Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;47(11):1371-1378.
doi: 10.1111/jcpe.13356. Epub 2020 Sep 14.

Three periodontitis phenotypes: Bone loss patterns, antibiotic-surgical treatment and the new classification

Chryssa Delatola  1 , Bruno G Loos  1 , Marja L Laine  1
Affiliations

Three periodontitis phenotypes: Bone loss patterns, antibiotic-surgical treatment and the new classification

Chryssa Delatola et al. J Clin Periodontol. 2020 Nov.

Abstract

Aim: To compare three periodontitis clusters (A, B and C) for alveolar bone loss (ABL) patterns, antibiotic prescriptions and surgeries and to relate them to the new classification of periodontitis.

Materials and methods: ABL patterns, prescription of systemic antibiotics and the number of surgeries were retrieved for all patients (n = 353) in the clusters. Comparisons and possible predictors for antibiotics were assessed, and results also evaluated in relation to the new classification.

Results: Cluster A is characterized by angular defects often affecting the first molars and localized stage III/IV grade C periodontitis. Cluster B contains mainly localized or generalized stage III/IV, grade C patients. Cluster C contains mainly patients with generalized stage III/IV grade C periodontitis. Patients in cluster A received significantly more antibiotics compared to B and C (78% vs. 23% and 17%); the predictors for antibiotic prescription were young age and localized ABL. No differences in numbers of periodontal surgeries were observed between clusters (A = 1.0 ± 1.4, B = 1.3 ± 1.4 and C = 1.3 ± 1.5).

Conclusions: Within stage III/IV grade C periodontitis, we could detect three clusters of patients. The distinct localized ABL pattern and younger age in cluster A presumably prompted clinicians to prescribe antibiotics.

Keywords: alveolar bone loss pattern; antibiotics; classification; periodontitis; phenotypes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest related to this study.

Figures

FIGURE 1
FIGURE 1
Alveolar bone loss (ABL) patterns for the three clusters. The vertical axis represents the percentage of the teeth affected, per cluster and per tooth type. Panel a shows the percentage of teeth without ABL, panel b shows the percentage of teeth with ≤30% ABL
FIGURE 2
FIGURE 2
Alveolar bone loss (ABL) patterns for the three clusters. The vertical axis represents the percentage of the teeth affected, per cluster and per tooth type. Panel c shows the percentage of teeth with >50% ABL, panel d shows the percentage of teeth with angular defects
FIGURE 3
FIGURE 3
Principal Component Analysis using as grouping factor the use of antibiotics; the available demographic and radiographic information was entered in the analysis. With some overlap, the antibiotic and the non‐antibiotic groups could be observed (F = 15.37, p = .0001). Component 1 and 2 explained 30% and 20% of the variance, respectively. The most discriminative variables were age, number of teeth present, number of teeth without alveolar bone loss, number of teeth with mild/moderate/severe percentage of alveolar bone loss and number of teeth with angular defects. All these parameters contributed with a loading ≥0.3, and this is visualized by the green lines which express the direction and the weight of the contribution of these variables in the PCA
See this image and copyright information in PMC

References

    1. Bongo, A. S. , Brustad, M. , Oscarson, N. , & Jönsson, B. (2020). Periodontal health in an indigenous Sámi population in Northern Norway: A cross‐sectional study. BMC Oral Health, 20(1), 104, 1–11. 10.1186/s12903-020-01098-3 - DOI - PMC - PubMed
    1. Delatola, C. , Loos, B. G. , Levin, E. , & Laine, M. L. (2017). At least three phenotypes exist among periodontitis patients. Journal of Clinical Periodontology, 44(11), 1068–1076. 10.1111/jcpe.12797 - DOI - PubMed
    1. Drisko, C. H. (2001). Nonsurgical periodontal therapy. Periodontology, 2000(25), 77–88. 10.1034/j.1600-0757.2001.22250106.x - DOI - PubMed
    1. Drisko, C. L. (2014). Periodontal debridement: Still the treatment of choice. Journal of Evidence‐Based Dental Practice, 14, 33–41.e1. 10.1016/j.jebdp.2014.02.007 - DOI - PubMed
    1. Feres, M. , Figueiredo, L. C. , Soares, G. M. , & Faveri, M. (2015). Systemic antibiotics in the treatment of periodontitis. Periodontology 2000, 67(1), 131–186. 10.1111/prd.12075 - DOI - PubMed

Publication types

Substances