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Zhang L, Xiao M, Chu H, Kotsakis GA, Guan W. Estimating Periodontitis Susceptibility Cases for Epidemiological Studies with Multiple Imputation. JDR Clin Trans Res 2024; 9:378-386. [PMID: 38482579 PMCID: PMC11403924 DOI: 10.1177/23800844241228277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2024] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT Our proposed estimate of periodontitis susceptibility cases addresses the issue of missing teeth, offering an innovative solution through a generative missing data imputation model. The implications of our findings extend to fostering more robust investigations into the relationships between periodontal health and systemic diseases, thereby offering valuable insights to clinicians for informed decision-making. Moreover, the study's capacity to shape clinical practices and interventions in public health will further fortify health policy strategies.
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Affiliation(s)
- L Zhang
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - M Xiao
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - H Chu
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Statistical Research and Data Science Center, Pfizer Inc., New York, NY, USA
| | - G A Kotsakis
- Department of Oral Biology & Clinical Research Center, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - W Guan
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Beak W, Park J, Ji S. Data-driven prediction model for periodontal disease based on correlational feature analysis and clinical validation. Heliyon 2024; 10:e32496. [PMID: 38912435 PMCID: PMC11193031 DOI: 10.1016/j.heliyon.2024.e32496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/25/2024] Open
Abstract
Objectives This study aimed to investigate the performance and reliability of data-driven models employing correlational feature analysis and clinical validation for predicting periodontal disease. Methods The 7th Korea National Health and Nutrition Examination Survey (n = 10,654) was used for correlation analysis to identify significant risk factors for periodontitis. Periodontal prediction models were developed with the selected factors and database, followed by internal validation with 5-fold cross-validation and 1000 bootstrap resampling. External validation was conducted with clinical data (n = 120) collected through self-reported questionnaires, clinical periodontal parameters, and radiographic image analysis. Predictive performance was assessed for logistics regression, support vector machine, random forest, XGBoost, and neural network algorithms using the area under the receiver operating characteristic curves (AUC) and other performance metrics. Results Correlation analysis identified 16 features from over 1000 potential risk factors for periodontitis. The best data-driven model (XGBoost) showed AUC values of 0.823 and 0.796 for internal and external validations, respectively. Modeling with clinical data revealed those same measures to be 0.836 and 0.649, respectively. In addition, the data-driven model could predict other clinical periodontal parameters including severe bone loss (AUC = 0.813), gingival bleeding (AUC = 0.694), and tooth loss (AUC = 0.734). A patient case study about prognostic predictions revealed that the probability of periodontitis can be reduced by 6.0 % (stop smoking) and 0.6 % (stop drinking) on average. Conclusions Data-driven models for predicting periodontitis and other periodontal parameters were developed from 16 risk factors, demonstrating enhanced prediction performance and reproducibility in internal-external validations.
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Affiliation(s)
- Woosun Beak
- Department of Dental Public Health, Ajou University Graduate School of Clinical Dentistry, Suwon, Republic of Korea
- Department of Dentistry, Gyeonggi Provincial Medical Center Suwon Hospital, Suwon, Republic of Korea
| | - Jihun Park
- Department of Materials Science and Engineering, University of Maryland, College Park, MD, USA
| | - Suk Ji
- Department of Dental Public Health, Ajou University Graduate School of Clinical Dentistry, Suwon, Republic of Korea
- Department of Periodontology, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Republic of Korea
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Zainal Abidin Z, Noor E, Mohd Nor NS, Mohamed Nazari NS, Anuar Zaini A, Azizi NZ, Soelar SA, Shahrizad MM, Abdul Halim R. Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases. Eur J Dent 2024; 18:534-543. [PMID: 38049120 PMCID: PMC11132774 DOI: 10.1055/s-0043-1772777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES The study aimed to evaluate type 1 diabetes mellitus (T1DM) patients' self-perceived periodontal health status and to identify the association between periodontal disease (PD) and DM. MATERIALS AND METHODS This cross-sectional study included 113 T1DM children between 3 and 18 years old from the Universiti Teknologi MARA and the University of Malaya. Periodontal health parameters, including plaque index, gingival index, probing pocket depth, simplified basic periodontal examination, and clinical attachment loss, were recorded. Self-perceived periodontal health status was assessed with questionnaires. STATISTICAL ANALYSIS Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters. RESULTS The median age was 11.4 years. Half of them (50.4%) were females. A total of 83.5% rated their oral condition as good, whereas 27.5% reported a history of gingival bleeding. Clinical examination revealed that 48.7% had healthy gingiva, whereas 47.8% had gingivitis. The question "Do you have bleeding when brushing, flossing, or eating food?" showed good accuracy in the evaluation of PD (p < 0.001). CONCLUSION The questionnaire has a high potential to be used by medical professionals in identifying T1DM patients at risk of PD to guide nondental health care providers in making appropriate referrals to dental services.
