis progression, the risk variables, bleeding on probing in more than 30% of sites (p=0.047), smoking (p=0.0036) and diabetes (p=0.028) for PMTP group and smoking (p=0.047) for PMTA group. To the tooth loss, smoking (p=0.021), diabetes (p=0.0042) and PS4-6mm up to 10% of sites (p=0.028) in PMTP group and PS 4-6mm up to 10% of sites in PMTA group showed a negative influence on periodontal status. Conclusion: periodontal maintenance therapy minimized, in both groups, the negative effect of risk variables on the periodontitis progression and tooth loss.