Root proximity as a risk factor for a progression of periodontal attachment loss : VA Dental Longitudinal Study
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Abstract
BACKGROUND: The purpose of the present longitudinal study was to evaluate the association between root proximity and alveolar bone loss. METHODS: We used data from the VA Dental Longitudinal Study, a closed-panel longitudinal cohort study with 1231 predominantly white men enrolled in 1968 with triennial follow-up exams. Periapical radiographs from baseline and the last examination available of lower incisors with 2:10 years of follow-up were selected. Root distance at CEJ level and alveolar bone levels were measured on digitized radiographs. The primary outcome was the average rate of bone loss over the time of follow-up. Secondary outcomes were the risk of losing at least 0.5 mm or 1.0 mm of bone over ten years. Site-specific linear and generalized linear models were fit to evaluate the association between root proximity and alveolar bone loss, adjusting for covariates. Empirical standard errors and general estimating equations were used to account for the correlation between sites within subjects. Fractional polynomial regression was used to evaluate the dose-response function. RESULTS: The final sample consisted of 473 men (mean age 46, range 28-71 years) with a mean follow-up of 23 years (range 10-35 years). The mean root distance was 1.0 ± 0.3 mm and mean bone loss over 10 years was 0.61 ± 0.59 mm. There was a significant non-linear association between root proximity and bone loss (p<0.005). Compared to root distances > 0.8 mm, sites with root distances 0.6-0.8 mm and [less than]0.6 mm were 13% (95% CI: 0% to 26%; p=0.041) and 28% (95% CI: 11% to 48%; p=0.001) more likely to loose 2:0.5 mm, and 10% (95% CI: -16% to 40%; p=0.54) and 52% (95% CI: 9% to 213%; p=0.013) more likely to loose 2:1.0 mm of bone over ten years , respectively. CONCLUSION: The results of this study suggest that interradicular root distances smaller than 0.8 mm are a risk factor for alveolar bone loss.
Description
Thesis (MSD)--Boston University, Goldman School of Dental Medicine, 2007 (Dept. of Dental Public Health).
Includes bibliography: leaves 36-38.
Includes bibliography: leaves 36-38.
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