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Performance of the 2017 AAP/EFP case definition compared with the CDC/AAP definition in population-based studies
Indexado
WoS WOS:000729136800001
Scopus SCOPUS_ID:85120900567
DOI 10.1002/JPER.21-0276
Año 2022
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Background Classification of the periodontal conditions is indispensable for epidemiological data in order to guide situational awareness and therapeutic strategies. The new classification of periodontal diseases and conditions introduced by the American Academy of Periodontology and the European Federation of Periodontology (AAP/EFP), however, has not yet been applied to population-based studies. The aim of the present study was to compare the prevalence of periodontitis between the AAP/EFP and the CDC/AAP classification system and to evaluate the accuracy of the new AAP/EFP classification system against the CDC/AAP case definition for population-based studies. Methods Epidemiological data from two cross-sectional studies were obtained. One of them was a population-based study on Chilean adults (1.456 individuals; 35-44 years; 65-74 years) and the other one a sample of adolescents (1.070 individuals; 15-19 years) from five countries; Argentina, Chile, Colombia, Ecuador, and Uruguay. All participants had undergone full-mouth periodontal examination by calibrated examiners. Epidemiological datasets were analyzed according to the AAP/EFP and the CDC/AAP case definitions. The accuracy of the AAP/EFP definition was examined by assessing the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating curve (ROC) using the CDC/AAP case definition as the reference standard. Results According to the AAP/EFP, the prevalence of periodontitis in adolescents was 75.6%. The majority of the adolescents were classified either as Stage I (39.2%) or Stage II (28.2%). By using the CDC/AAP classification the prevalence of periodontitis in adolescents was 27.2%. The most common form of periodontitis with the CDC/AAP classification was moderate periodontitis (15.3%) followed by mild periodontitis (11.4%). The AAP/EFP revealed high sensitivity in moderate (95.7%) and severe periodontitis (100%) as well as a moderate (75%) to high specificity (92%) in moderate and severe periodontitis, respectively. The PPV was 41.6% in moderate and 5.7% in severe periodontitis whereas the NPV was high in both categories (moderate = 99%; severe = 100%). The AUC was 0.91 (95% CI = 0.89-0.93). In adults, the prevalence of periodontitis was 99% according to the AAP/EFP. The majority of adults were classified as Stage IV (81.3%) whereas Stage III amounted to 12.8%. By using the CDC/AAP classification, the prevalence of periodontitis in adults was 88.3% and the most common form of periodontitis was moderate periodontitis (57.2%) followed by severe periodontitis (29.7%). In adults, the AAP/EFP revealed high sensitivity for moderate (99.7%) and severe periodontitis (100%), but low specificity for both categories (moderate = 6.8%; severe = 8.3%). The PPV was 88.7% in moderate and 31.7% in severe periodontitis. The NPV was high in both categories (moderate = 76.5%; severe = 100%). The AUC was 0.57 (95% CI = 0.53-0.62). Conclusions This study revealed a clear discrepancy in the prevalence of periodontitis between the AAP/EFP and the CDC/AAP classification when using epidemiological data. The 2017 AAP/EFP classification system performs well when compared to the CDC/AAP case definition in identifying adolescents with periodontitis. The AAP/EFP system seems less accurate in adults with high prevalence of periodontitis.

Revista



Revista ISSN
Journal Of Periodontology 0022-3492

Métricas Externas



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Disciplinas de Investigación



WOS
Dentistry, Oral Surgery & Medicine
Scopus
Periodontics
SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 MORALES-CHVETS, ALICIA ALVAROVNA Mujer Universidad de Chile - Chile
2 Strauss, Franz-Josef Hombre Universidad de Chile - Chile
UNIV ZURICH - Suiza
Med Univ Vienna - Austria
Universität Zürich - Suiza
Medizinische Universitat Wien - Austria
3 Haemmerle, Christoph H. F. Hombre UNIV ZURICH - Suiza
3 Hämmerle, Christoph H.F. Hombre Universität Zürich - Suiza
4 Romandini, Mario Hombre UNIV COMPLUTENSE MADRID - España
Universidad Complutense de Madrid - España
5 PLAZA-FLORES, ANITA Hombre Universidad de Chile - Chile
6 Baeza, Mauricio Hombre Universidad de Chile - Chile
7 Sanz, Mariano Hombre UNIV COMPLUTENSE MADRID - España
Universidad Complutense de Madrid - España
8 GAMONAL-ARAVENA, JORGE ANTONIO Hombre Universidad de Chile - Chile

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Financiamiento



Fuente
Comisión Nacional de Investigación Científica y Tecnológica
Fondo de Fomento al Desarrollo Científico y Tecnológico
Federacion Iberopanamericana de Periodoncia
Santiago de Chile
Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT, Santiago de Chile, Chile)
Scientific and Technological Development Support Fund (FONDEF, Santiago de Chile, Chile), Chile project

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Agradecimientos



Agradecimiento
We thank the Universities and educational institutions for their support of this study. This research was supported by The Scientific and Technological Development Support Fund (FONDEF, Santiago de Chile, Chile), Chile project; ID18I10034. Franz Josef Strauss was supported by the Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT, Santiago de Chile, Chile). The authors thank the Federacion Iberopanamericana de Periodoncia (FIPP; multinational association, South America & Spain, Europe) and Colgate-Palmolive (New York, NY, USA). The authors have stated explicitly that there are no conflicts of interest in connection with this article. The funding bodies were not otherwise involved in the design of the study, nor the collection, analysis, or interpretation of data and writing of the manuscript.
We thank the Universities and educational institutions for their support of this study. This research was supported by The Scientific and Technological Development Support Fund (FONDEF, Santiago de Chile, Chile), Chile project; ID18I10034. Franz Josef Strauss was supported by the Comisión Nacional de Investigación Científica y Tecnológica (CONICYT, Santiago de Chile, Chile). The authors thank the Federación Iberopanamericana de Periodoncia (FIPP; multinational association, South America & Spain, Europe) and Colgate-Palmolive (New York, NY, USA). The authors have stated explicitly that there are no conflicts of interest in connection with this article. The funding bodies were not otherwise involved in the design of the study, nor the collection, analysis, or interpretation of data and writing of the manuscript.

Muestra la fuente de financiamiento declarada en la publicación.