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Teza H, Pattanateepapon A, Lertpimonchai A, Vathesatogkit P, J McKay G, Attia J, Thakkinstian A. Development of Risk Prediction Models for Severe Periodontitis in a Thai Population: Statistical and Machine Learning Approaches. JMIR Form Res 2023; 7:e48351. [PMID: 38096008 PMCID: PMC10755655 DOI: 10.2196/48351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Severe periodontitis affects 26% of Thai adults and 11.2% of adults globally and is characterized by the loss of alveolar bone height. Full-mouth examination by periodontal probing is the gold standard for diagnosis but is time- and resource-intensive. A screening model to identify those at high risk of severe periodontitis would offer a targeted approach and aid in reducing the workload for dentists. While statistical modelling by a logistic regression is commonly applied, optimal performance depends on feature selections and engineering. Machine learning has been recently gaining favor given its potential discriminatory power and ability to deal with multiway interactions without the requirements of linear assumptions. OBJECTIVE We aim to compare the performance of screening models developed using statistical and machine learning approaches for the risk prediction of severe periodontitis. METHODS This study used data from the prospective Electricity Generating Authority of Thailand cohort. Dental examinations were performed for the 2008 and 2013 surveys. Oral examinations (ie, number of teeth and oral hygiene index and plaque scores), periodontal pocket depth, and gingival recession were performed by dentists. The outcome of interest was severe periodontitis diagnosed by the Centre for Disease Control-American Academy of Periodontology, defined as 2 or more interproximal sites with a clinical attachment level ≥6 mm (on different teeth) and 1 or more interproximal sites with a periodontal pocket depth ≥5 mm. Risk prediction models were developed using mixed-effects logistic regression (MELR), recurrent neural network, mixed-effects support vector machine, and mixed-effects decision tree models. A total of 21 features were considered as predictive features, including 4 demographic characteristics, 2 physical examinations, 4 underlying diseases, 1 medication, 2 risk behaviors, 2 oral features, and 6 laboratory features. RESULTS A total of 3883 observations from 2086 participants were split into development (n=3112, 80.1%) and validation (n=771, 19.9%) sets with prevalences of periodontitis of 34.4% (n=1070) and 34.1% (n=263), respectively. The final MELR model contained 6 features (gender, education, smoking, diabetes mellitus, number of teeth, and plaque score) with an area under the curve (AUC) of 0.983 (95% CI 0.977-0.989) and positive likelihood ratio (LR+) of 11.9 (95% CI 8.8-16.3). Machine learning yielded lower performance than the MELR model, with AUC (95% CI) and LR+ (95% CI) values of 0.712 (0.669-0.754) and 2.1 (1.8-2.6), respectively, for the recurrent neural network model; 0.698 (0.681-0.734) and 2.1 (1.7-2.6), respectively, for the mixed-effects support vector machine model; and 0.662 (0.621-0.702) and 2.4 (1.9-3.0), respectively, for the mixed-effects decision tree model. CONCLUSIONS The MELR model might be more useful than machine learning for large-scale screening to identify those at high risk of severe periodontitis for periodontal evaluation. External validation using data from other centers is required to evaluate the generalizability of the model.
