Clinical Oral Investigations

, Volume 23, Issue 11, pp 4123–4131 | Cite as

Risk factors associated with long-term outcomes after active and supporting periodontal treatments: impact of various compliance definitions on tooth loss

  • Catherine Petit
  • Sylvie Schmeltz
  • Alexandre Burgy
  • Henri Tenenbaum
  • Olivier Huck
  • Jean-Luc DavideauEmail author
Original Article



The aim of this retrospective study was to determine factors influencing tooth loss during a long-term follow-up, emphasizing the impact of various compliance definitions.

Materials and methods

Patients with periodontitis who were treated and presenting for maintenance care for at least up to 6 years were included. The effects of compliance and other patient- and treatment-related factors on tooth loss were assessed. Lack of compliance was defined in three ways: (1) fewer than 1.4 visits per year (irregular compliers), (2) no maintenance visit over a 2-year period (erratic compliers), and (3) no maintenance visit over a 2- to 5-year period (partial compliers) and no maintenance visit for a period of more than 5 years (non-compliers).


One hundred and one patients were selected. The mean follow-up was 9.72 ± 1.17 years. Tooth loss per patient-year was significantly higher in erratic compliers (0.35 ± 0.19) and non-compliers (0.40 ± 0.20) compared with compliers (0.18 ± 0.10). No significant differences were found for irregular (0.30 ± 0.17) and partial (0.25 ± 0.15) compliers. Similar results were obtained for the number of patients who lost more than three teeth. Multivariable regression analysis showed that lack of compliance and periodontitis severity (more than 3% of periodontal pockets > 7 mm at baseline) were independent risk factors for tooth loss.


During long-term follow-up, non-compliance and initial periodontitis severity were the principal risk factors that increased tooth loss.

Clinical relevance

Tooth loss associated with lack of compliance was essentially observed in patients with long continuous periods without maintenance visits and was less influenced by patients’ attended mean visit frequency.


Tooth loss Periodontitis Treatment Patient compliance 


Compliance with ethical standards

This study was conducted in agreement with the 2008 revised Declaration of Helsinki. The Ethics Committee of Strasbourg’s University Hospitals approved the protocol (AMK/BG/2016-95). Recalled patients were informed about the study objectives and protocol and gave their oral informed consent, which was noted in each patient’s file.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Periodontology, University Hospitals of StrasbourgUniversity of StrasbourgStrasbourgFrance

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