HISTORY
SUPPORTIVE PERIODONTAL THERAPY (SPT)








How to use the online form
Enter the following clinical findings in the online form to determine the indicated SPT interval: probing depth in mm, furcations, oral hygiene and bleeding index.
The degree of furcation involvement is indicated by using a circle. An open circle (degree 1), a semicircle (degree 2), and a filled circle (degree 3).
SPT Intervals
After clicking the "Direct" button, the data relevant for determining the SPT interval can alternatively be entered into the corresponding form. This way, the larger form above can be bypassed.
The values to be entered into the form are: number of teeth and number of sites with probing depths of 4mm, 5mm or ≥6mm. The following data will also be recorded: the number of sites with degree 2 or 3 furcation involvement and the percentage of sites with plaque and bleeding on probing (BOP).
The interval suggested in the analysis or a self-selected interval can be entered into the form.
Patient Information
The "Remote Control" on the left allows you to open visual information for your patients. This includes illustrations of gingival pockets, bone loss, and furcation involvements.
These modals can be shown to the patient during the consultation to improve understanding of the clinical situation. You can also choose to include these visualizations in the personalized patient report.
Background
Recommended SPT intervals are based on the residual periodontal pocket profiles recorded on this website. The profiles are based on the percentage of residual pockets from 4mm, 5mm and ≥6mm.
In the first step of the evaluation, a maximum interval is determined for each category of residual pockets from 4mm, from 5mm and from 6mm: in the evaluation table, the corresponding cell is shaded in green.
In a second step, the resulting SPT interval is determined from the category with the shortest interval: in the evaluation table, the corresponding cell with the recommended interval is shaded in yellow.
The algorithm used here to determine the SPT interval goes back to a retrospective study from 2019, in which the threshold values for periodontal stability were determined from existing residual pocket profiles in 883 patients and a total of 11,842 SPT visits (Ramseier et al. 2019).
Considering risk factors
The recommended SPT interval should not be exceeded. If necessary, the proposed interval should be shortened if there is an increased inflammatory (BOP) index or risk factors are present.
Periodontal stability is assessed with the existing inflammation index (bleeding on probing, BOP). For non-smokers or former smokers, a value of 23% is considered the threshold, while for smokers this value is 16%. These thresholds are based on a retrospective study of 445 patients who had been enrolled in SPT for at least five years (Ramseier et al. 2015). A shorter interval should therefore be chosen for patients with an increased inflammation index. In the evaluation this is shown with an arrow labelled with BOP.
Furthermore, teeth with a degree 2 or 3 furcation involvement are classified in a higher risk category. This finding is based on a retrospective study with 117 patients who had been enrolled in SPT over an average period of 11.5 years (Salvi et al. 2014). Accordingly, a shorter interval should be chosen for affected patients. In the evaluation, this is indicated by an arrow labelled with the letter F.
Finally, a shorter interval is also recommended for smokers and patients with type II diabetes. In the evaluation this is shown with an arrow and the letters S and D respectively.
Literature
Ramseier, C. A. (2024). Diagnostic measures for monitoring and follow-up in periodontology and implant dentistry. Periodontology 2000, 95(1), 129-155. doi:10.1111/prd.12588.
Ramseier, C. A., Nydegger, M., Walter, C., Fischer, G., Sculean, A., Lang, N. P., Salvi, G. E. (2019). Time between recall visits and residual probing depths predict long-term stability in patients enrolled in supportive periodontal therapy. Journal of Clinical Periodontology, 46(2), 218-230. doi:10.1111/jcpe.13041.
Ramseier, C. A., Mirra, D., Schutz, C., Sculean, A., Lang, N. P., Walter, C., Salvi, G. E. (2015). Bleeding on probing as it relates to smoking status in patients enrolled in supportive periodontal therapy for at least 5 years. Journal of Clinical Periodontology, 42(2), 150-159. doi:10.1111/jcpe.12344.
Salvi, G. E., Mischler, D. C., Schmidlin, K., Matuliene, G., Pjetursson, B. E., Bragger, U., & Lang, N. P. (2014). Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. Journal of Clinical Periodontology, 41(7), 701-707. doi:10.1111/jcpe.12266.
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