Abstract
In this study, we explore the diagnostic accuracy of a Radiographic-based Periodontal Bone Loss (R-PBL) method as a screening tool for periodontitis, in the form of radiographic bone loss, under the 2018 case definition in comparison to the 2012 case definition. The analysis was based on 456 patients (253 females and 203 males), screened for periodontal status in the Study of Periodontal Health in Almada-Seixal (SoPHiAS) project and subjected to a panoramic dental X-ray. Patients were diagnosed for the presence of periodontitis following the 2018 and 2012 case definition. R-PBL classification was defined by alveolar bone loss and diagnosed as no periodontitis (≥80% remaining alveolar bone), mild to moderate periodontitis (66% to 79%), or severe periodontitis (<66%). We appraise the X-ray quality to look for the influence on the performance of R-PBL. Sensitivity, specificity, accuracy, and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass Receiver operating characteristic/are under the curve (ROC/AUC) analyses. Our results show that the tested R-PBL method under the 2018 case definition is a reliable tool in periodontitis cases screening. This method does not replace clinical periodontal evaluation, but rather, it screens patients towards a definitive periodontitis diagnosis. These results will contribute to support the development of automated prediction systems towards periodontitis surveillance.
Highlights
Over the past few years, several surveillance programs have implemented different methods to assess periodontal status [1,2]
The present study aimed to explore the diagnostic accuracy of a Radiographic-based Periodontal Bone Loss (PBL) (R-PBL) method as a screening tool for periodontitis, in the form of radiographic bone loss, according to the 2018 case definition in comparison to the 2012 case definition
One hundred and eighty-five patients had no disease, 160 had mild-to-moderate periodontitis and 111 patients were diagnosed with severe periodontitis according to European Federation of Periodontology (EFP)/Academy of Periodontology (AAP) 2018 case definition
Summary
Over the past few years, several surveillance programs have implemented different methods to assess periodontal status [1,2]. Radiographic assessment is a critical component that confirms the presence of interproximal clinical findings of periodontal bone levels to estimate the prognosis of periodontally involved teeth, the treatment plan and the evaluation of the recurrence or progression of periodontitis [10,11]. In this sense, radiographic bone loss evaluation becomes important to the classification of periodontitis based on stages defined by severity, and grades that reflect this disease progression [10]
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