Prognostic performance of the 2017 World Workshop classification on staging and grading of periodontitis compared with the British Society of Periodontology's implementation.
attachment loss
periodontitis
risk factor assessment
tooth loss
validation study
Journal
Journal of periodontology
ISSN: 1943-3670
Titre abrégé: J Periodontol
Pays: United States
ID NLM: 8000345
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
revised:
15
07
2021
received:
13
05
2021
accepted:
22
07
2021
pubmed:
28
7
2021
medline:
14
4
2022
entrez:
27
7
2021
Statut:
ppublish
Résumé
The British Society of Periodontology (BSP) implemented a simplified version of the 2017 World Workshop Classification (WWC) on staging and grading of periodontitis, for use in UK clinical practice. The aim of this study was to assess the long-term (>10 years) prognostic capability of BSP's implementation (BSP-i) compared with the 2017 WWC, using periodontal-related tooth loss (TLP) as a disease outcome. Data on medical history, smoking status, and clinical periodontal parameters were retrieved from 270 patients who received non-surgical and surgical periodontal therapy from 1966 to 2007. Each patient received a baseline diagnosis according to the 2017 WWC and the BSP-i guidelines for implementation. Univariate multilevel Cox regression frailty models were performed to analyze the association between variables with TLP. A post-hoc comparison with Bonferroni correction was performed to analyze interclass comparisons. The prognostic performance of both systems was analyzed using Harrell C index. The prognostic performance of both systems was very similar (0.922 for the 2017 WWC and 0.925 for the BSP-i). The singular prognostic performance of BSP stage was slightly higher than that of 2017 WWC stage (0.9212 versus 0.9188), while the 2017 WWC grade showed a slightly better performance than BSP grade (0.9175 versus 0.9155). BSP-i's extent performed better than the 2017 WWC extent (0.9203 versus 0.9098); however, in the 2017 WWC extent, the class "localized" was associated with a better prognosis than "generalized." The overall prognostic performance of the two systems was excellent, with both systems having a Harrell C index score of >0.92.
Sections du résumé
BACKGROUND
The British Society of Periodontology (BSP) implemented a simplified version of the 2017 World Workshop Classification (WWC) on staging and grading of periodontitis, for use in UK clinical practice. The aim of this study was to assess the long-term (>10 years) prognostic capability of BSP's implementation (BSP-i) compared with the 2017 WWC, using periodontal-related tooth loss (TLP) as a disease outcome.
METHODS
Data on medical history, smoking status, and clinical periodontal parameters were retrieved from 270 patients who received non-surgical and surgical periodontal therapy from 1966 to 2007. Each patient received a baseline diagnosis according to the 2017 WWC and the BSP-i guidelines for implementation. Univariate multilevel Cox regression frailty models were performed to analyze the association between variables with TLP. A post-hoc comparison with Bonferroni correction was performed to analyze interclass comparisons. The prognostic performance of both systems was analyzed using Harrell C index.
RESULTS
The prognostic performance of both systems was very similar (0.922 for the 2017 WWC and 0.925 for the BSP-i). The singular prognostic performance of BSP stage was slightly higher than that of 2017 WWC stage (0.9212 versus 0.9188), while the 2017 WWC grade showed a slightly better performance than BSP grade (0.9175 versus 0.9155). BSP-i's extent performed better than the 2017 WWC extent (0.9203 versus 0.9098); however, in the 2017 WWC extent, the class "localized" was associated with a better prognosis than "generalized."
CONCLUSION
The overall prognostic performance of the two systems was excellent, with both systems having a Harrell C index score of >0.92.
Identifiants
pubmed: 34314515
doi: 10.1002/JPER.21-0296
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
537-547Informations de copyright
© 2021 American Academy of Periodontology.
Références
Hajishengallis G, Lamont RL. Beyond the red complex and into more complexity: the polymicrobial synergy and dysbiosis (PSD) model of periodontal disease etiology. Mol Oral Microbiol. 2012;27:409-419.
Bartold PM, Van Dyke TE. An appraisal of the role of specific bacteria in the initial pathogenesis of periodontitis. J Clin Periodontol. 2019;46:6-11.
Meyle J, Chapple ILC. Molecular aspects of the pathogenesis of periodontitis. Periodontol 2000. 2015;69:7-17.
Tonetti MS, Eickholz P, Loos BG, et al. Principles in prevention of periodontal diseases Consensus report of group 1 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Periodontol. 2015;42(16):S5-S11. Suppl.
Becker W, Becker BE, Berg LE. Periodontal treatment without maintenance. A retrospective study in 44 patients. J Periodontol. 1984;55:505-509.
Chapple ILC. Risk assessment in periodontal care: the principles. In: Chapple ILC, Papapanou P, eds. Risk assessment in oral health. A Concise Guide for Clinical Application. Switzerland: Springer Nature; 2020:77-88. https://doi.org/10.1007/978-3-030-38647-4. ISBN: 978-3-030-38646-7
Salvi GE, Lawrence HP, Offenbacher S, Beck JD. Influence of risk factors on the pathogenesis of periodontitis. Periodontol 2000. 1997;14:173-201.
Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the classification of periodontal and peri-implant diseases and conditions. J Clin Periodontol. 2018;45:S162-S170.
Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67:93-99.
Orucevic A, Bell JL, King M, McNabb AP, Heidel RE. Nomogram update based on tailorx clinical trial results - oncotype dx breast cancer recurrence score can be predicted using clinicopathologic data. Breast J. 2019;46:116-125.
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Clin Periodontol. 2018;45(20):S149-S161. Suppl.
Ravida A, Qazi M, Troiano G, et al. Using periodontal staging and grading system as a prognostic factor for future tooth loss: a long-term retrospective study. J Periodontol. 2020;91:454-461.
Dietrich T, Ower P, Tank M, et al. Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions: implementation in clinical practice. Br Dent J. 2019;226:16-22.
Commissioning Standard for Restorative Dentistry. NHS England & NHS Improvement, https://www.england.nhs.uk/wp-content/uploads/2019/07/commissioning-standard-for-restorative-dentistry-v1.pdf
Dental standard operating procedure: transition to recovery. NHS England & NHS Improvement, https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C1029-SOP-Transition-to-recovery-A-phased-transition-for-dental-practices-towards-the-resumption-of-the-full-r.pdf
World Medical Association. (2013). World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310:2191-2194.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Epidemiology. 2007;18:800-804. STROBE initiative.
Pepelassi EA, Tsiklakis K, Diamanti-Kipioti A. Radiographic detection and assessment of the periodontal endosseous defects. J Clin Periodontol. 2000;27:224-230.
Sanz M, Papapanou PN, Tonetti MS, Greenwell H, Kornman K. Guest Editorial: clarifications on the use of the new classification of periodontitis. J Clin Periodontol. 2020;47:658-659.
Al-Shammari KF, Al-Khabbaz AK, Al-Ansari JM, Neiva R, Wang HL. Risk indicators for tooth loss due to periodontal disease. J Periodontol. 2005;76:1910-1918.
Ravida A, Troiano G, Qazi M, et al. Dose-dependent effect of smoking and smoking cessation on periodontitis-related tooth loss during 10-47 years periodontal maintenance: a retrospective study in compliant cohort. J Clin Periodontol. 2020;47:1132-1143.
Ramseier CA, Woelber JP, Kitzmann J, Detzen L, Carra MC, Bouchard P. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: a systematic review. J Clin Periodontol. 2020;47(22):S90-S106. Suppl.
Trombelli L, Simonelli A, Franceschetti G, Maietti E, Farina R. What periodontal recall interval is supported by evidence? Periodontol 2000. 2020;84:124-133.
Tada S, Allen PF, Ikebe K, Matsuda K, Maeda Y. Impact of periodontal maintenance on tooth survival in patients with removable partial dentures. J Clin Periodontol. 2015;42:46-53.
Costa FO, Lages EJ, Cota LO, Lorentz TC, Soares RV, Cortelli JR. Tooth loss in individuals under periodontal maintenance therapy: 5-year prospective study. J Periodontal Res. 2014;49:121-128.
Salvi GE, Mischler DC, Schmidlin K, et al. Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. J Clin Periodontol. 2014;41:701-707.
Ramseier CA, Nydegger M, Walter C, et al. Time between recall visits and residual probing depths predict long-term stability in patients enrolled in supportive periodontal therapy. J Clin Periodontol. 2019;46:218-230.
Matuliene G, Pjetursson BE, Salvi GE, et al. Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol. 2008;35:685-695.
American Academy of Periodontology task force report on the update to the 1999 classification of periodontal diseases and conditions. J Periodontol, 2015;86:835-838.
Royston P, Altman DG. External validation of a Cox prognostic model: principles and methods. BMC Med Res Methodol. 2013;13:33.
Collins GS, DeGroot JA, Dutton S, et al. External validation of multivariable prediction models: a systematic review of methodological conduct and reporting. BMC Med Res Methodol. 2014;14:40.
Debray TP, Vergouwe Y, Koffijberg H, Nieboer D, Steyerberg EW, Moons KG. A new framework to enhance the interpretation of external validation studies of clinical prediction models. J Clin Epidemiol. 2015;68:279-289.
Collins GS, Ogundimu EO, Altman DG. Sample size considerations for the external validation of a multivariable prognostic model: a resampling study. Stat Med. 2016;35:214-226.
Walter C, Chapple ILC, Ower P, et al. Periodontal diagnosis in the context of the BSP implementation plan for the 2017 classification system of periodontal diseases and conditions: presentation of a patient with severe periodontitis following successful periodontal therapy and supportive periodontal treatment. Br Dent J. 2019;226:411-413.
Walter C, Ower P, Tank M, et al. Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions: presentation of a middle-aged patient with localized periodontitis. Br Dent J. 2019;226:98-100.
NHS. Avoidance of doubt: provision of phased treatments. https://www.england.nhs.uk/wp-content/uploads/2018/02/B0615-Update-to-avoidance-of-doubt-provision-of-phased-treatments-300621-.pdf