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Classic Lit Fall 2021 > Longitudinal Studies > Flashcards

Longitudinal Studies Flashcards

1
Q

What were the aims of these Longitudinal Studies?

A

to document the immediate and long-term clinical results following several types of periodontal therapy

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2
Q

What are the differences in American vs European studies?

A
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3
Q

What was the first Longitudinal study?

A

Ramfjord et al. 1968

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4
Q

Ramfjord et al. 1968

A

32pts

SRP/occlusal adjustment
FOLLOWED BY
SubG Currettage

vs

Gingivectomy (PD_<3mm) or flap + osteoplasty/ectomy (PD>_4mm)

CAL gain after SubCR in PD>6mm
Pocket Elimination had CAL loss and greater relapse

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5
Q

Ramfjord et al. 1973

A

Follow up to 1968

4-7yr follow up

NSSD loss of CAL between SubG Curretage and Pocket Elimination surgery

PE showed a greater and better sustained pocket reduction

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6
Q

Ramfjord et al. 1975

A

CR vs PE (gingivectomy or osseous) vs MWF

NSSD between these after 5yrs

PE Not justified - does not improve long term benefit compared to MWF or CR

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7
Q

Which study was the first to stratify based on PD?

A

Knowles et al. 1979

Shallow (1-3mm), Moderate (4-6mm) and deep (7-12mm) pockets

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8
Q

Knowles et al. 1979

A

8yr follow up to Ramfjord 1975

Large PD have greater reduction than moderate PD

MWF best long term for both PD reduction and CAL

(CR vs PE vs MWF)

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9
Q

Hill et al. 1981

A

5sites/tooth - Evaluated effect of initial NSPT

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10
Q

Ramfjord 1987

A

5yr follow up to Hill et al. 1981

SRP vs CR vs PE vs MWF

1-3mm - no change in PD - CAL loss from all tx

4-6mm - PD: PE > MWF > SRP > CR
CALoss: PE > MWF > SRP

7-12mm - PE > MWF > SRP > CR
CALgain all 4

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11
Q

What studies investigated the importance of maintenance?

A

Ramfjord et al. 1982

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12
Q

Ramfjord et al. 1982

A

8yr follow up (same patients as Knowles 1979)

Looked at top and bottom 25% of patient’s PI

CAL and PD maintained over 7yr regardless of OH w/ 3mrc

Initial PDreduction and CALgain greater in patients with good OH - NSSD after 3-4yrs

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13
Q

Ramfjord 1987

A

Review

Periodic (3-4mo) maintenance is recommended for all levels of OH to prevent CAL loss over time

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14
Q

What did the Minnesota Longitudinal studies investigate?

A

SRP vs SRP + MWF at 4 and 6.5yrs

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15
Q

What where the results of the Michigan longitudinal studies?

A

Mod - Deep pockets respond better to surgical therapy with some loss of initial gains

Treatment of shallow pockets often results in CALoss

Maintenance (every 3-4mo) is important regardless of OH

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16
Q

What were the results of the Minnesota longitudinal studies?

A

Deep pockets (7mm) improved more from surgical (SRP + MWF)

Surgical had better long term stability (6.5yrs) than non-surgical (3yrs)

Molars respond less to therapy than non-molars

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17
Q

What were the main findings of the Nebraska Longitudinal Studies?

A

Supragingival Scaling (SC) had the most breakdown

Smokers had less favorable response to perio treatment

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18
Q

What were the main findings of the Lloma Linda Longitudinal Studies?

A

SRP vs Ultrasonic are similar

Home care alone does not improve pockets

Repeated SRP doesnt work

Operator variability in SRP is minimal

Better results in non-molars or molar-flat-surfaces

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19
Q

Who lead the Minnesota studies?

A

Pihlstrom

20
Q

Pihlstrom 1981

A

Minnesota

SRP vs MWF

1-3mm, 4-6mm, 7-12mm

MWF: Increased PD reduction and CAL gain for deeper pockets

21
Q

Pihlstrom 1983

A

Minnesota

6.5yr follow up to 1981

1-3mm: MWF had CALoss

4-6mm: PD: SRP = MWF (Less CALoss in SRP)

7-12mm: MWF stable 6.5yrs | SRP stable 3yrs | SRP MORE PD RECURRENCE

22
Q

Pihlstrom 1984

A

Minnesota

Another 6.5yr follow up to 1981 but this is only Molars vs Non-molars

4-6mm: Molars had less CAL gain than non-molars

7mm+: NSSD in PD reduction after SRP alone - (proof of Stanbaugh 1983?)

23
Q

Who lead the Nabraska longitudinal studies?

