Impact of Periodontal Therapy on Function and Quality of Life in Stage III Periodontitis

February 26, 2026 updated by: Zeliha Guney, Ankara Medipol University

Stage III, Grade B periodontitis is a severe form of gum disease that damages the tissues and bone supporting the teeth. It can cause loose teeth, difficulty chewing, and reduced quality of life. Although periodontal (gum) treatment is known to improve gum health, less is known about how it affects chewing ability and how patients feel about their oral health after treatment.

This study looked at how comprehensive periodontal treatment affects gum health, chewing function, and oral health-related quality of life. Twenty patients with Stage III, Grade B periodontitis and twenty individuals with healthy gums participated. Patients with periodontitis received non-surgical treatment (deep cleaning and root surface debridement) followed, when needed, by surgical periodontal therapy.

Researchers measured gum health (including probing depth and bleeding), tooth mobility, chewing performance, and patient-reported quality of life. Chewing performance was tested using a standardized chewing test with silicone material. Quality of life was assessed using a validated questionnaire (OHIP-14), which measures how oral health affects daily life, comfort, and well-being.

Assessments were performed before treatment, after non-surgical therapy, and after surgical treatment.

At the start of the study, patients with periodontitis had worse gum health, poorer chewing ability, and lower oral health-related quality of life compared to healthy individuals. After treatment, gum inflammation and tooth mobility significantly improved. Chewing ability also improved after therapy, especially after surgical treatment. Patients reported better quality of life, with fewer symptoms and less discomfort.

The study also found that better chewing performance was strongly associated with better quality of life. This suggests that improving function is closely linked to how patients feel about their oral health.

Overall, comprehensive periodontal therapy not only improves clinical gum health but also enhances chewing efficiency and patient well-being. These findings highlight the functional and quality-of-life benefits of periodontal rehabilitation in patients with advanced gum disease.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Stage III, Grade B periodontitis is characterized by advanced periodontal attachment loss, deep periodontal pockets, tooth mobility, and radiographic bone loss. In addition to structural damage, this condition may impair masticatory efficiency and negatively affect oral health-related quality of life (OHRQoL). While conventional periodontal therapy effectively reduces inflammation and stabilizes periodontal tissues, its functional and patient-reported outcomes in advanced disease stages require further clarification.

This prospective controlled clinical study was designed to evaluate the impact of comprehensive periodontal therapy on clinical periodontal parameters, objective masticatory performance, and OHRQoL in patients with Stage III, Grade B periodontitis.

Study Population: The study included 20 systemically healthy patients diagnosed with Stage III, Grade B periodontitis and 20 periodontally healthy individuals serving as controls. Participants were recruited from a university dental clinic. Inclusion criteria for the periodontitis group were consistent with current periodontal classification guidelines. Exclusion criteria included systemic diseases affecting periodontal status, recent periodontal treatment, smoking, pregnancy, and use of medications known to influence periodontal tissues.

Study Design and Interventions: At baseline, all participants underwent comprehensive periodontal examination, including; Probing depth (PD), Bleeding on probing (BOP), Clinical attachment level (CAL), Tooth mobility measured using Periotest. Masticatory performance was assessed using a standardized silicone cube chewing test. Participants chewed the test material for a defined number of cycles. The comminuted material was sieved through multiple apertures to calculate objective performance indices. OHRQoL was evaluated using the validated Oral Health Impact Profile (OHIP-14) questionnaire.

Patients in the periodontitis group received: Non-surgical periodontal therapy (scaling and root planing) and surgical periodontal therapy when indicated, following re-evaluation. Clinical and functional assessments were repeated after completion of non-surgical therapy and again following surgical treatment. The healthy control group was evaluated once for baseline comparison.

Outcome Measures:

Primary outcomes included changes in:

Clinical periodontal parameters (PD, BOP, CAL) Tooth mobility (Periotest values) Masticatory performance indices OHIP-14 scores Secondary analyses examined correlations between masticatory performance and OHRQoL.

Statistical Analysis: Data distribution was assessed prior to analysis. Between-group comparisons were performed using ANOVA or Kruskal-Wallis tests, as appropriate. Within-group longitudinal changes were analyzed using repeated measures approaches. Spearman's rank correlation was used to evaluate associations between chewing efficiency and OHRQoL scores. Statistical significance was set at p < 0.05.

Scientific Rationale: This study addresses the multidimensional impact of periodontal rehabilitation beyond traditional clinical parameters. By integrating objective functional measurements and patient-reported outcomes, the research aims to clarify whether improvements in periodontal stability translate into meaningful gains in chewing efficiency and perceived well-being.

Understanding this relationship is important for patient-centered periodontal care and may contribute to more comprehensive treatment planning in advanced periodontitis.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Ankara
      • Ankara, Ankara, Turkey (Türkiye), 06010
        • Ankara Medipol University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria: Eligibility criteria included

  • ≥ 20 natural teeth
  • at least four functional chewing units (one molar pair = two units; one premolar pair = one unit).
  • positive bleeding on probing in ≥ four chewing units
  • probing depth ≥ 5 mm in ≥ four molar or premolar teeth
  • age between 20 and 45 years.

