Patient-reported experiences and outcomes following two different approaches for non-surgical periodontal treatment: a randomized field study. 2021

Anna Liss, and Jan L Wennström, and Maria Welander, and Cristiano Tomasi, and Max Petzold, and Kajsa H Abrahamsson
Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Gothenburg, Sweden. anna.liss@odontologi.gu.se.

The current report is part of a prospective, multi-center, two-arm, quasi-randomized field study focusing on the effectiveness in general praxis of evidence-based procedures in the non-surgical treatment of patients with periodontitis. The specific aims were to (i) evaluate patient-reported experience and outcome measures of treatment following a guided approach to periodontal infection control (GPIC) compared to conventional non-surgical therapy (CNST) and to (ii) identify potential predictors of subjective treatment outcomes and patient's adherence to self-performed infection control, i.e. adequate oral hygiene. The study sample consisted of 494 patients treated per protocol with questionnaire- and clinical data at baseline and 6-months. The GPIC approach (test) comprised patient education for adequate oral hygiene prior to a single session of full-mouth ultra-sonic instrumentation, while the CNST approach (control) comprised education and instrumentation (scaling and root planing) integrated at required number of consecutive appointments. Clinical examinations and treatment were performed by Dental Hygienists, i.e. not blinded. Data were processed with bivariate statistics for comparison between treatment groups and with multiple regression models to identify potential predictors of subjective and clinical outcomes. The primary clinical outcome was gingival bleeding scores. No substantial differences were found between the two treatment approaches regarding patient-reported experiences or outcomes of therapy. Patients' experiences of definitely being involved in therapy decisions was a significant predictor for a desirable subjective and clinical outcome in terms of; (i) that oral health was considered as much improved after therapy compared to how it was before, (ii) that the treatment definitively had been worth the cost and efforts, and (iii) adherence to self-performed periodontal infection control. In addition, to be a current smoker counteracted patients' satisfaction with oral health outcome, while gingival bleeding scores at baseline predicted clinical outcome in terms of bleeding scores at 6-months. The results suggest that there are no differences with regard to patient-reported experiences and outcomes of therapy following a GPIC approach to periodontal infection control versus CNST. Patients' experiences of being involved in therapy decisions seem to be an important factor for satisfaction with care and for adherence to self-performed periodontal infection control. Registered at: ClinicalTrials.gov (NCT02168621).

UI MeSH Term Description Entries
D009910 Oral Hygiene The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. Dental Hygiene,Hygiene, Dental,Hygiene, Oral
D010510 Periodontal Diseases Pathological processes involving the PERIODONTIUM including the gum (GINGIVA), the alveolar bone (ALVEOLAR PROCESS), the DENTAL CEMENTUM, and the PERIODONTAL LIGAMENT. Parodontosis,Pyorrhea Alveolaris,Disease, Periodontal,Diseases, Periodontal,Parodontoses,Periodontal Disease
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071066 Patient Reported Outcome Measures Assessment of the quality and effectiveness of health care as measured and directly reported by the patient. Patient Reported Outcome Measure,Patient-Reported Outcome,Patient-Reported Outcomes,Patient Reported Outcome,Patient Reported Outcomes,Outcome, Patient Reported,Outcome, Patient-Reported
D012534 Dental Scaling Removal of dental plaque and dental calculus from the surface of a tooth, from the surface of a tooth apical to the gingival margin accumulated in periodontal pockets, or from the surface coronal to the gingival margin. Root Scaling,Scaling, Dental,Scaling, Root,Scaling, Subgingival,Scaling, Supragingival,Root Scalings,Scalings, Root,Subgingival Scaling,Supragingival Scaling
D016745 Root Planing A procedure for smoothing of the roughened root surface or cementum of a tooth after subgingival curettage or scaling, as part of periodontal therapy. Planing, Root,Planings, Root,Root Planings
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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