Validation of an Algorithm for Chronic Periodontitis Risk Assessment and Prognostication: Risk Predictors, Explanatory Values, Measures of Quality, and Clinical Use

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Lang NP, Suvan JE, Tonetti MS. Risk factor assessment tools for the prevention of periodontitis progression a systematic review. J Clin Periodontol 2015; 42 (Suppl. 16): S59-S70. doi: 10.1111/jcpe.12350. AbstractObjectives: (i) To identify characteristics of currently published patient-based tools used to assess levels of risk for periodontitis progression and (ii) systematically review the evidence documenting the use of patient-based risk assessment tools for predicting periodontitis progression. Material and methods: A systematic review was prepared on the basis of an electronic search of the literature supplemented with manually searching the relevant journals of the latest 5 years. Prospective and retrospective cohort studies were included as no randomized controlled clinical trials were available. Results: The search identified 336 titles, and 19 articles were included in this systematic review. The search identified five different risk assessment tools. Results of nine of 10 cohort studies reporting outcomes of 2110 patients indicate that risk assessment tools are able to identify subjects with different probability of periodontitis progression and/or tooth loss. Subjects with higher risk scores showed more progression of periodontitis and tooth loss. Conclusions: In treated populations, results of patient-based risk assessments, for example periodontal risk calculator (PRC) and periodontal risk assessment (PRA), predicted periodontitis progression and tooth loss in various populations. Additional research on the utility of risk assessment and results in improving patient management are needed.

“…), while 2 studies were conducted fully with a prospective design (Lindskog et al. , Costa et al. ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Risk factor assessment tools for the prevention of periodontitis progression a systematic review

Lang

Suvan

Tonetti³

2015

164

150

“…Several risk assessment tools in the second approach have been developed based on well‐documented risk factors and have been assessed in longitudinal studies (Lang & Tonetti, ; Lindskog et al., ; Page et al., ; Page, Krall, Martin, Mancl, & Garcia, ) and their ability to identify patients with different levels of risk has been established (Lang, Suvan, & Tonetti, ).…”

Section: Introductionmentioning

confidence: 99%

Predictors of long‐term outcomes in patients undergoing periodontal maintenance

Martinez-Canut

Andrés

Romero

2017

AimThis retrospective study aimed to characterize the baseline status of patients following periodontal maintenance, analysing the association between the long‐term outcome of these patients, smoking, bruxism, and the main clinical and radiographic variables.Material and methodsA sample of 174 patients with moderate to severe periodontitis was refined into homogeneous subsamples according to smoking and bruxism and the rate of tooth loss due to periodontal disease (TLPD): 0, 1–2, and >2 teeth. The association and the distribution (χ² test) of the variables within the subsamples were analysed.ResultsSmoking and bruxism were significantly associated with higher TLPD rates. Vertical and circumferential bone defects (p < .0001), and abfractions (p < .0001) were associated with bruxism and particularly with bruxism and TLPD >2.Furcation defects (p = .0002), fewer radio‐opaque subgingival calculus (χ² p < .0001), a lower mean Gingival index (χ² p = .027), and increased mean recessions >1.5 mm (χ² p = .0026) were associated with smoking and higher TLPD rates. The mean baseline mobility, abfractions, and recessions characterized two basic types of TLPD.ConclusionsSmoking, bruxism, and routine clinical and radiological parameters can be used to characterize the baseline status of patients with worse outcomes.

“…The first approach attempted to characterize the baseline status of patients that lose more teeth during PM (Fardal, Grytten, Martin, Houlihan, & Heasman, 2016; Martinez‐Canut, 2015; Martinez‐Canut, Llobell, & Romero, 2017; Tonetti, Muller‐Campanile, & Lang, 1998; Wasserman & Hirschfeld, 1988); the second approach focused on assessing the risk of disease progression and the resulting tooth loss (Lang & Tonetti, 2003; Lindskog et al., 2010; Page et al., 2002; Page, Krall, Martin, Mancl, & Garcia, 2002). The tools developed for this purpose have been assessed in longitudinal studies, their capability to identify patients with different levels of risk being demonstrated (Lang, Suvan, & Tonetti, 2015).…”

Section: Introductionmentioning

confidence: 99%

A comprehensive approach to assigning periodontal prognosis

Martinez-Canut

Llobell

2018

AimThe purpose of this retrospective case series study was to evaluate the usefulness and performance of a comprehensive approach to assigning periodontal prognosis by assessing the risk of tooth loss due to periodontal disease (TLPD) and estimate the survival time (ST) of periodontally compromised teeth (PCT).Material and MethodsThe Long‐Term Outcome (LTO) index was utilized to assess the risk of TLPD, at baseline, in 100 patients following periodontal maintenance for a mean 24.7 year (±2.4). A TLPD prediction model was utilized to assign ST to PCT. The performance of the TLPD prediction based on both parameters was assessed.ResultsThe mean TLPD rate increased as the LTO index increased (Kruskal–Wallis p < .001). The percentage of TLPD increased as the ST decreased, with significantly differences between the LTO categories <4 and ≥4 for all ST intervals (Mann–Whitney p < .001 to p .021).Only 21% of PCT were lost. This percentage was 58% for teeth assigned the shortest ST and increased to 71% and 88% for these teeth in LTO ≥4 patients.ConclusionsThis approach might be useful to predict TLPD in patients with an initial higher risk of TLPD while it was not useful in patients with lower risk of TLPD.