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Eficácia de uma nova estratégia de screening periodontal
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Abstract(s)
Objetivos: Analisar o desempenho diagnóstico da nova metodologia de rastreio periodontal que combina dados auto-reportados sobre saúde periodontal com a perda óssea periodontal radiográfica (R-PBL), com a finalidade de identificar indivíduos com doença periodontal.
Materiais e Métodos: O estudo teve como população alvo doentes que estavam a realizar a sua primeira consulta de triagem na Clínica Dentária Egas Moniz (CDEM). Os critérios de inclusão estabelecidos foram os seguintes: pacientes a realizar a primeira consulta de triagem na CDEM com dezoito ou mais anos, não edêntulos e que consintam em participar. O estudo passa pela execução do diagnóstico periodontal com o método RPBL e avaliação periodontal completa sendo este o atual gold standard.
Resultados: Foram incluídos um total de 100 participantes no estudo, distribuídos equitativamente entre casos de periodontite e casos controlos, com uma idade média de 49 anos. O modelo baseado na perda óssea periodontal radiográfica demonstrou o melhor desempenho preditivo tanto para a periodontite (AUC: 0,833) como para a periodontite severa (AUC: 0,796), apresentando os valores mais elevados de precisão e benefício
líquido ao longo dos diferentes limiares. O modelo Either revelou um desempenho semelhante, particularmente ao nível da sensibilidade, enquanto os modelos baseados apenas em auto-reporte (SR) e na combinação dos dois (both) apresentaram desempenhos inferiores. A análise da curva de decisão confirmou a superior utilidade clínica dos modelos R-PBL e Either na orientação da tomada da decisão.
Conclusão: A conjugação de dados auto-reportados com a análise da perda óssea periodontal radiográfica (R-PBL) revelou um desempenho satisfatório enquanto estratégia de rastreio da periodontite. Esta abordagem complementar poderá constituir uma alternativa viável para identificação de indivíduos elevado risco de desenvolver a doença, especialmente em contextos nos quais a realização de um exame clínico exaustivo
se encontre limitada ou inviável.
Aim: To analyze the diagnostic performance of the new periodontal screening approach that combines periodontal self-report and radiographic periodontal bone loss (R-PBL) for the identification of individuals affected by periodontal disease. Material & Methods: The study targeted patients attending their first appointment at Egas Moniz Dental Clinic (CDEM). The inclusion criteria were the following: patients attending their first consultation at CDEM, aged eighteen years or older, not edentulous, and consent to participate. The study involves performing periodontal diagnosis using the R-PBL method and conducting a complete periodontal evaluation, which is considered the current gold standard. Results: A total of 100 participants were included in the study, equally distributed between periodontitis cases and control subjects, with a mean age of 49 years. The model based on radiographic periodontal bone loss demonstrated the highest predictive performance for both periodontitis (AUC: 0.833) and severe periodontitis (AUC: 0.796), showing the greatest precision and net benefic across varying threshold. The Either model exhibited comparable performance, particularly in terms of sensitivity, while the model based solely on self-report (SR) and the combined approach (both) showed inferior results. Decision curve analysis confirmed the superior clinical utility of the R-PBL and Either model in guiding decision-making. Conclusion: The integration of self-reported data with radiographic bone loss analysis demonstrated satisfactory performance as a periodontitis screening strategy. This complementary approach may constitute a viable alternative for identifying individuals at risk of developing periodontal disease, particularly in contexts where conducting a full clinical examination is limited or unfeasible.
Aim: To analyze the diagnostic performance of the new periodontal screening approach that combines periodontal self-report and radiographic periodontal bone loss (R-PBL) for the identification of individuals affected by periodontal disease. Material & Methods: The study targeted patients attending their first appointment at Egas Moniz Dental Clinic (CDEM). The inclusion criteria were the following: patients attending their first consultation at CDEM, aged eighteen years or older, not edentulous, and consent to participate. The study involves performing periodontal diagnosis using the R-PBL method and conducting a complete periodontal evaluation, which is considered the current gold standard. Results: A total of 100 participants were included in the study, equally distributed between periodontitis cases and control subjects, with a mean age of 49 years. The model based on radiographic periodontal bone loss demonstrated the highest predictive performance for both periodontitis (AUC: 0.833) and severe periodontitis (AUC: 0.796), showing the greatest precision and net benefic across varying threshold. The Either model exhibited comparable performance, particularly in terms of sensitivity, while the model based solely on self-report (SR) and the combined approach (both) showed inferior results. Decision curve analysis confirmed the superior clinical utility of the R-PBL and Either model in guiding decision-making. Conclusion: The integration of self-reported data with radiographic bone loss analysis demonstrated satisfactory performance as a periodontitis screening strategy. This complementary approach may constitute a viable alternative for identifying individuals at risk of developing periodontal disease, particularly in contexts where conducting a full clinical examination is limited or unfeasible.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Doença periodontal Diagnóstico periodontal Periodontal screening Radiographic based periodontal bone loss