A retrospective study on patients' compliance with supportive periodontal therapy

Woong-Kyu Park; Jae-Kwan Lee; Beom-Seok Chang; Heung-Sik Um

doi:10.5051/jkape.2009.39.1.59

Journal List > J Korean Acad Periodontol > v.39(1) > 1049825

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Park, Lee, Chang, and Um: A retrospective study on patients' compliance with supportive periodontal therapy

Original Article

The Journal of the Korean Academy of Periodontology

The Journal of the Korean Academy of Periodontology 2009; 39(1): 59-70.

Published online: 31 March 2009

DOI: https://doi.org/10.5051/jkape.2009.39.1.59

A retrospective study on patients' compliance with supportive periodontal therapy

Woong-Kyu Park, Jae-Kwan Lee

, Beom-Seok Chang, Heung-Sik Um

Department of Periodontology, College of Dentistry, Kangnung National University, Gangneung, Korea.

Correspondence: Dr. Heung-Sik Um. Department of Periodontology, College of Dentistry, Kangnung National University, 123 Jibyun-dong, Gangneung, Gangwon-do, 210-720, Korea. hsum@kangnung.ac.kr, Tel: 033-640-3184, Fax: 033-640-3103

Received 4 February 2009 Accepted 11 May 2009

Abstract

Purpose

The purpose of this study was to investigate the degree of compliance with supportive periodontal therapy(SPT), to determine if any significant differences existed in the characteristics of compliant, erratically compliant and non-compliant patients and to identify reasons for poor compliance.

Materials and methods

Four hundred five patients who initially visited between July 2003 and December 2004 and were treated until June 2005 were retrospectively evaluated for their compliance with SPT in terms of attendance for a recommended schedule of visits. Patients' compliance was classified as complete compliance(attended more than 80% of the recommended appointments), erratic compliance(attended less than 80% of the recommended appointments or discontinued) and non-compliance(did not return for SPT). Analysis was made for each group to correlate the degree of compliance with gender, age, smoking, distance between their houses and the hospital, disease severity, type of therapy, implant, plaque control instruction and systemic diseases. Tele research of erratically compliant and non-compliant patients was carried out to identify reasons for their poor compliance.

Results

Only 24.7% of the patients were in complete compliance. The highest drop-out rate(32.4%) occurred in the first year. A significantly greater percentage of non-smokers and patients who finished plaque control instruction were in complete compliance. A significantly greater percentage of patients without implant and patients who had been treated by only scaling and root planing were in non-compliance. More males were found to be compliant with SPT, although this was marginally significant. There were no significant differences between compliant, erratically compliant and non-compliant patients with regard to age, distance, disease severity and systemic disease. The survey revealed that the main reasons for poor compliance with SPT were inconvenient location and insufficient time.

Conclusion

Patients' compliance with SPT was poor and the highest drop-out rate(32.4%) occurred in the first year. Significant relationships were found between the degree of compliance and smoking, type of therapy, implant, plaque control instruction and gender.

Keywords: supportive periodontal therapy, patient compliance, periodontal diseases/therapy

Figures and Tables

Figure 1

Timetable of active periodontal treatment and SPT

Figure 2

Percentage of patients who attended SPT according to duration.

Figure 3

Percentage of patients who attended SPT according to number of visits.

Table 1

Inclusion Criteria

Table 2

Exclusion Criteria

SPT, supportive periodontal therapy.

Table 3

Classification of Patients by Compliance with SPT

SPT, supportive periodontal therapy.

Table 4

Classifications of Patients by Age, Smoking, Distance, Disease Severity, Type of Therapy, Implant, Plaque Control Instruction and Systemic Disease

PPD, probing pocket depth; SRP, scaling and root planing; Sx, surgery; PCI, plaque control instruction; Ds, disease.

Table 5

Number and Percentage of Patients by Compliance

Table 6

Number and Percentage of Complete, Erratic and Non-Compliant Patients' Demographic, Behavioral and Clinical Characteristics

PPD, probing pocket depth; SRP, scaling and root planing; Sx, surgery; PCI, plaque control instruction; Ds, disease.

