ArticleInternational dental journal2026
Comparative Effect of Non-surgical Versus Surgical Therapy for Stage III/IV Periodontitis: A Retrospective Cohort Study.
Article in International dental journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
INTRODUCTION AND
aimsPeriodontitis is a major cause of tooth loss and a persistent challenge in clinical management. Although both non-surgical periodontal therapy (NSPT) and surgical periodontal therapy (SPT) are widely used for advanced periodontitis (Stages III/IV), their long-term comparative effectiveness in Chinese patients remains not well established. This retrospective study aimed to compare the clinical efficacy of NSPT versus SPT and to identify predictors of long-term treatment success. MATERIALS AND
methodsThis retrospective study included 2982 patients who received NSPT and 212 patients who underwent SPT, all diagnosed with stage III/IV periodontitis. Participants had a baseline periodontal evaluation and at least one re-evaluation between April 2017 and September 2022. Clinical parameters including probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP) were retrieved from a hospital-based electronic periodontal record system. Statistical analyses included independent t-tests, linear regression, and multilevel models, adjusted for age, sex, smoking, and follow-up compliance.
resultsOver a mean follow-up of 1.56 years, patients receiving SPT demonstrated significantly greater reductions than NSPT in PD (1.16 ± 1.06 versus 0.77 ± 0.81 mm), CAL (0.97 ± 1.13 versus 0.68 ± 0.90 mm), and BOP% (0.28% ± 0.27% versus 0.23% ± 0.29%) (all P < .01). However, this therapeutic advantage of SPT diminished with longer follow‑up (>3 years). Regular supportive periodontal care was consistently associated with improved clinical outcomes, regardless of whether intervention was SPT or repeated NSPT.
conclusionsIn a large Chinese cohort with advanced periodontitis, SPT provided superior short-term clinical improvements compared to NSPT. However, long-term outcomes depend on sustained maintenance care. These findings highlight that successful periodontal management relies on both patient compliance and clinician awareness of the long-term value of NSPT. CLINICAL RELEVANCE: SPT offers superior short-term outcomes, while NSPT with maintenance achieves comparable long-term stability. Long-term success depends more on maintenance adherence than initial therapy.
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