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Validação de questionário de autorrelato de periodontite em pacientes com doença de Parkinson
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Objetivo: Avaliar a validade preditiva de um questionário de autorrelato de periodontite, previamente validado na população portuguesa, em pacientes com doença de Parkinson (DP), explorando igualmente a associação entre a condição neurológica e o estado de saúde oral.
Materiais e métodos: Este estudo preliminar observacional transversal decorreu entre janeiro e abril de 2026, nas Clínicas Dentárias Egas Moniz. Foi aplicado um questionário de 13 itens de autorrelato para a periodontite prévalidado para a população portuguesa, conduzida uma avaliação periodontal clínica completa e a gravidade da DP avaliada pela escala modificada de Hoehn e Yahr.
Resultados: Foram recrutados 36 pacientes com DP (14 mulheres, 22 homens), dos quais 83.3% apresentavam periodontite. A versão completa apresentou elevada sensibilidade (82.9% na amostra total e 96.2% na subanálise de casos leves-a-moderados), mas reduzida capacidade discriminativa (AUC de 0.5 em ambos), especificidade e valor preditivo negativo (ambos a 0.0%). A versão curta demonstrou melhor desempenho global, com maior capacidade discriminativa (AUC de 0.7 na amostra total e de 0.6 nos casos leves-a-moderados), embora tenha evidenciado menor sensibilidade na deteção de casos em estágios iniciais da DP (sensibilidade 61.5%), com melhor identificação de indivíduos sem periodontite (especificidade 60.0%). Entre os participantes com DP avançada (H&Y 2–5), 88% apresentaram periodontite moderada a severa, probabilidade 12 vezes superior de periodontite moderada a severa (OR = 12.83; IC 95%).
Conclusão: A versão completa revelou desempenho diagnóstico limitado, com marcada tendência para classificação de falsos positivos apesar da elevada sensibilidade, enquanto a versão curta apresentou melhor aplicabilidade clínica pela maior capacidade discriminativa e identificação de indivíduos sem periodontite, embora dependente da gravidade da DP. Verificou-se ainda uma associação significativa entre estágios avançados de DP e maior probabilidade de periodontite moderada a severa.
Objective: To assess the predictive validity of a self-reported periodontitis questionnaire, previously validated in the Portuguese population, in patients with Parkinson's disease (PD), while also exploring the association between the neurological condition and oral health status. Materials and methods: This preliminary, observational, cross-sectional study was carried out between January and April 2026 at the Egas Moniz Dental Clinics. A 13-item self-reported periodontitis questionnaire, pre-validated for the Portuguese population, was administered; a full clinical periodontal examination was conducted; and PD severity was assessed using the modified Hoehn and Yahr scale. Results: Thirty-six patients with PD (14 women, 22 men) were recruited, of whom 83.3% presented with periodontitis. The full version showed high sensitivity (82.9% in the total sample and 96.2% in the mild-to-moderate subanalysis) but low discriminative capacity (AUC of 0.5 in both), with specificity and negative predictive value both at 0.0%. The short version demonstrated better overall performance, with greater discriminative capacity (AUC of 0.7 in the total sample and 0.6 in mild-to-moderate cases), although it showed lower sensitivity in detecting cases in the early stages of PD (sensitivity 61.5%), with better identification of individuals without periodontitis (specificity 60.0%). Among participants with advanced PD (H&Y 2–5), 88% presented with moderate-tosevere periodontitis, a twelve-fold higher probability of moderate-to-severe periodontitis (OR = 12.83; 95% CI). Conclusion: The full version revealed limited diagnostic performance, with a marked tendency towards false-positive classification despite its high sensitivity, whereas the short version showed better clinical applicability owing to its greater discriminative capacity and identification of individuals without periodontitis, albeit dependent on PD severity. A significant association was also found between advanced stages of PD and a higher probability of moderate-to-severe periodontitis.
Objective: To assess the predictive validity of a self-reported periodontitis questionnaire, previously validated in the Portuguese population, in patients with Parkinson's disease (PD), while also exploring the association between the neurological condition and oral health status. Materials and methods: This preliminary, observational, cross-sectional study was carried out between January and April 2026 at the Egas Moniz Dental Clinics. A 13-item self-reported periodontitis questionnaire, pre-validated for the Portuguese population, was administered; a full clinical periodontal examination was conducted; and PD severity was assessed using the modified Hoehn and Yahr scale. Results: Thirty-six patients with PD (14 women, 22 men) were recruited, of whom 83.3% presented with periodontitis. The full version showed high sensitivity (82.9% in the total sample and 96.2% in the mild-to-moderate subanalysis) but low discriminative capacity (AUC of 0.5 in both), with specificity and negative predictive value both at 0.0%. The short version demonstrated better overall performance, with greater discriminative capacity (AUC of 0.7 in the total sample and 0.6 in mild-to-moderate cases), although it showed lower sensitivity in detecting cases in the early stages of PD (sensitivity 61.5%), with better identification of individuals without periodontitis (specificity 60.0%). Among participants with advanced PD (H&Y 2–5), 88% presented with moderate-tosevere periodontitis, a twelve-fold higher probability of moderate-to-severe periodontitis (OR = 12.83; 95% CI). Conclusion: The full version revealed limited diagnostic performance, with a marked tendency towards false-positive classification despite its high sensitivity, whereas the short version showed better clinical applicability owing to its greater discriminative capacity and identification of individuals without periodontitis, albeit dependent on PD severity. A significant association was also found between advanced stages of PD and a higher probability of moderate-to-severe periodontitis.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Questionários de autorrelato Periodontite Doença de Parkinson Medidas autorrelatadas