Operative Dentistry, Endodontology and Periodontology
Online ISSN : 2436-4975
Original Articles
Five-year Prognosis and Risk Factor Analysis of Open Flap Debridement for Older People
Yukari AOKI-NONAKA, Takahiro HOKARI, Yumi MATSUKAWA, Keisuke SATO, Miki HARA, Mai TAKEUCHI, Kei TAKAMISAWA, Kyoko YAMAZAKI, Takahiro TSUZUNO, Hikaru TAMURA, Takumi HIYOSHI, Fumiya MEGURO, Emi HOSHIKAWA, Aoi MATSUGISHI, Chihiro KANEKO, Shuhei MINEO, Moe YAMASHITA, Koichi TABETA
著者情報
キーワード: older people, open flap debridement, risk factor
ジャーナル オープンアクセス

2023 年 3 巻 1 号 p. 22-34

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 Purpose: Examination of the effectiveness of periodontal surgery for older people for which no solid evidence is available is important because the number of healthy, independent older patients is increasing annually. This study aimed to clarify the risk factors associated with the efficacy and prognosis of open flap debridement for older patients.

 Methods: Clinical data of 186 patients who underwent open flap debridement and were subsequently followed by supportive periodontal therapy (SPT) or maintenance for ＞5 years were retrospectively reviewed. Patients were divided into two groups according to age at the time of periodontal surgery: an adult group, aged 20-64 years and an older group, aged ≥65 years. Improvement, recurrence, and tooth loss were evaluated, and related risk factors were analyzed by multivariate logistic regression analysis.

 Results: The improvement of periodontal disease by open flap debridement in the older group was similar to that in the adult group, and no difference was found in the frequency of tooth loss in the 5 years after the start of SPT. However, the risk of recurrence at 5 years after the start of SPT was three times higher in the older group than in the adult group, suggesting that age is a risk factor for recurrence. In this study, no risk factors were specific to the older group other than age. This suggests that aggressive open flap debridement can be considered even in patients aged ≥65 years if there are no underlying diseases or compliance problems. However, the possibility of future hospital visits affected by health status and social background, presence of bleeding during probing, increase in pocket depth of ≥6 mm, and changes in the total periodontal inflamed surface area (total PISA), should be fully considered, and regular maintenance should be continued after surgical procedures.

 Conclusion: The results of open flap debridement in patients aged ≥65 years were comparable to those in patients aged ＜65 years. In older patients without underlying disease or compliance problems, open flap debridement should be actively considered. However, age is a risk factor for recurrence and regular postoperative management should be continued with attention to changes in clinical parameters.

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© 2023 Japanese Society of Conservative Dentistry
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