Three periodontitis phenotypes: Bone loss patterns, antibiotic-surgical treatment and the new classification

J Clin Periodontol. 2020 Nov;47(11):1371-1378. doi: 10.1111/jcpe.13356. Epub 2020 Sep 14.

Abstract

Aim: To compare three periodontitis clusters (A, B and C) for alveolar bone loss (ABL) patterns, antibiotic prescriptions and surgeries and to relate them to the new classification of periodontitis.

Materials and methods: ABL patterns, prescription of systemic antibiotics and the number of surgeries were retrieved for all patients (n = 353) in the clusters. Comparisons and possible predictors for antibiotics were assessed, and results also evaluated in relation to the new classification.

Results: Cluster A is characterized by angular defects often affecting the first molars and localized stage III/IV grade C periodontitis. Cluster B contains mainly localized or generalized stage III/IV, grade C patients. Cluster C contains mainly patients with generalized stage III/IV grade C periodontitis. Patients in cluster A received significantly more antibiotics compared to B and C (78% vs. 23% and 17%); the predictors for antibiotic prescription were young age and localized ABL. No differences in numbers of periodontal surgeries were observed between clusters (A = 1.0 ± 1.4, B = 1.3 ± 1.4 and C = 1.3 ± 1.5).

Conclusions: Within stage III/IV grade C periodontitis, we could detect three clusters of patients. The distinct localized ABL pattern and younger age in cluster A presumably prompted clinicians to prescribe antibiotics.

Keywords: alveolar bone loss pattern; antibiotics; classification; periodontitis; phenotypes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Bone Loss* / drug therapy
  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Periodontitis* / drug therapy
  • Phenotype

Substances

  • Anti-Bacterial Agents