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Affiliation(s)
- Zaridah Zainal Abidin
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Erni Noor
- Centre of Studies for Periodontology, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Noor Shafina Mohd Nor
- Department of Paediatrics, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | | | - Azriyanti Anuar Zaini
- Paediatric Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nurul Zeety Azizi
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Aiman Soelar
- Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Marshah Mohamad Shahrizad
- Kuching Division Dental Office, Sarawak State Dental Health Department, Braang Bayur Dental Clinic, Sarawak, Malaysia
| | - Rohaida Abdul Halim
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
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Tamiya H, Mitani A, Abe M, Nagase T. Putative Bidirectionality of Chronic Obstructive Pulmonary Disease and Periodontal Disease: A Review of the Literature. J Clin Med 2023; 12:5935. [PMID: 37762876 PMCID: PMC10531527 DOI: 10.3390/jcm12185935] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/24/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide and is currently the third leading cause of death globally. The long-term inhalation of toxic substances, mainly cigarette smoke, deteriorates pulmonary function over time, resulting in the development of COPD in adulthood. Periodontal disease is an inflammatory condition that affects most adults and is caused by the bacteria within dental plaque. These bacteria dissolve the gums around the teeth and the bone that supports them, ultimately leading to tooth loss. Periodontal disease and COPD share common risk factors, such as aging and smoking. Other similarities include local chronic inflammation and links with the onset and progression of systemic diseases such as ischemic heart disease and diabetes mellitus. Understanding whether interventions for periodontal disease improve the disease trajectory of COPD (and vice versa) is important, given our rapidly aging society. This review focuses on the putative relationship between COPD and periodontal disease while exploring current evidence and future research directions.
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Affiliation(s)
- Hiroyuki Tamiya
- Division for Health Service Promotion, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akihisa Mitani
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masanobu Abe
- Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Takahide Nagase
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Reckelkamm SL, Kamińska I, Baumeister SE, Holtfreter B, Alayash Z, Rodakowska E, Baginska J, Kamiński KA, Nolde M. Optimizing a Diagnostic Model of Periodontitis by Using Targeted Proteomics. J Proteome Res 2023. [PMID: 37269315 DOI: 10.1021/acs.jproteome.3c00230] [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] [Indexed: 06/05/2023]
Abstract
Periodontitis (PD), a widespread chronic infectious disease, compromises oral health and is associated with various systemic conditions and hematological alterations. Yet, to date, it is not clear whether serum protein profiling improves the assessment of PD. We collected general health data, performed dental examinations, and generated serum protein profiles using novel Proximity Extension Assay technology for 654 participants of the Bialystok PLUS study. To evaluate the incremental benefit of proteomics, we constructed two logistic regression models assessing the risk of having PD according to the CDC/AAP definition; the first one contained established PD predictors, and in addition, the second one was enhanced by extensive protein information. We then compared both models in terms of overall fit, discrimination, and calibration. For internal model validation, we performed bootstrap resampling (n = 2000). We identified 14 proteins, which improved the global fit and discrimination of a model of established PD risk factors, while maintaining reasonable calibration (area under the curve 0.82 vs 0.86; P < 0.001). Our results suggest that proteomic technologies offer an interesting advancement in the goal of finding easy-to-use and scalable diagnostic applications for PD that do not require direct examination of the periodontium.
