Periodontal grading—estimation of responsiveness to therapy and progression of disease

Bumm, Caspar Victor ; Ern, Christina; Folwaczny, Julia; Wölfle, Uta Christine; Heck, Katrin ; Werner, Nils und Folwaczny, Matthias (1. Mai 2024): Periodontal grading—estimation of responsiveness to therapy and progression of disease. In: Clinical Oral Investigations, Bd. 28, 289

Abstract

Objective

To investigate the capability of periodontal grading to estimate the progression of periodontal disease and the responsiveness to therapy.

Materials and methods

Eighty-four patients who underwent non-surgical therapy (NST) were included. Direct and indirect evidence of progression were determined according to the current classification. Responsiveness to therapy was examined using mean pocket probing depths reduction (PPDRed), reduction of bleeding on probing (BOPRed), and the rate of pocket closure (%PC) after six months.

Results

Statistical analysis revealed no agreement between direct and indirect evidence in grading periodontitis (κ = 0.070). The actual rate of progression as determined by longitudinal data was underestimated in 13% (n = 11), overestimated in 51% (n = 43) and correctly estimated in 30% (n = 36) by indirect evidence. No significant differences in responsiveness to therapy were observed in patients graded according to direct evidence. Using indirect evidence, patients assigned grade C showed more PPDRed but less BOPRed and lower %PC compared to grade B.

Conclusion

The present data indicate that indirect evidence may lead to inaccuracies compared to direct evidence regarding the estimation of periodontal progression. However, indirect evidence seems to be more suitable in the estimation of responsiveness to therapy than direct evidence, helping to identify cases that are more likely to require additional therapies such as re-instrumentation or periodontal surgery.

Clinical relevance

Regarding the estimation of disease progression and responsiveness to periodontal therapy, accuracy and reliability of both direct and indirect evidence are limited when grading periodontitis.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Klinikum der LMU München > Poliklinik für Zahnerhaltung und Parodontologie
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1436-3771
• Sprache: Englisch