Natural history of periodontitis: Disease progression and tooth loss over 40 years.

Ramseier, Christoph; Anerud, Age; Dulac, Mary; Lulic, Martina; Cullinan, Mary P; Seymour, Gregory J; Faddy, Malcolm J; Bürgin, Walter; Schätzle, Marc; Lang, Niklaus Peter (2017). Natural history of periodontitis: Disease progression and tooth loss over 40 years. Journal of clinical periodontology, 44(12), pp. 1182-1191. Wiley 10.1111/jcpe.12782

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OBJECTIVES To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years. MATERIAL AND METHODS Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined. RESULTS PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age. CONCLUSIONS These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology
04 Faculty of Medicine > School of Dental Medicine > School of Dental Medicine, Periodontics Research

UniBE Contributor:

Ramseier, Christoph and Lang, Niklaus Peter


600 Technology > 610 Medicine & health








Doris Burri

Date Deposited:

30 Jul 2019 15:24

Last Modified:

24 Oct 2019 11:46

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

clinical attachment loss longitudinal natural history periodontal disease progression prediction tooth loss




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