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Affiliation(s)
- Htun Teza
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anuchate Pattanateepapon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Gareth J McKay
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - John Attia
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Lertpimonchai A, Tuntrakul S, Rattanasiri S, Sutthiboonyapan P, Vathesatogkit P, Udomsak A, Tavedhikul K. Validity of Simple Self-Reported Periodontal Status Questions. Int Dent J 2022; 73:121-127. [PMID: 36460520 PMCID: PMC9875259 DOI: 10.1016/j.identj.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/03/2022] [Accepted: 10/30/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The aim of this research was to evaluate the validity of the questions developed by Thai periodontists on self-reported periodontal status and symptoms in identifying severe periodontitis amongst adults in Thailand. METHODS Registered Electricity Generating Authority of Thailand (EGAT) employees completed medical examinations and full-mouth periodontal examinations. They also were interviewed using a self-reported questionnaire that was developed by Thai periodontists. The questions pertained to their periodontal status and symptoms comprising swollen gums, bad breath, loose teeth, bleeding on brushing, painful gums, and pus or abscesses. The participants were categorised as having nonsevere and severe periodontitis according to the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology (CDC/AAP) case definitions. Self-reported periodontal status and symptom results were compared with actual periodontal status. The area under the receiver operating characteristic curve (AUROCC), sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. RESULTS A total of 1393 EGAT employees participated in this study. The questions on self-reported periodontal status and all symptoms poorly identified patients with severe periodontitis, with an AUROCC of 0.52 to 0.60. The sensitivity was 5.0% to 40.2%; however, the specificity was good, at 73.2% to 99.1%. The validity of the self-reported questions was comparable amongst the sex, education, and income subgroups. CONCLUSIONS This study demonstrated that self-reported periodontal status and symptoms were inadequate in identifying patients with severe periodontal disease.
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Affiliation(s)
- Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Supang Tuntrakul
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pimchanok Sutthiboonyapan
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Artit Udomsak
- Medical and Health Division, Electric Generation Authority of Thailand, Nonthaburi, Thailand
| | - Kanoknadda Tavedhikul
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand,Corresponding author. Kanoknadda Tavedhikul, Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand.
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Sim CPC, Li H, Peres MA. Who to Be Treated: Nomogram Using Self-Reported Periodontal Screening Instrument among English-Speaking Adults in Multi-Ethnic Singapore. J Pers Med 2022; 12:jpm12060931. [PMID: 35743716 PMCID: PMC9225178 DOI: 10.3390/jpm12060931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
Periodontal disease is a major public health problem. This study aimed to develop a nomogram using a self-reported periodontitis screening instrument in predicting severe periodontitis (SP), defined by the World Workshop on Classification of Periodontal and Peri-Implant Diseases and Conditions, and evaluate its utility in clinical setting. An Akaike information criterion selected multivariable model was developed to predict SP using a self-reported questionnaire, with a nomogram developed based on its regression coefficients. Discriminatory capability was evaluated by Receiver-operating characteristic curve. Ability to predict SP of individual patients was evaluated with bootstrapping. Decision curve analysis (DCA) was performed to evaluate its potential clinical utility by evaluating clinical net benefit at different thresholds. 58.1% of 155 participants were classified with SP. Older males without tertiary education, with ‘loose teeth’, ‘bone loss’ and ‘mouth rinse use’ had higher SP risk. The nomogram showed excellent discriminatory capability with Area under Curve of 0.83 (95% CI = (0.76, 0.89)), good calibration (intercept = 0.026) and slight overestimation of high risk and underestimation of low risk (slope = 0.834). DCA showed consistent clinical net benefit across the range of thresholds relative to assumption of ‘no patient’ or ‘all patient’ with SP. Our nomogram using a self-reported periodontitis instrument is useful in SP screening in English-speaking Singaporean adults.
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Affiliation(s)
- Christina P. C. Sim
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
- Correspondence: ; Tel.: +65-6324-8928; Fax: +65-6324-8900
| | - Huihua Li
- ACP Research Office, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore;
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
| | - Marco A. Peres
- National Dental Centre Singapore, National Dental Research Institute Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore;
- Oral Health Academic Clinical Programme, Health Services and Systems Research Institute Singapore, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
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Sorunke ME, Onigbinde OO, Oyapero A, Coker OA. Self-Reported Periodontal Disease and its Association with Dental Anxiety in Lagos, Nigeria. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Periodontal Disease and Tooth Loss Are Associated with Lung Cancer Risk. BIOMED RESEARCH INTERNATIONAL 2021; 2020:5107696. [PMID: 32802852 PMCID: PMC7403933 DOI: 10.1155/2020/5107696] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 01/11/2023]
Abstract
Background The associations between periodontal disease, tooth loss, and lung cancer risk remain debatable. Therefore, the purpose of the present study is to evaluate whether periodontal disease and tooth loss are associated with lung cancer risk. Methods A literature search was performed for relevant studies using PubMed and Embase databases. Risk ratio (RR) with 95% confidence interval (CI) was applied as effect size to summarize the associations between periodontal disease, tooth loss, and lung cancer risk. A further dose-response analysis was also performed. Results A total of twelve studies comprising 263,238 participants were included. The results indicated that periodontal disease was positively associated with lung cancer risk (RR = 1.37, 95%CI = 1.16‐1.63). There was a positive association between tooth loss and lung cancer risk (RR = 1.69, 95%CI = 1.46‐1.96). Moreover, there was a significantly linear dose-response relationship between tooth loss and lung cancer risk, and every 5 increment in tooth loss was associated with 10% increased lung cancer risk. Similar results were obtained in subgroup analysis. Conclusions Periodontal disease and tooth loss are increased risk factors for lung cancer. Prevention and treatment of periodontal disease may be effective potential prevention strategies for lung cancer.
