The 2018 classification of periodontal diseases: Its predictive value for tooth loss

Abstract

Background Predictive models and assessment tools for disease susceptibility and progression are necessary to enhance personalized medicine. The aim of this study is to assess the predictive accuracy of using the 2018 classification to predict likelihood of tooth loss. Methods A total of 134 patients were screened 10 years after periodontal therapy. Data were extracted from 82 patients’ records and periodontal diagnoses were assigned according to the 1999 and 2018 classifications at baseline, whereas patient‐ and tooth‐related parameters were documented at baseline and at reexamination. Statistical analysis included descriptive statistics, hurdle regression with a zero and count model as well as logistic regression. Results Significantly more teeth were lost during SPT in patients with Stage IV or Grade C (P < 0.05). Patients’ adherence seems to have an impact on the predictability of the 2018 classification (P < 0.001). In comparison, neither classification system alone (1999 vs 2018) showed a high predictive value for tooth loss (area under the curve [AUC] = 59.2% vs 58.2%). Conclusion Class III and IV/Grade C of the 2018 classification of periodontal diseases show similar predictive accuracy for tooth loss as severe cases in the former classification. Patients adherence seems to influence the prognostic value of the classification.

Risk factors for tooth loss and progression of periodontitis in patients undergoing periodontal maintenance therapy

“…The corresponding figure for Stage III cases was 37.04% (40 of 108). In the multivariate negative binomial regression model, Stage IV periodontitis was a significant risk factor for tooth loss (IRR = 4.61; 95% CI [2.97–7.81], p < .001), a finding consistent with other recently published retrospective studies (Ravidà et al, 2019; El Sayed et al, 2021; Ravidà, Qazi, et al, 2021).…”

“…The corresponding figure for Stage III cases was 37.04% (40 of 108). In the multivariate negative binomial regression model, Stage IV periodontitis was a significant risk factor for tooth loss (IRR = 4.61; 95% CI [2.97-7.81], p < .001), a finding consistent with other recently published retrospective studies(Ravidà et al, 2019;El Sayed et al, 2021;.T A B L E 3Abbreviations: CI, confidence interval; FMBS, full-mouth bleeding score; IRR, incidence rate ratio; PPD, probing pocket depth. a Variables with p < .2 were included in the multivariate model.…”

“…We identified that in this cohort of mainly Stage III/IV patients, a maintenance frequency of 5–6 months, compared with every 3–4 months, was associated with an increased risk for periodontitis progression (OR = 1.81; 95% CI [1.11–2.94], p = .018). Other retrospective studies found that tooth loss rates in Stage III/IV cases were more significantly influenced by the frequency of maintenance visits than Stage I/II cases were (El Sayed et al, 2021; Ravidà, Galli, et al, 2021). In patients with residual PPD ≥6 mm at their first SPT visit, a reduced maintenance frequency has been associated with a higher frequency of tooth loss (Ramseier et al, 2019).…”

Clinical benefits of systemic amoxicillin/metronidazole may depend on periodontitis stage and grade: An exploratory sub‐analysis of the ABPARO trial

“…Therefore, we used the total number of missing teeth except for third molars as the discriminator between stages III and IV, which may have introduced misclassification in some cases. However, other groups have applied this approach earlier (El Sayed et al, 2022; Graetz et al, 2019). Fourth, not all radiographs obtained at baseline could be retrieved because of the long time that had passed since the start of the study.…”

The use of oral probiotics in non-surgical periodontal therapy: Literature Review

“…Education is evaluated because based on that, clinical pathologies or disease progression are observed. Gives information to the specialist, how to communicate, instructions but above all the understanding of the patient [35] .…”