Risk Assessment for Clinical Attachment Loss in Periodontitis Patients: A Retrospective Observational Study

Background The purpose of this study was to assess the risk factors of clinical attachment loss (CAL) in periodontitis patients in different dental regions. Methods A total of 15904 sites of 3976 teeth from 142 patients with periodontitis were recruited. The teeth were categorized into three groups according interdental CAL values: 1mm ≤ CAL ≤ 2mm group, 3mm ≤ CAL ≤ 4mm group and CAL ≥ 5mm 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. Results In anterior teeth, 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])) showed significant correlation as the CAL values increased ( P  < 0.05). In maxillary teeth, the significantly correlated factors 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])), and 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])) in different CAL group ( P  < 0.05). As for mandibular teeth, ABD in both 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])) had significant correlation in different CAL group ( P  < 0.05). Conclusions The risk factors varied with dental regions and the severity of CAL in periodontitis patients. Dentists must pay more attention on advising treatment plans.