Radiographic alveolar bone loss in German patients with disabilities and treatment in general anesthesia

Abstract

Introduction: The cross-sectional study aimed at assessing the periodontal status of German adult patients with disabilities (intellectual, physical, and/or dementia) requiring dental treatment in general anesthesia. Material and Methods: Between 2011 and 2017, 206 patients received dental treatment(s) in general anesthesia. Periodontal status was retrospectively assessed based on the radiographically visible alveolar bone loss (%). Staging and grading of periodontal disease according to the 2017 classification for periodontal disease was performed. Various general and periodontal parame­ters, medications, and diagnoses of systemic diseases in association with periodontal diseases were analyzed as potential risk factors for bone loss. Statistical analysis was performed using Pearson correlations, Wilcoxon rank-sum tests, Kruskal-Wallis tests, and multiple linear regressions (p < 0.05). Results: Periapical radiographs were available from 199 patients (86 females; age: 41.1 ± 15.0 years). Based on a distance from the cemento-enamel junction to the marginal bone level exceeding 2 mm, 174 (87.4 %) patients were diagnosed with periodontitis (22.4 ± 20.6 % bone loss). Most periodontitis patients were classified as stage I (39.7 %), followed by stage II (29.1 %), stage III (14.1 %), and stage IV (4.5 %). Generalized periodontitis was most frequently observed in stage I patients (p ≤ 0.047). Significant predictors of % bone loss were age (β = 0.65; 95%-CI: 0.40–0.89; p < 0.001), intellectual disability (β = 11.87; 95%-CI: 1.21–22.52; p = 0.029), and smoking/nicotine dependence (β = 17.29; 95%-CI: 3.42–31.16; p = 0.015). Conclusion: Periodontal disease is common in German patients with disabilities. Bone loss is associated with older age, intellectual disability, and smoking/nicotine dependence.