Diagnostic accuracy of severe periodontitis case definitions: Comparison of the CDC/AAP, EFP/AAP, and CPI criteria

Abstract

Background: This cross-sectional study aimed to evaluate the diagnostic accuracy of severe periodontitis by three different case definitions.Methods: Patients aged >35 years (n = 243, mean age = 47.8 ± 9.3 years) were evaluated by periodontal examinations and classified in patients with severe periodontitis according to the case definition proposed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Academy of Periodontology (AAP)-CDC/AAP, the new periodontal disease classification proposed jointly by the AAP and the European Federation of Periodontology (EFP/AAP), and the Community Periodontal Index (CPI). The primary outcome was to compare the diagnostic accuracy of severe periodontitis between the three case definitions. Sensitivity (SS), specificity (SP), and area under the receiver operating characteristic (ROC) curve were used to analyze the accuracy. Results: The proportion of subjects presenting the most severe definitions of each classification was: severe periodontitis (CDC/AAP) = 47.3%, type III and IV periodontitis (EFP/AAP) = 43.2% and CPI code 4 = 44.4%. When comparing the CDC/AAP case definitions with the EFP/AAP classification, SS, SP, and ROC of 81.7%, 91.4%, and 0.866 (CI, 95%: 0.816 to 0.916), respectively, were obtained. Similarly, when comparing CDC/AAP to CPI code 4, SS, SP, and ROC of 81.7%, 89.1%, and 0.854 (CI, 95%: 0.802 to 0.906), respectively, were obtained. When type III and IV periodontitis (EFP/AAP) was compared with CPI code 4, the values were 92.4%, 92%, and 0.922 (CI, 95%: 0.883 to 0.961), respectively. Conclusions: The EFP/AAP classification and the CPI demonstrated high diagnostic accuracy with the CDC/AAP case definition to diagnose severe periodontitis.

Diagnostic performance of the AAP/EFP classification and the CDC/AAP case definition among pregnant women and a practical screening tool for maternal periodontal diseases

“…Recently, several studies have focused on the comparison of CDC/AAP and AAP/EFP case definitions; and AUC, diagnostic performance, and agreement have been used appropriately. [34][35][36]46 Overall, these studies show the high agreement of AAP/EFP classification with CDC/AAP system.…”

“…However, only when every single subject has same diagnosis by two different case definitions, a high agreement could be achieved. Recently, several studies have focused on the comparison of CDC/AAP and AAP/EFP case definitions; and AUC, diagnostic performance, and agreement have been used appropriately 34–36,46 . Overall, these studies show the high agreement of AAP/EFP classification with CDC/AAP system.…”

“…[31][32][33] Recently, several population-based studies have reported the diagnostic performance and agreement between the CDC/AAP system and AAP/EFP classification. [34][35][36] Currently, there is a lack of such comparative studies on these diagnostic systems in pregnant females. It has been shown that different diagnostic approaches considerably account for the variation in the prevalence of periodontitis among pregnant women.…”

“…While the current classification scheme of periodontal and peri‐implant diseases and conditions, jointly presented by the AAP and the European Federation of Periodontology (AAP/EFP), has been launched since 2018 31–33 . Recently, several population‐based studies have reported the diagnostic performance and agreement between the CDC/AAP system and AAP/EFP classification 34–36 . Currently, there is a lack of such comparative studies on these diagnostic systems in pregnant females.…”

Comparison of the triglyceride glucose index and modified triglyceride glucose indices in assessing periodontitis in Korean adults

“…It would be ideal to bring in other validated indices in the future. 41 Despite the limitations, the role of TyG combined with body composition measures has been highlighted. To the best of our knowledge, this is the first study to assess associations between modified TyG parameters and the risk of periodontitis.…”