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Affiliation(s)
- Stefan Lars Reckelkamm
- Institute of Health Services Research in Dentistry, University of Münster, Münster 48149, Germany
| | - Inga Kamińska
- Department of Integrated Dentistry, Medical University of Bialystok, Bialystok 15-276, Poland
| | | | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald 17475, Germany
| | - Zoheir Alayash
- Institute of Health Services Research in Dentistry, University of Münster, Münster 48149, Germany
| | - Ewa Rodakowska
- Department of Clinical Dentistry-Cariology Section, University of Bergen, Bergen 5020, Norway
| | - Joanna Baginska
- Department of Dentistry Propaedeutics, Medical University of Bialystok, Białystok 15-276, Poland
| | - Karol Adam Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok 15-269, Poland
| | - Michael Nolde
- Institute of Health Services Research in Dentistry, University of Münster, Münster 48149, Germany
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Perdoncini NN, Furquim CP, Bonfim CMS, Soares GMS, Torres-Pereira CC. Self-perception of periodontal health status among individuals with Fanconi anemia. Hematol Transfus Cell Ther 2021; 43:453-458. [PMID: 33023865 PMCID: PMC8573027 DOI: 10.1016/j.htct.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. AIM To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. METHODS AND RESULTS Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (p = 0.014). The DMFT was higher in those who had already undergone dental treatments (p = 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (p = 0.03). The question "Do your gums bleed easily?" had good accuracy in the evaluation of periodontal disease (p = 0.68). CONCLUSION Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
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Optimal Examination Sites for Periodontal Disease Evaluation: Applying the Item Response Theory Graded Response Model. J Clin Med 2020; 9:jcm9113754. [PMID: 33233427 PMCID: PMC7700480 DOI: 10.3390/jcm9113754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/09/2023] Open
Abstract
Periodontal examination data have a complex structure. For epidemiological studies, mass screenings, and public health use, a simple index that represents the periodontal condition is necessary. Periodontal indices for partial examination of selected teeth have been developed. However, the selected teeth vary between indices, and a justification for the selection of examination teeth has not been presented. We applied a graded response model based on the item response theory to select optimal examination teeth and sites that represent periodontal conditions. Data were obtained from 254 patients who participated in a multicenter follow-up study. Baseline data were obtained from initial follow-up. Optimal examination sites were selected using item information calculated by graded response modeling. Twelve sites—maxillary 2nd premolar (palatal-medial), 1st premolar (palatal-distal), canine (palatal-medial), lateral incisor (palatal-central), central incisor (palatal-distal) and mandibular 1st premolar (lingual, medial)—were selected. Mean values for clinical attachment level, probing pocket depth, and bleeding on probing by full mouth examinations were used for objective variables. Measuring the clinical parameters of these sites can predict the results of full mouth examination. For calculating the periodontal index by partial oral examination, a justification for the selection of examination sites is essential. This study presents an evidence-based partial examination methodology and its modeling.
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Ueno M, Shimazu T, Sawada N, Tsugane S, Kawaguchi Y. Validity of Self-Reported Periodontitis in Japanese Adults: The Japan Public Health Center-Based Prospective Study for the Next-Generation Oral Health Study. Asia Pac J Public Health 2020; 32:346-353. [PMID: 32741221 DOI: 10.1177/1010539520944721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the validity of self-reported periodontitis measures among 2404 Japanese adults aged 40 to 75 years. A self-administered questionnaire survey and a clinical periodontal examination were conducted from 2013 through 2016. The self-reported periodontitis questions included 3 sociodemographic, 3 health, and 5 periodontal health-related items. Based on the clinical case definition of periodontitis, 26.5% of participants were found to be periodontally healthy, 2.7% had mild periodontitis, 55.2% moderate periodontitis, and 15.6% severe periodontitis. No single self-reported question demonstrated satisfactory validity in predicting the presence or absence of periodontitis. The predictive ability in mild and/or moderate periodontitis was poor even after combining multiple sociodemographic, health, and periodontal health-related questions. In severe periodontitis, the model including age, sex, education level, smoking status, diabetes history, body mass index, informed by a dentist, gingival bleeding, calculus deposit, and tooth mobility, presented moderate predictive performance (C-statistic: 0.676, sensitivity: 65.2%, and specificity: 61.1%). An age-stratified analysis on severe periodontitis showed that sensitivity was higher, and specificity was lower in older age group (60-75 years) than younger age group (40-59 years). Further refinement of questions in the self-report is required to increase the accuracy of the prediction of clinical periodontitis.
