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Objective <p>Given the inconsistent evidence in the literature, the aim of this prospective cohort study was to evaluate the impact of lifestyle on the clinical response to Steps 1 and 2 of periodontal therapy in patients with severe periodontitis.</p> Materials and methods <p>Patients with untreated stage III/IV periodontitis received non-surgical periodontal therapy and were re-evaluated 3 months later (T1). Based on baseline self-administered questionnaires, four lifestyle factors - physical activity, dietary habits, smoking, and alcohol consumption- were scored as either healthy (1 point) or unhealthy (0 point). An overall healthy lifestyle variable was calculated for each patient by summing the individual scores (ranging from 0 to 4 points), and its impact on clinical outcomes was analyzed. The primary outcome of the study was disease control (≤ 4 residual probing pocket depth (PPD) ≥ 5&#xa0;mm).</p> Results <p>A total of 120 patients were treated. At T1, a statistically significant association was observed between the overall lifestyle score and treatment response (<i>p</i> = 0.029). Specifically, 55.1% of patients with healthy lifestyle behaviors (score 3–4) achieved the primary endpoint, compared to 29.0% and 32.5% of those with partial (score 2) or poor health attentiveness (score 0–1), respectively. Additionally, health-conscious individuals demonstrated better control of gingival inflammation, despite having comparable oral hygiene levels (<i>p</i> &lt; 0.001). In the logistic regression model, attentiveness to one’s health (OR 3.39, 95% CI 1.13–9.47, <i>p</i> = 0.020), normal body weight (OR 2.93, 95% CI 1.12–7.70, <i>p</i> = 0.029) and percentage of sites with PPD ≥ 6&#xa0;mm at baseline (OR 0.90, 95% CI = 0.84–0.97, <i>p</i> = 0.006) were significantly associated with treatment outcome.</p> Conclusion <p>Adherence to positive healthy lifestyle factors contributes to better clinical outcomes following periodontal therapy in patients with stage III/IV periodontitis.</p> Clinical relevance <p>The adoption of healthy lifestyle behaviors should be considered as part of the overall management strategy for patients with severe periodontitis.</p>

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Impact of lifestyle behaviors on clinical outcomes of steps 1 and 2 of periodontal therapy in stage iii-iv periodontitis: a cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Federica Romano,
  • Giacomo Baima,
  • Melanie Llerena-Velasquez,
  • Lisa Siccardi,
  • Giacomo Tonello,
  • Marta Vernero,
  • Davide Giuseppe Ribaldone,
  • Mario Aimetti

摘要

Objective

Given the inconsistent evidence in the literature, the aim of this prospective cohort study was to evaluate the impact of lifestyle on the clinical response to Steps 1 and 2 of periodontal therapy in patients with severe periodontitis.

Materials and methods

Patients with untreated stage III/IV periodontitis received non-surgical periodontal therapy and were re-evaluated 3 months later (T1). Based on baseline self-administered questionnaires, four lifestyle factors - physical activity, dietary habits, smoking, and alcohol consumption- were scored as either healthy (1 point) or unhealthy (0 point). An overall healthy lifestyle variable was calculated for each patient by summing the individual scores (ranging from 0 to 4 points), and its impact on clinical outcomes was analyzed. The primary outcome of the study was disease control (≤ 4 residual probing pocket depth (PPD) ≥ 5 mm).

Results

A total of 120 patients were treated. At T1, a statistically significant association was observed between the overall lifestyle score and treatment response (p = 0.029). Specifically, 55.1% of patients with healthy lifestyle behaviors (score 3–4) achieved the primary endpoint, compared to 29.0% and 32.5% of those with partial (score 2) or poor health attentiveness (score 0–1), respectively. Additionally, health-conscious individuals demonstrated better control of gingival inflammation, despite having comparable oral hygiene levels (p < 0.001). In the logistic regression model, attentiveness to one’s health (OR 3.39, 95% CI 1.13–9.47, p = 0.020), normal body weight (OR 2.93, 95% CI 1.12–7.70, p = 0.029) and percentage of sites with PPD ≥ 6 mm at baseline (OR 0.90, 95% CI = 0.84–0.97, p = 0.006) were significantly associated with treatment outcome.

Conclusion

Adherence to positive healthy lifestyle factors contributes to better clinical outcomes following periodontal therapy in patients with stage III/IV periodontitis.

Clinical relevance

The adoption of healthy lifestyle behaviors should be considered as part of the overall management strategy for patients with severe periodontitis.