A

Kaldahl

24
Q

Kaldahl et al. 1988

A

Nebraska

SC vs SRP vs MWF vs APF+OS

Split mouth - Multi-rooted - 2yr FU

PD reduction: APF+OS > MWF > SRP > SC

20% SC teeth needed re-treatment

25
Q

Kaldahl et al. 1996

A

Nebraska

7yr follow up to 1988

PD >5mm - sustained greater reduction in APF+OS group (NSSD in others)

PD 1-4mm - CAL loss in APF group - CAL gain SRP

CS created abscess in pockets _>_7mm

Surgical and non-surgical can improve and maintain longerm

26
Q

Kaldahl et al. 1996c

A

Nabraska

Effect of Cigarettes
another analysis: 7yr follow up to 1988

Past and Non-smokers had 2x CAL gain and PD reduction

27
Q

Badersten et al. 1981/1984

A

Lloma Linda

Hand instrumentation vs Ultrasonic had NSSD (Single rooted ONLY)

28
Q

Cercek et al. 1983

A

Lloma Linda

Minimal effect from OH alone (supra OR sub) - Effect from SRP

3 Phase study

Phase 1: At home OH w/Flossing (5mo)
Phase 2: CHX sub g rinsing (3mo)
Phase 3: SRP (9mo)

29
Q

Badersten et al 1984b

A

Lloma Linda

No additional benefit to repeated SRP (single rooted)

30
Q

Badersten et al. 1985d

A

Lloma Linda

Periodontist vs Hygienist

Operator variability is minimal

31
Q

Nordland et al. 1987

A

Lloma Linda

Molars with FI had less CAL gain than those without or single rooted teeth

Furcation=more recurrent CAL loss

32
Q

What are the Arizona studies referred to as and why?

A

Tucson-Michigan-Houston

Private practice: Tucson

Calibration: Michigan

2 authors: Texas

33
Q

What did the Arizona studies compare? Who lead them?

A

SRP vs APF+OS vs MWF
Becker

34
Q

Becker et al 1988

A

1yr follow up - 16pts - split mouth - 3mrc - Michigan O probe

SRP vs APF+OSS vs MWF

Surgery increases PD reduction (4-6mm, _>_7mm PD) but causes CAL loss (1-3mm PD)

35
Q

Becker et al 2001

A

5yr follow up, 3mrc

SRP vs PFS+OSS vs MWF

Osseous had highest no. PD 1-3mm and greatest no. sites CAL loss _>_2mm

All treatments resulted in CAL loss 1-3mm PDs and gain in 4-6, _>_7mm PDs

w/ good maintenance - excellent results achieved with various methods

36
Q

What studies make up the Arizona studies, and what is the summary of the studies?

A

Becker et al. 1988, 2001

Provided validity to the university studies as they had similar results - the results are applicable to private practice.

37
Q

According to Becker et al 2001 - Osseous surgery has a ______ effect in reducing PD compared to MWF in patients with good maintenance in the 5 year study.

A

SIMILAR

38
Q

What did the Washington studies investigate?

A

Flap curretage vs OSS

39
Q

What were the Washington studies and what did they find?

A

Smith et al. 1980
6mo follow up - OSS greater PD reduction and maintenance but also had temporary mobility

Olsen et al. 1985
5yr follow up - OSS were stable after 5yrs compared to flap curretage. - Deeper pockets better improvement with OSS

40
Q

Who lead the Swedish studies? What did they research?

A

Lindhe, Rosling, Heitz-Mayfield, Lang

Evaluated the effects of bone removal and then surgical vs non-surgical therapy.

41
Q

What is the summary of the Swedish studies?

A

There is a critical probing depth that should be considered when determining treatment

Oral hygiene effects long-term results more than surgical technique

42
Q

Rosling et al. 1976

A

APF + OSS vs MWF + OSS vs Gingivectomy

Best healing when no bone removed

Gingivectomy had residual infrabony pockets

43
Q

Lindhe et al. 1982a and 1982b + Heitz-Mayfield Lang 2013

A

2yr follow up - split mouth
SRP vs SRP+MWF

a:
Sig PD reduction in both groups
6-12mo SRP CAL gain vs MWF CALoss
after 2yrs MWF resulted in >PD reduction and CAL gain
b:
CRITICAL PROBING DEPTHS
SRP: 2.9mm
MWF: 4.2mm

2013: 5.4mm

44
Q

Lindhe et al. 1984

A

20% sites with poor OH lost 2mm
3% of sites with good OH lost 2mm

Low plaque (<10% PI) had more PD reduction and CAL gain

OH effects long-term results more than technique

45
Q

Lindhe et al. 1985

A

granulation tissue is not critical for proper wound healing

46
Q

Isidor et al. 1985

A

MWF had 0.5mm of coronal regrowth of bone in angular bony defects

47
Q

Isidor et al. 1984

A

MWF and APF had shallower PD than SRP

SRP had slightly more CAL gain than surgical procedures

Classic Lit Fall 2021 (29 decks)

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