3‐year longitudinal study of the periodontal status of an adult population with gingivitis

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Abstract
69 adults ranging in age from 20 to 73 (mean age: 37) were randomly assigned to a control (C) and a test (T) group. Of these, 61 completed the 3‐year longitudinal study. All subjects had varying degrees of gingivitis at the start, but no overt periodontitis. Following a base line examination for PII, GI, probing depth (PD) and recession, a differential darkfield microscopic (DDFM) count of subgingival bacterial morphotypes was carried out on a pooled sample originating from one tooth surface in each sextant with the greatest probing depth. Examinations were repeated every 6 months for 3 years. The C group received regular prophylaxes every 6 months. The T subjects received prophylaxes according to a previously described schedule, and on the basis of the DDFM test outcome.Recall intervals at the end of the study for the T group ranged from 1 to 24 months (mean: 15.7 months). Of 30 subjects in the T group at the end of the study, one half had not had their teeth cleaned for periods of 18 to 36 months without any detectable deterioration in their periodontal status by comparison with the other T subjects or the patients in the C group. Both C and T subjects exhibited increased mean PII and GI scores as compared to base line during the first half of the study. However, mean PD measurements remained unchanged.Increases in PD from base line of 3 mm or more were observed only in approximately 1 out of a 1000 individual tooth surface comparisons, a frequency comparable to that expected to occur by chance alone. This observation indicates that in this population, little if any pocket formation occurred during the study period. GI score increases of 2 units or more occurred in relatively few subjects. 2 of 31 C patients accounted for 42 of the affected dental units, while 5 out of 30 T subjects accounted for 40.8 % of the affected dental units in that group. These observations suggest that despite the relatively high prevalence and incidence of gingivitis, the subjects were relatively resistant to periodontitis. Neither preventive schedule was effective in eliminating gingivitis. The lack of significant destructive disease in this population prevented any meaningful comparison of the relative effectiveness of the two preventive maintenance regimens in preventing recurrences of periodontitis.