Long-term outcomes of supportive periodontal care: A 24-month trial

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Created On: 04/02/2026

This randomized controlled trial aimed to determine the long-term potency of two supportive periodontal care (SPC) protocols in periodontitis and also sought to identify key predictors influencing alteration in bleeding on probing (BoP) over a 24-month follow-up period.

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Key take away

Supportive periodontal care that includes subgingival instrumentation markedly reduces bleeding on probing over 24 months, while smoking and deeper periodontal pockets limit treatment success.

Background

Method

Overall, 56 patients diagnosed with periodontitis initially underwent active periodontal therapy using quadrant-based subgingival instrumentation. Following this phase, volunteers were randomly allocated to either:

Control group (n=28): Received oral hygiene guidance combined with supragingival instrumentation and dental polishing
Test group (n = 28): Received oral hygiene guidance with both supra- and subgingival instrumentation plus dental polishing

Result

After 24 months, both SPC protocols illustrated remarkable improvements in periodontal health outcomes (p < 0.05). However, the test group exhibited superior clinical benefits, including a greater reduction in median BoP (p = 0.033), GBI (p = 0.023), and the number of bleeding periodontal pockets ≥4 mm (p = 0.018). Remarkable improvements were also noted in pocket depth categories of 4–5 mm (p = 0.048), 5–6 mm (p = 0.011), and >6 mm (p = 0.023).

Regression analysis revealed that BoP reduction over time was negatively linked with higher median PPD (p = 0.031), increased numbers of 4–5 mm (p = 0.029) and 5–6 mm pockets (p = 0.036), smoking status (p = 0.039), and cigarette consumption per day (p = 0.042). In contrast, inclusion of subgingival instrumentation during SPC had a positive impact on BoP reduction (p = 0.033).

Conclusion

SPC that incorporates subgingival instrumentation offered markedly greater long-term reduction in BoP when compared with supragingival care alone. Smoking habits and the presence of deep periodontal pockets adversely affected treatment outcomes during periodontal maintenance therapy. These findings highlight the importance of personalized SPC strategies to boost long-term periodontal disease control and oral health outcomes.