{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T18:46:05Z","timestamp":1782499565724,"version":"3.54.5"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate tooth loss attributable to periodontal disease during periodontal maintenance care (PMC) in young adults with Grade C Periodontitis and to identify factors associated with tooth loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 63 patients (mean age: 29.49\u2009\u00b1\u20094.65 years) were included. All patients received non\u2011surgical periodontal therapy using a comprehensive full\u2011mouth disinfection protocol with adjunctive systemic antibiotics as part of active periodontal therapy (APT), delivered through an individualized treatment approach. Clinical assessments were performed after completion of APT (T1) and during PMC, T2. Multivariable Firth-penalized Cox proportional hazards regression was applied to identify factors associated with time to tooth loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1,709 teeth (1,228 non-molars, 481 molars) were analyzed. Over a mean follow\u2011up period of 60\u2009\u00b1\u20092 months, 15 teeth were lost, corresponding to an overall tooth loss rate of 0.88% (0.048 teeth\/patient\/year). Bone loss &lt;60%, Molar\u2011Incisor Grade C Periodontitis, and adherence to PMC were associated with greater tooth retention. The overall regression model was statistically significant (likelihood ratio test p\u2009=\u20090.0016). Bone loss exceeding 60% was associated with a significantly increased hazard of tooth loss (HR: 14.83; 95% CI: 1.98\u20131896.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), whereas compliant patients with PMC showed a significant protective association (HR: 0.29; 95% CI: 0.10\u20130.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tooth loss during PMC was minimal over 5 years. Severe periodontal bone loss and non\u2011compliance with maintenance care were associated with increased tooth\u2011loss risk. Long\u2011term retention of most teeth appears achievable through conservative periodontal management in young adults with Grade C Periodontitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0352255","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:48:31Z","timestamp":1782496111000},"page":"e0352255","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tooth loss and associated factors during periodontal maintenance care in young adults with Grade C Periodontitis at a tertiary care center in Kathmandu, Nepal"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4395-3536","authenticated-orcid":true,"given":"Khushboo","family":"Goel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirjana","family":"Dahal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"issue":"11","key":"pone.0352255.ref001","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1177\/0022034514552491","article-title":"Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression","volume":"93","author":"NJ Kassebaum","year":"2014","journal-title":"J Dent Res"},{"issue":"5","key":"pone.0352255.ref002","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1902\/jop.1978.49.5.225","article-title":"A long-term survey of tooth loss in 600 treated periodontal patients","volume":"49","author":"L Hirschfeld","year":"1978","journal-title":"J Periodontol"},{"issue":"1","key":"pone.0352255.ref003","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1600-0757.2011.00397.x","article-title":"Principles of periodontology","volume":"61","author":"A Dentino","year":"2013","journal-title":"Periodontol 2000"},{"key":"pone.0352255.ref004","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.1600-0757.2004.03676.x","article-title":"Effects of nonsurgical periodontal therapy on hard and soft tissues","volume":"36","author":"PA Adriaens","year":"2004","journal-title":"Periodontol 2000"},{"key":"pone.0352255.ref005","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1600-0757.1996.tb00074.x","article-title":"Supportive periodontal treatment introduction--definition, extent of need, therapeutic objectives, frequency and efficacy","volume":"12","author":"TG Wilson Jr","year":"1996","journal-title":"Periodontol 2000"},{"key":"pone.0352255.ref006","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1034\/j.1600-0757.2002.290108.x","article-title":"Global epidemiology of periodontal diseases in children and young persons","volume":"29","author":"JM Albandar","year":"2002","journal-title":"Periodontol 2000"},{"issue":"4","key":"pone.0352255.ref007","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/jcpe.13266","article-title":"Global prevalence of aggressive periodontitis: a systematic review and meta-analysis","volume":"47","author":"A Bouziane","year":"2020","journal-title":"J Clin Periodontol"},{"issue":"1","key":"pone.0352255.ref008","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1902\/annals.1999.4.1.53","article-title":"Consensus report: Aggressive periodontitis","volume":"4","author":"N Lang","year":"1999","journal-title":"Ann Periodontol"},{"issue":"10","key":"pone.0352255.ref009","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1177\/0022034513501878","article-title":"Tooth loss in aggressive periodontitis: a systematic review","volume":"92","author":"L Nibali","year":"2013","journal-title":"J Dent Res"},{"issue":"11","key":"pone.0352255.ref010","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1902\/jop.2001.72.11.1624","article-title":"Position paper: Guidelines for periodontal therapy","volume":"72","author":"Committee on Research, Science and Therapy. 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