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Affiliation(s)
- Masayuki Ueno
- Saitama Prefectural University, Koshigaya, Japan.,Tokyo Medical and Dental University, Tokyo, Japan
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Du M, Haag D, Song Y, Lynch J, Mittinty M. Examining Bias and Reporting in Oral Health Prediction Modeling Studies. J Dent Res 2020; 99:374-387. [DOI: 10.1177/0022034520903725] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Recent efforts to improve the reliability and efficiency of scientific research have caught the attention of researchers conducting prediction modeling studies (PMSs). Use of prediction models in oral health has become more common over the past decades for predicting the risk of diseases and treatment outcomes. Risk of bias and insufficient reporting present challenges to the reproducibility and implementation of these models. A recent tool for bias assessment and a reporting guideline—PROBAST (Prediction Model Risk of Bias Assessment Tool) and TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis)—have been proposed to guide researchers in the development and reporting of PMSs, but their application has been limited. Following the standards proposed in these tools and a systematic review approach, a literature search was carried out in PubMed to identify oral health PMSs published in dental, epidemiologic, and biostatistical journals. Risk of bias and transparency of reporting were assessed with PROBAST and TRIPOD. Among 2,881 papers identified, 34 studies containing 58 models were included. The most investigated outcomes were periodontal diseases (42%) and oral cancers (30%). Seventy-five percent of the studies were susceptible to at least 4 of 20 sources of bias, including measurement error in predictors ( n = 12) and/or outcome ( n = 7), omitting samples with missing data ( n = 10), selecting variables based on univariate analyses ( n = 9), overfitting ( n = 13), and lack of model performance assessment ( n = 24). Based on TRIPOD, at least 5 of 31 items were inadequately reported in 95% of the studies. These items included sampling approaches ( n = 15), participant eligibility criteria ( n = 6), and model-building procedures ( n = 16). There was a general lack of transparent reporting and identification of bias across the studies. Application of the recommendations proposed in PROBAST and TRIPOD can benefit future research and improve the reproducibility and applicability of prediction models in oral health.
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Affiliation(s)
- M. Du
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - D. Haag
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Y. Song
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - J. Lynch
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Population Health Sciences, University of Bristol, Bristol, UK
| | - M. Mittinty
- School of Public Health, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
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FRANCISCATTO GJ, KOPPE BTDF, HOPPE CB, OLIVEIRA JAPD, HAAS AN, GRECCA FS, ROSSI-FEDELE G, GOMES MS. Validation of self-reported history of root canal treatment in a southern Brazilian subpopulation. Braz Oral Res 2019; 33:e007. [DOI: 10.1590/1807-3107bor-2019.vol33.0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 12/17/2018] [Indexed: 12/28/2022] Open
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Kim HN, Jang YE, Kim CB, Kim NH. Socioeconomic status and self-reported periodontal symptoms in community-dwelling individuals: data from the Korea Community Health Surveys of 2011 and 2013. Int Dent J 2018; 68:411-419. [DOI: 10.1111/idj.12407] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Fleming E. A Self-Report to 2-Domain Questions May Accurately Screen for Periodontitis. J Evid Based Dent Pract 2017; 17:271-273. [PMID: 28865826 DOI: 10.1016/j.jebdp.2017.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION A two-domain self-report measure of periodontal disease has good accuracy for periodontitis screening in dental school outpatients. Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. J Periodontol 2016;87:1165-73. SOURCE OF FUNDING Information not available TYPE OF STUDY/DESIGN: Cohort study.
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