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Micu IC, Bolboacă SD, Caracostea GV, Gligor D, Ciurea A, Iozon S, Soancă A, Mureșan D, Roman A. Self-reported and clinical periodontal conditions in a group of Eastern European postpartum women. PLoS One 2020; 15:e0237510. [PMID: 32810155 PMCID: PMC7433868 DOI: 10.1371/journal.pone.0237510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/28/2020] [Indexed: 12/02/2022] Open
Abstract
Periodontitis is a highly prevalent condition leading to a continuous destruction of tooth-supporting tissues. It increases the risk for various systemic diseases and adverse pregnancy outcomes. Therefore, screening for periodontitis is important. Screening measures can range from self-reported symptoms to clinical full-mouth periodontal examination. The hypothesis of our study was that self-reported parameters and clinical definition perform equally well in identifying periodontitis patients. The aim of this study was to develop, validate its internal consistency, and evaluate a self-reported instrument against periodontal clinical evaluation for diagnosis of periodontitis in a group of postpartum women, as well as to describe their periodontal status and the risk factors associated with periodontal disease. A cross-sectional study on postpartum women was conducted in a tertiary university hospital, from April 2018 to March 2019. Sociodemographic and behavioral data, periodontal clinical parameters, and self-reported periodontal perception were collected. A 16-item questionnaire was developed to obtain information about perceived periodontal alterations and oral hygiene habits. The utility of the questionnaire was tested against a periodontal diagnosis based on a full-mouth periodontal examination. The questionnaire was applied in 215 postpartum women aged 29.16±5.54 years (mean age (y) ± standard deviation) having the following periodontal status: 16 individuals without periodontal disease (7.44%), 32 individuals with gingivitis (14.88%), 19 individuals with mild periodontitis (8.84%), 132 individuals with moderate periodontitis (61.39%), and 16 individuals with severe periodontitis (7.44%). A significant association was observed between oral hygiene score, smoking status, and periodontal conditions (p<0.05). A significant association between the self-reported items related to “gum swelling”, “halitosis”, “previous periodontal diagnosis” and “previous periodontal treatment” with clinical periodontitis have been identified (p<0.05). Using self-reported questionnaires for detection of periodontal disease was ineffective in our studied population, since self-reported parameters and clinical definition do not appear to perform equally in identifying periodontitis cases. Clinical periodontal examination remains the gold standard for screening. Periodontitis was frequent in our group and the severity was significantly associated with the oral hygiene score and smoking. These results underline the necessity for periodontal clinical examination during pregnancy.