Exclusion Criteria:

  • Individuals with systemic diseases
  • pregnancy
  • smoking habits
  • recent antibiotic or anti-inflammatory use

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Screening
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Periodontal teratment
Periodontitis patients underwent both non-surgical and surgical periodontal treatments.
Procedure: non-surgical periodontal treatment
non-surgical periodontal treatment
Procedure: surgical periodontal treatment
Periodontitis patients underwent surgical periodontal treatments.
No Intervention: Periodontal evaluation
Both Healthy controls and periodontitis patients went through periodontal examination.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Plaque index
Time Frame: At Day 0, Day 30, Day 90
Plaque accumulation was assessed using a standardized plaque index at four sites per tooth. The presence of visible dental plaque along the gingival margin was recorded following gentle probing and air-drying when necessary. Scores were assigned according to established criteria (0 = no plaque; 1 = plaque detectable with probe; 2 = visible plaque; 3 = abundant plaque accumulation). Mean plaque index scores were calculated per participant to reflect overall oral hygiene status. Higher scores indicate greater plaque accumulation and poorer oral hygiene.
At Day 0, Day 30, Day 90
Probing depth
Time Frame: At Day 0, Day 30, Day 90
Probing depth was measured in millimeters using a calibrated periodontal probe at six sites per tooth (mesiobuccal, midbuccal, distobuccal, mesiolingual/palatal, midlingual/palatal, distolingual/palatal). The distance from the gingival margin to the base of the periodontal pocket was recorded. Measurements were rounded to the nearest millimeter. Mean probing depth values were calculated per participant. Greater probing depth values indicate more severe periodontal tissue destruction and disease severity.
At Day 0, Day 30, Day 90
Clinical attachment level
Time Frame: At Day 0, Day 30, Day 90
Clinical attachment level was measured in millimeters using a calibrated periodontal probe at six sites per tooth. CAL was calculated as the distance from the cemento-enamel junction (CEJ) to the base of the periodontal pocket. In cases of gingival recession, the recession value was added to the probing depth; in cases of gingival enlargement, it was subtracted accordingly. Mean CAL values were calculated per participant. Higher CAL values indicate greater loss of periodontal attachment and increased disease severity.
At Day 0, Day 30, Day 90
Bleeding on probing
Time Frame: At Day 0, Day 30, Day 90
Bleeding on probing was assessed at six sites per tooth using a calibrated periodontal probe. After gentle probing of the sulcus or periodontal pocket, the presence or absence of bleeding within 15 seconds was recorded. BOP was expressed as the percentage of bleeding sites relative to the total number of sites examined per participant. Higher percentages indicate increased gingival inflammation and active periodontal disease.
At Day 0, Day 30, Day 90
Tooth mobility measurement
Time Frame: At Day 0, Day 30, Day 90
Tooth mobility was quantified using a Periotest M device (Medizintechnik Gulden, Modautal, Germany). Periotest values (PTVs) between +10 and +30 indicated Miller Class II, and between +30 and +50 Miller Class III mobility.
At Day 0, Day 30, Day 90
Masticatory performance
Time Frame: At Day 0, Day 30, Day 90
Masticatory efficiency was assessed using the silicone cube chewing test. Standardized cubes(8 × 8 × 8 mm) were prepared from Optosil® (Heraeus Kulzer, South Bend, IN, USA) using a plexiglass mold, sterilized in an autoclave, and weighed for standardization. Participants were instructed to chew eight cubes for 20 cycles while seated upright. The procedure was visually monitored by the examiner and recorded on video to verify the number of cycles. The chewed material was collected, rinsed, and dried at room temperature for three days before analysis. Chewed samples were analyzed using a multiple-sieve system with apertures of 4.0, 2.0, 1.0, 0.5, and 0.25 mm (in accordance with the ISO standard). The participant rinsed their mouth with water to remove residual particles, expelling them into the same receptacles. The particles were washed with water, allowed to dry, and removed from the paper filter. The median particle size was calculated from the cumulative weight distribution.
At Day 0, Day 30, Day 90

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Assessment of oral health-related quality of life
Time Frame: At Day 0, Day 30, Day 90
The Turkish version of the Oral Health Impact Profile-14 (OHIP-14) was used to assess OHRQoL at baseline and post-treatment. Each item was scored on a five-point Likert scale (0 = never, 4 = very often), and total scores ranged from 0 to 56, with higher scores indicating a greater negative impact on quality of life.
At Day 0, Day 30, Day 90

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara Medipol University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2019

Primary Completion (Actual)

July 1, 2021

Study Completion (Actual)

July 5, 2021

Study Registration Dates

First Submitted

February 21, 2026

First Submitted That Met QC Criteria

February 26, 2026

First Posted (Actual)

March 4, 2026

Study Record Updates

Last Update Posted (Actual)

March 4, 2026

Last Update Submitted That Met QC Criteria

February 26, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • No. 36290600/45; 25 October 20

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

There is not a plan to make IPD available because of the participants consent.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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