In Drupal 7 we used Node Hierarchy module to keep track of a hierarchy of pages. Node hierarchy ties directly to the menu system. When getting a list of all ancestors or descendents, it is a O(n) operation, and at least one site we use it on has a lot of nodes in the tree. Performance was terrible. Add to that it has no notion of revisions or forward revisions, so changing the parent and saving a draft can cause all sorts of issues with your menu.
 
When the time came to update the site to Drupal 8, we took a different approach.