Problems of dental preservation and complex therapy of chronic generalized periodontitis

Epidemiological studies have reported the prevalence of inflammatory periodontal diseases of 85%–90% in individuals aged >30 years. Predicting the possibility of preserving teeth is an important integral part of treatment planning for periodontitis. Traditionally, the prognosis is based on the likelihood of tooth loss. The article presents a review of the literature characterizing the factors that affect the prognosis of the service life of teeth in case of periodontitis. For the literature review, a literature search was performed on the MedLine, EMBASE, CyberLeninka, and eLibrary databases. The following factors should be considered when assessing the long-term prognosis in patients with the highest risk for tooth loss: severity of periodontitis, smoking, bruxism, number of abutment teeth, age, type of tooth, depth of probing the periodontal pocket, bone loss, furcation involvement, root mobility and proportions, and tooth crowns. Indicators for molar loss include furcation lesion, bone loss progression, endodontic treatment, persistent periodontal pocket, age, female sex, smoking, and diabetes mellitus. A favorable treatment result and preservation of teeth depend on the entire group of teeth, with the following values: 85% in single-rooted anterior teeth, 78% in premolars, and 47% in molars. The low accuracy of standard predictive tooth loss indices can be explained by the point that the indices are mainly based on factors related to teeth and do not take into account the influence of patient-related factors. Thus, predicting the service life of teeth with periodontitis is a difficult task and requires taking into account both individual indicators of periodontal status and general factors.