Risk assessment for clinical attachment loss in periodontitis patients: a retrospective observational study

Periodontitis is a chronic inflammatory disease caused by plaque that arises in periodontal supporting tissue. Several factors can influence the onset and progression of periodontitis; these are known as the risk factors. The purpose of this study was to assess the risk factors of periodontitis patients with different severity of clinical attachment loss (CAL) and different dental regions. A total of 15,904 sites of 3976 teeth from 142 patients with periodontitis were recruited in this retrospective observational study. The teeth were categorized into three groups according to interdental CAL values: 1 mm ≤ CAL ≤ 2 mm group, 3 mm ≤ CAL ≤ 4 mm group and CAL ≥ 5 mm group. The multilevel regression analysis was carried out to find out the risk factors of the severity of CAL in anterior teeth, maxillary teeth and mandibular teeth, respectively. In anterior teeth, significant correlations were observed with increasing CAL values for the following factors: current smoking (2.21, 95%CI: [1.27–3.83]), drinking (0.65, 95%CI: [0.44–0.98]), probing depth (PD) (1.19, 95%CI: [1.02–1.38]) and alveolar bone defect (ABD) (1.33, 95%CI: [1.10–1.62]) (P < 0.05). For maxillary teeth, the factors showing significant correlations were ABD in both premolars (0.87, 95%CI: [0.78–0.98]; 0.77, 95%CI: [0.66–0.90] and 1.46, 95%CI: [1.03–2.06]) and molars (1.50, 95%CI: [1.30–1.73]; 1.74, 95%CI: [1.40–2.17] and 2.72, 95%CI: [1.52–5.13]), as well as root concavities (1.36, 95%CI: [1.26–1.46]; 1.48, 95%CI: [1.32–2.66] and 1.17, 95%CI: [1.05–1.61]) across different CAL groups (P < 0.05). As for mandibular teeth, ABD in premolars (0.89, 95% CI: [0.79–1.01]; 0.87, 95%CI: [0.74–1.02] and 1.51, 95%CI: [1.12–2.04]) and molars (1.58, 95%CI: [1.35–1.85]; 2.16, 95%CI: [1.71–2.72] and 1.92, 95%CI: [1.10–3.57]) demonstrated significant correlations across different CAL groups (P < 0.05). The severity of CAL in periodontitis is associated with a variety of risk factors, and the effects of these factors are varied in different dental regions. Periodontitis is an inflammatory disease caused by microbial infection, leading to the destruction of supporting tissues. The risk factors of periodontitis encompass local, systemic, demographic, and behavioral host conditions, which are of great significance for assessing the extent of pathological alterations and anticipating prognosis. In this study, we evaluated epidemiological characteristics and clinical parameters of periodontitis patients, aimed at identifying the factors that influenced the varying degrees of CAL in anterior teeth, maxillary posterior teeth and mandibular posterior teeth, respectively. The results of this retrospective observational study indicated that the risk factors could differ depending on the specific dental region and the severity of periodontitis present. Therefore, dentists should pay more attention to patients presenting these aforementioned factors when diagnosing and advising treatment plans. The findings of this study will be beneficial in clinical diagnosis and treatment planning for periodontitis, facilitating more targeted and effective care.