Table 7

Statistical Analysis for Complete, Erratic and Non-Compliance

PCI, plaque control instruction; Ds, disease.

Table 8

Percentage of Patients Who Attended SPT According to Duration and Number of Visits

SPT, supportive periodontal therapy.

Table 9

Reasons for Erratic and Non-Compliance with SPT

SPT, supportive periodontal therapy.

References

1. Shick RA. Maintenance phase of periodontal therapy. J Periodontol. 1981. 52:576–583.

2. Axelsson P, Lindhe J. The significance of maintenance care in the treatment of periodontal disease. J Clin Periodontol. 1981. 8:281–294.

3. Ramfjord SP, Morrison EC, Burgett FG, et al. Oral hygiene and maintenance of periodontal support. J Periodontol. 1982. 53:26–30.

4. Ramfjord SP. Maintenance care for treated periodontitis patients. J Clin Periodontol. 1987. 14:433–437.

5. Wilson TG Jr, Glover ME, Malik AK, Schoen JA, Dorsett D. Tooth loss in maintenance patients in a private periodontal practice. J Periodontol. 1987. 58:231–235.

6. Chambrone LA, Chambrone L. Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil. J Clin Periodontol. 2006. 33:759–764.

7. American Academy of Periodontology. Glossary of periodontal terms. 1992. Chicago: American Academy of Periodontology;39.

8. American Academy of Periodontology. Periodontal Maintenance (position paper). J Periodontol. 2003. 74:1395–1401.

9. Wilson TG Jr. Supportive periodontal treatment introduction-definition, extent of need, therapeutic objectives, frequency and efficacy. Periodontol 2000. 1996. 12:11–15.

10. Haynes R. Sackett D, Haynes R, editors. A critical review of the "determinants" of patient compliance with therapeutic regimens. Compliance with Therapeutic Regimens. 1976. Baltimore: Johns Hopkins University Press;1–6.

11. Wilson TG Jr. How patient compliance to suggested oral hygiene and maintenance affect periodontal therapy. Dent Clin North Am. 1998. 42:389–403.

12. Wilson TG Jr, Glover ME, Schoen J, Baus C, Jacobs T. Compliance with maintenance therapy in a private periodontal practice. J Periodontol. 1984. 55:468–473.

13. Wilson TG Jr, Hale S, Temple R. The results of efforts to improve compliance with supportive periodontal treatment in a private practice. J Periodontol. 1993. 64:311–314.

14. Demetriou N, Tsami-Pandi A, Parashis A. Compliance with supportive periodontal treatment in private periodontal practice. A 14-year retrospective study. J Periodontol. 1995. 66:145–149.

15. König J, Plagmann HC, Langenfeld N, Kocher T. Retrospective comparison of clinical variables between compliant and non-compliant patients. J Clin Periodontol. 2001. 28:227–232.

16. Mendoza AR, Newcomb GM, Nixon KC. Compliance with supportive periodontal therapy. J Periodontol. 1991. 62:731–736.

17. Novaes AB Jr, Novaes AB. Compliance with supportive periodontal therapy. Part 1. Risk of non-compliance in the first 5-year period. J Periodontol. 1999. 70:679–682.

18. Novaes AB Jr, Novaes AB, Bustamanti A, et al. Supportive periodontal therapy in South America. A retrospective multipractice study on compliance. J Periodontol. 1999. 70:301–306.

19. Novaes AB Jr, de Lima FR, Novaes AB. Compliance with supportive periodontal therapy and its relation to the bleeding index. J Periodontol. 1996. 67:976–980.

20. Novaes AB Jr, Novaes AB. Compliance with supportive periodontal therapy. Part II: Risk of non-compliance in a 10-year period. Braz Dent J. 2001. 12:47–50.

21. Demirel K, Efeodlu A. Retrospective evaluation of patient compliance with supportive periodontal treatment. J Nihon Univ Sch Dent. 1995. 37:131–137.

