IADR Abstract Archives
Agreement Between Severe Periodontitis Case Definitions
Objectives: This cross-sectional study aimed to evaluate the diagnostic agreement of severe periodontitis by three different case definitions.
Methods: Patients over 35 years (n = 244, mean age = 47.8 ± 9.4 years) were evaluated by full-mouth periodontal examination along with periodontal screening and recording (PSR). They were then classified according to the most severe periodontitis criterion of the CDC/AAP definitions (Eke et al., 2012), the new periodontal disease classification (EFP/AAP, Tonetti et al., 2018) and the PSR (ADA/AAP, 1992). The primary outcome was to compare the diagnostic agreement of severe periodontitis between the three case definitions. The kappa test was used to analyze the agreement. Sensitivity (SS), specificity (SP) and ROC curve were also calculated.
Results: The proportion of subjects presenting the most severe definitions of each classification was: severe periodontitis (CDC/AAP) = 48.8%, type III and IV periodontitis (EFP/AAP) = 43% and PSR code 4 = 44.3%. When comparing the EFP/AAP classification with the CDC/AAP it was obtained kappa, SS, SP and ROC of 0.737, 91.4%, 83.5% and 0.874, respectively. Similarly, when comparing CDC/AAP to PSR code 4, kappa, SS, SP and ROC of 0.696, 79.8%, 89.6% and 0.847, respectively, were obtained. And when type III and IV periodontitis (EFP/AAP) was compared to PSR code 4, the values were 0.842, 92.4%, 92.1% and 0.922, respectively.
Conclusions: Both the new classification of periodontal diseases (EFP/AAP) and the PSR demonstrated good agreement with CDC/AAP case definition for the diagnosis of severe periodontitis. However, better agreement and improved ability to classify those with and without the severe periodontitis were obtained between the new classification and the PSR.
Methods: Patients over 35 years (n = 244, mean age = 47.8 ± 9.4 years) were evaluated by full-mouth periodontal examination along with periodontal screening and recording (PSR). They were then classified according to the most severe periodontitis criterion of the CDC/AAP definitions (Eke et al., 2012), the new periodontal disease classification (EFP/AAP, Tonetti et al., 2018) and the PSR (ADA/AAP, 1992). The primary outcome was to compare the diagnostic agreement of severe periodontitis between the three case definitions. The kappa test was used to analyze the agreement. Sensitivity (SS), specificity (SP) and ROC curve were also calculated.
Results: The proportion of subjects presenting the most severe definitions of each classification was: severe periodontitis (CDC/AAP) = 48.8%, type III and IV periodontitis (EFP/AAP) = 43% and PSR code 4 = 44.3%. When comparing the EFP/AAP classification with the CDC/AAP it was obtained kappa, SS, SP and ROC of 0.737, 91.4%, 83.5% and 0.874, respectively. Similarly, when comparing CDC/AAP to PSR code 4, kappa, SS, SP and ROC of 0.696, 79.8%, 89.6% and 0.847, respectively, were obtained. And when type III and IV periodontitis (EFP/AAP) was compared to PSR code 4, the values were 0.842, 92.4%, 92.1% and 0.922, respectively.
Conclusions: Both the new classification of periodontal diseases (EFP/AAP) and the PSR demonstrated good agreement with CDC/AAP case definition for the diagnosis of severe periodontitis. However, better agreement and improved ability to classify those with and without the severe periodontitis were obtained between the new classification and the PSR.
