Tooth loss in Periodontitis: how valuable are the predictors?

Data sources Three electronic databases including Medline, Embase and Cochrane Central were searched for finding the relevant literature. Cross-referencing, reviews and editorials were also used to identify original studies. Unpublished studies/ Grey literature were excluded. Study selection Both observational and interventional studies were included for the review and only the studies with a minimum of 3 year follow-up period and which have reported the association between the predictor and tooth loss via odds/risk ratio or their derivatives were selected. Data extraction and synthesis Data like study characteristics, assessed predictors (risk factors or indicators), tooth loss per year as well as the association estimated (as OR, RR or any derivative) were extracted from the included studies. Meta-analysis and meta-regression analysis was carried to find the impact of predictors on the tooth loss. Results After screening, 20 studies were finally included in the study with a total of 15,422 participants. The mean age of the patient was 44.5 (range: 31-54 years) while the mean follow-up period was 12 years (range: 4-20 years). Predictors were pooled as patient level and tooth level predictors. Strong association was found for most of the patient level (age, compliance, diabetes, IL-1 polymorphism, diabetes and smoking) as well as tooth level predictors (Bone loss, pocket depth, tooth type, furcation involvement and mobility) except for sex (patient level predictor) and endodontic involvement (tooth level predictor). Conclusions The meta-analysis depicted in the review exhibited strong association for most of the predictors which can be used by the dentists for treatment planning. Overall tooth level factors have stronger associations than patient level factors.