22. Ojima M, Hanioka T, Shizukuishi S. Survival analysis for degree of compliance with supportive periodontal therapy. J Clin Periodontol. 2001. 28:1091–1095.

23. Matthews DC, Smith CG, Hanscom SL. Tooth loss in periodontal patients. J Can Dent Assoc. 2001. 67:207–210.

24. Checchi L, Pelliccioni GA, Gatto MR, Kelescian L. Patient compliance with maintenance therapy in an Italian periodontal practice. J Clin Periodontol. 1994. 21:309–312.

25. Novaes AB, Novaes AB Jr, Moraes N, Campos GM, Grisi MF. Compliance with supportive periodontal therapy. J Periodontol. 1996. 67:213–216.

26. Axtelius B, Soderfeldt B, Edwardsson S, Attstrom R. Therapy-resistant periodontitis (II). Compliance and general and dental health experiences. J Clin Periodontol. 1997. 24:646–653.

27. Becker W, Becker BE, Caffesse R, et al. A longitudinal study comparing scaling, osseous surgery, and modified Widman procedures: results after 5 years. J Periodontol. 2001. 72:1675–1684.

28. Fardal O, Linden GJ. Re-treatment profiles during long-term maintenance therapy in a periodontal practice in Norway. J Clin Peridontol. 2005. 32:744–749.

29. Fardal O. Interviews and assessments of returning non-compliant periodontal maintenance patients. J Clin Periodontol. 2006. 33:216–220.

30. Hancock EB, Newell DH. Preventive strategies and supportive treatment. Periodontology 2000. 2001. 25:59–76.

31. Jansson LE, Hagstrom KE. Relationship between compliance and periodontal treatment outcome in smokers. J Periodontol. 2002. 73:602–607.

32. Leung WK, Ng DKC, Jin L, Corbet EF. Tooth loss in treated periodontitis patients responsible for their supportive care arrangements. J Clin Periodontol. 2006. 33:265–275.

33. Mengel R, Schroder T, Flores-de-Jacoby L. Osseointegrated implants in patients treated for generalized chronic periodontitis and generalized aggressive periodontitis: 3- and 5-year results of a prospective long-term study. J Periodontol. 2001. 72:977–989.

34. Ojima M, Kanagawa H, Nishida N, et al. Relationship between attitudes toward oral health at initial office visit and compliance with supportive periodontal treatment. J Clin Periodontol. 2005. 32:364–368.

35. Reddy MS, Geurs NC, Jeffcoat RL, Proskin H, Jeffcoat MK. Periodontal disease progression. J Periodontol. 2000. 71:1583–1590.

36. Renvert S, Persson GR. Supportive periodontal therapy. Periodontology 2000. 2004. 36:179–195.

37. Rieder C, Joss A, Lang NP. Influence of compliance and smoking habits on the outcomes of supportive periodontal therapy (SPT) in a private practice. Oral Health Prev Dent. 2004. 2:89–94.

38. Rosen B, Olavi G, Badersten A, et al. Effect of different frequencies of preventive maintenance treatment on periodontal conditions. 5-Year observations in general dentistry patients. J Clin Periodontol. 1999. 26:225–233.

39. Tan AE, Powell RN, Seymour GJ. Patient attendance compliance in periodontal therapy. Aust Dent J. 1992. 37:467–471.

40. Weinstein R, Tosolin F, Ghilardi L, Zanardelli E. Psychological intervention in patients with poor compliance. J Clin Periodontol. 1996. 23:283–288.

41. Wilson TG Jr. Compliance and its role in periodontal therapy. Periodontology 2000. 1996. 12:16–23.

42. Wilson TG Jr. Compliance. A review of the literature with possible applications to periodontics. J Periodontol. 1987. 58:706–714.

TOOLS

ORCID iDs: Jae-Kwan Lee
https://orcid.org/http://orcid.org/0000-0003-1710-1580
Similar articles