Patient Reported Outcomes Following Periodontal Therapy. a Systematic Review

Objectives: To systematically review the data for patient reported outcomes (PRO) following periodontal therapy in order to inform on the design of a clinical study of PROs. Methods: A detailed protocol was designed to facilitate the comprehensive evaluation of PRO research in periodontology. Multiple electronic databases were searched with no language restrictions. Quality assurance included a priori design of protocol and independent duplicate screening of study eligibility. Data synthesis was qualitative due to the heterogeneity of study characteristics and outcomes. Results: The search identified 5840 records of which 12 were relevant to this systematic review. A diversity of outcomes was found with most investigated in only one or two studies. The results showed that periodontal therapy can positively affect patient quality of life. In addition, patients generally experienced improvement in outcomes such as bleeding gums and halitosis. However, contradictions were shown in some aspects of the therapy such as chewing ability and aesthetic dissatisfaction. Methodological limitations of contributing studies were identified, particularly in the use and design of questionnaires for patient reported outcomes. Most of the questionnaires used had no evidence of testing for validity or reliability. Conclusions: Despite a multitude of studies reporting clinical outcomes following periodontal therapy, only few studies have investigated PROs. The ability to draw conclusions is limited by the heterogeneity of methods, sparse data and methodological limitations. Therefore, more data are needed, employing more robust methodology, to understand the role of periodontal therapy on patient reported outcomes. We are grateful to the Eastman Foundation for Oral Research and Training (EFFORT) for funding.