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Affiliation(s)
- Iulia C. Micu
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Gabriela V. Caracostea
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Diana Gligor
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sofia Iozon
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Daniel Mureșan
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
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Montero E, La Rosa M, Montanya E, Calle‐Pascual AL, Genco RJ, Sanz M, Herrera D. Validation of self‐reported measures of periodontitis in a Spanish Population. J Periodontal Res 2019; 55:400-409. [DOI: 10.1111/jre.12724] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Martina La Rosa
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Eduard Montanya
- Bellvitge Hospital‐IDIBELL Barcelona Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) Barcelona Spain
- Department of Clinical Sciences University of Barcelona Barcelona Spain
| | - Alfonso L. Calle‐Pascual
- Medical School. University Complutense Madrid Spain
- Endocrinology and Nutrition Department Hospital Clínico Universitario San Carlos Madrid Spain
| | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
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Carra MC, Gueguen A, Thomas F, Pannier B, Caligiuri G, Steg PG, Zins M, Bouchard P. Self-report assessment of severe periodontitis: Periodontal screening score development. J Clin Periodontol 2018; 45:818-831. [DOI: 10.1111/jcpe.12899] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Alice Gueguen
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Frédérique Thomas
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
| | - Bruno Pannier
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
- Department of Cardiology; Georges Pompidou European Hospital, AP-HP; Paris France
- Medicine Faculty; Paris 5-Descartes University; Paris France
| | | | - Philippe Gabriel Steg
- INSERM-Unité 1148; Paris France
- French Alliance for Cardiovascular Trials (FACT); Département Hospitalo-Universitaire FIRE; Hôpital Bichat; Assistance Publique-Hôpitaux de Paris; Paris France
- Université Paris-Diderot; Sorbonne-Paris Cité; Paris France
- Royal Brompton Hospital; Imperial College; London UK
| | - Marie Zins
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Philippe Bouchard
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- EA 2496, Paris 5-Descartes University; Paris France
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Abbood HM, Hinz J, Cherukara G, Macfarlane TV. Validity of Self-Reported Periodontal Disease: A Systematic Review and Meta-Analysis. J Periodontol 2016; 87:1474-1483. [DOI: 10.1902/jop.2016.160196] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. A Two-Domain Self-Report Measure of Periodontal Disease Has Good Accuracy for Periodontitis Screening in Dental School Outpatients. J Periodontol 2016; 87:1165-73. [DOI: 10.1902/jop.2016.160043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Renatus A, Kottmann T, Schwarzenberger F, Jentsch H. Evaluation of a New Self-Reported Tool for Periodontitis Screening. J Clin Diagn Res 2016; 10:ZC107-12. [PMID: 27504399 PMCID: PMC4963759 DOI: 10.7860/jcdr/2016/19518.8063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/10/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Periodontitis is still highly prevalent in industrial population whereas at the same time appropriate screening programs are missing. AIM To evaluate, a self-reported questionnaire about periodontal risk factors in combination with the Periodontal Screening Index (PSI) to identify an existing need for periodontal treatment combined with the early recognition of high-risk patients. MATERIALS AND METHODS Total 200 patients took part in the questionnaire based study and were examined using the PSI. Thereafter the participants were divided into two groups, subjects with periodontitis (Group 1; PSI 0-2) and subjects without periodontitis (Group 2; PSI 3-4). The answers were evaluated using a point system ranging from 0 to 8, based on known periodontal risk factors and their assumed degree of influence. Receiver-Operating Characteristic (ROC) curve analysis were applied to examine the overall discriminatory power, sensitivity, specificity and corresponding cut-off points of the self-reported periodontal disease scale. RESULTS There was a significant difference between Group 1 and 2 concerning the majority of the inquired items (12 of 16, p<0.05). The distribution of the individual total score exhibited a high statistical significance (p<0.001) of robustness in terms of differing definitions of periodontitis. The Area Under the Curve (AUC) was 0.912 with a sensitivity of 86% and a specificity of 76%. CONCLUSION The questionnaire produced a reliable assessment of the individual risk (total score) and the need for periodontal treatment as well as the differentiation between gingivitis and periodontitis. CLINICAL RELEVANCE Patient-based data (clinical variables and periodontal risk factors of periodontitis) were adequate to make a preliminary assessment of a possible need for periodontal treatment.
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Affiliation(s)
- Antonio Renatus
- Faculty, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | | | - Fabian Schwarzenberger
- Professor for Stochastics, Faculty of Informatics/Mathematics at the HTW Dresden, Dresden, Germany
| | - Holger Jentsch
- Professor, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
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Khader Y, Alhabashneh R, Alhersh F. Development and validation of a self-reported periodontal disease measure among Jordanians. Int Dent J 2015; 65:203-10. [PMID: 26041308 DOI: 10.1111/idj.12170] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The development of self-reported measures of periodontal disease would be of great benefit to facilitate epidemiological studies of periodontal disease on a larger scale, and to allow for surveillance of the periodontal condition of populations over time. OBJECTIVES To develop a culturally adapted self-reported measure of periodontal disease, test its predictive and discriminative validity and establish a cut-off value for this measure to diagnose periodontal disease. METHODS A total of 288 Jordanian adults completed the questionnaire assessing self-reported periodontal health (18 questions) and underwent periodontal examination. Of the 18 questions, six were significantly associated with at least one clinical definition of periodontitis and were used to constitute the self-reported periodontal disease measure. Receiver-operating characteristics (ROC) curve analyses were used to examine the overall discriminatory power, sensitivity and specificity, and corresponding cut-off points of the self-reported periodontal disease measure. RESULTS ROC analysis showed that the self-reported periodontal disease measure had an excellent performance to discriminate between those with and without periodontal disease, regardless of the clinical definition used. A score of 2, on a scale of 0 to 6, had the highest sensitivity and specificity to detect periodontal disease when defined by all study criteria. Significant associations were observed between self-reported periodontal disease measures and all clinical definitions in the regression analysis (the odds ratio ranged from 8.31 to 18.96), according to the clinical definition to be predicted. CONCLUSION Self-reported periodontal disease measures have excellent predictive and discriminative validity when tested against clinical definitions, and severity and extent of periodontal disease.
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Affiliation(s)
- Yousef Khader
- Department of Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rola Alhabashneh
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Fadi Alhersh
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Impact of periodontal disease on outcomes in diabetes. Contemp Clin Trials 2015; 41:93-9. [PMID: 25623292 DOI: 10.1016/j.cct.2015.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/16/2015] [Accepted: 01/19/2015] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The prevalence of periodontal disease (POD) among adults aged 30years and older in the United States is reported to be more than 47%, with higher prevalence seen among patients with diabetes mellitus (DM). POD has been associated with systemic inflammation, a known risk factor for cardiovascular and bone disease, both of which are more common in patients with DM. However, there is mixed evidence that treatment of POD reduces inflammation, improves DM control, and reduces DM complications. Our study objectives are to assess factors associated with POD in patients with DM and determine the impact of POD treatment on inflammation and bone turnover biomarkers associated with complications of DM. METHODS In this pilot study, we will first recruit 200 patients with DM to complete a 48-item investigator-administered questionnaire designed to assess socio-economic status, oral health status, adequacy of oral care, glycemic control and presence of DM complications. Responses will be verified by individual chart review. Then, using a crossover design, a subgroup of 24 subjects with responses suggestive of POD will be assigned to undergo POD treatment for three months followed by three months of routine dental care (group 1) or be followed for three months during routine dental care then receive POD treatment for three months (group 2). Outcome measures will be collected before and after POD treatment and include glycemic control and inflammatory and bone turnover biomarkers. RESULTS We hypothesize that the prevalence of POD among DM patients will be associated with inadequate glycemic control and greater DM complications.
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Zhan Y, Holtfreter B, Meisel P, Hoffmann T, Micheelis W, Dietrich T, Kocher T. Prediction of periodontal disease: modelling and validation in different general German populations. J Clin Periodontol 2014; 41:224-31. [DOI: 10.1111/jcpe.12208] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Yiqiang Zhan
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Peter Meisel
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Thomas Hoffmann
- Department of Periodontology; Medical Faculty Carl Gustav Carus; Dresden Germany
| | | | - Thomas Dietrich
- Department of Oral Surgery; School of Dentistry; University of Birmingham; Birmingham UK
| | - Thomas Kocher
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
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