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BMC Oral Health
Published in: BMC Oral Health 1/2010

Open Access 01-12-2010 | Correspondence

Methodological issues in epidemiological studies of periodontitis - how can it be improved?

Authors: Roos Leroy, Kenneth A Eaton, Amir Savage

Published in: BMC Oral Health | Issue 1/2010

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Abstract

Background

This position paper was commissioned by the European Association of Dental Public Health, which has established six working groups to investigate the current status of six topics related to oral public health. One of these areas is epidemiology of periodontal diseases.

Methods

Two theses "A systematic review of definitions of periodontitis and the methods that have been used to identify periodontitis" [1] and "Factors affecting community oral health care needs and provision" [2] formed the starting point for this position paper. Additional relevant and more recent publications were retrieved through a MEDLINE search.

Results

The literature reveals a distinct lack of consensus and uniformity in the definition of periodontitis within epidemiological studies. There are also numerous differences in the methods used. The consequence is that data from studies using differing case definitions and differing survey methods are not easily interpretable or comparable. The limitations of the widely used Community Periodontal Index of Treatment Need (CPITN) and its more recent derivatives are widely recognized. Against this background, this position paper reviews the current evidence base, outlines existing problems and suggests how epidemiology of periodontal diseases may be improved.

Conclusions

The remit of this working group was to review and discuss the existing evidence base of epidemiology of periodontal diseases and to identify future areas of work to further enhance it.
Literature
1.
Savage A: A Systematic Review of Definitions of Periodontitis and Methods that have been used to identify this Disease. 2007, University of London
2.
Eaton KA: Factors affecting community oral health care needs and provision. 2002, Eastman Dental Institute for Oral Health - University of London
3.
Macaulay WR, Taylor GO, Lennon MA, Worthington HV, Clerehugh V: The suitability of three periodontal indices for epidemiological studies conducted for planning purposes. Community Dent Health. 1988, 5: 113-119.PubMed
4.
5.
Borrell LN, Papapanou PN: Analytical epidemiology of periodontitis. J Clin Periodontol. 2005, 32 (Suppl 6): 132-158. 10.1111/j.1600-051X.2005.00799.x.CrossRefPubMed
6.
Savage A, Eaton KA, Moles DR, Needleman I: A systematic review of definitions of periodontitis and the methods that have been used to identify this disease. J Clin Periodontol. 2009, 36: 458-467. 10.1111/j.1600-051X.2009.01408.x.CrossRefPubMed
7.
Preshaw PM: Definitions of periodontal disease in research. J Clin Periodontol. 2009, 36: 1-2. 10.1111/j.1600-051X.2008.01320.x.CrossRefPubMed
8.
Machtei EE, Christersson LA, Grossi SG, Dunford R, Zambon JJ, Genco RJ: Clinical criteria for the definition of "established periodontitis". J Periodontol. 1992, 63: 206-214.CrossRefPubMed
9.
Locker D, Leake JL: Inequities in health: dental insurance coverage and use of dental services among older Ontario adults. Can J Public Health. 1993, 84: 139-140.PubMed
10.
Beck JD, Loe H: Epidemiological principles in studying periodontal diseases. Periodontol 2000. 1993, 2: 34-45. 10.1111/j.1600-0757.1993.tb00218.x.CrossRefPubMed
11.
Chen X, Wolff L, Aeppli D, Guo Z, Luan W, Baelum V: Cigarette smoking, salivary/gingival crevicular fluid cotinine and periodontal status. A 10-year longitudinal study. J Clin Periodontol. 2001, 28: 331-339. 10.1034/j.1600-051x.2001.028004331.x.CrossRefPubMed
12.
Burt B: Position paper: epidemiology of periodontal diseases. J Periodontol. 2005, 76: 1406-1419. 10.1902/jop.2005.76.8.1406.CrossRefPubMed
13.
Page RC, Eke PI: Case definitions for use in population-based surveillance of periodontitis. J Periodontol. 2007, 78: 1387-1399. 10.1902/jop.2007.060264.CrossRefPubMed
14.
Tonetti MS, Claffey N: Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European Workshop in Periodontology. J Clin Periodontol. 2005, 32 (Suppl 6): 210-213. 10.1111/j.1600-051X.2005.00822.x.CrossRefPubMed
15.
Newman HN: Attrition, eruption, and the periodontium. J Dent Res. 1999, 78: 730-734. 10.1177/00220345990780030401.CrossRefPubMed
16.
Peng TK, Yao JH, Shih KS, Dong YJ, Chen CK, Pai L: Assessment of periodontal disease in an adult population survey in Taipei city using CPITN and GPM/T indices. Chung-Hua Ya i Hsueh Hui Tsa Chih [Chinese Dental Journal]. 1990, 9: 67-74.
17.
Agerholm DM, Ashley FP: Clinical assessment of periodontitis in young adults--evaluation of probing depth and partial recording methods. Community Dent Oral Epidemiol. 1996, 24: 56-61. 10.1111/j.1600-0528.1996.tb00814.x.CrossRefPubMed
18.
Anagnou-Vareltzides A, Diamanti-Kipioti A, Afentoulidis N, Moraitaki-Tsami A, Lindhe J, Mitsis F: A clinical survey of periodontal conditions in Greece. J Clin Periodontol. 1996, 23: 758-763. 10.1111/j.1600-051X.1996.tb00606.x.CrossRefPubMed
19.
Laurell L, Romao C, Hugoson A: Longitudinal study on the distribution of proximal sites showing significant bone loss. J Clin Periodontol. 2003, 30: 346-352. 10.1034/j.1600-051X.2003.00298.x.CrossRefPubMed
20.
Carlos JP, Wolfe MD, Kingman A: The extent and severity index: a simple method for use in epidemiologic studies of periodontal disease. J Clin Periodontol. 1986, 13: 500-505. 10.1111/j.1600-051X.1986.tb01497.x.CrossRefPubMed
21.
Eaton KA, Duffy S, Griffiths GS, Gilthorpe MS, Johnson NW: The influence of partial and full-mouth recordings on estimates of prevalence and extent of lifetime cumulative attachment loss: a study in a population of young male military recruits. J Periodontol. 2001, 72: 140-145. 10.1902/jop.2001.72.2.140.CrossRefPubMed
22.
Susin C, Valle P, Oppermann RV, Haugejorden O, Albandar JM: Occurrence and risk indicators of increased probing depth in an adult Brazilian population. J Clin Periodontol. 2005, 32: 123-129. 10.1111/j.1600-051X.2005.00637.x.CrossRefPubMed
23.
Chuang SK, Tian L, Wei LJ, Dodson TB: Predicting dental implant survival by use of the marginal approach of the semi-parametric survival methods for clustered observations. J Dent Res . 2002, 81: 851-855. 10.1177/154405910208101211.CrossRefPubMed
24.
Daly B, Watt RG, Batchelor P, Treasure ET: Essential dental public health. 2002, Oxford University Press
25.
26.
WHO: Oral health surveys: Basic methods. 1987, Geneva, World Health Organisation, 3
27.
Croxson LJ: A simplified periodontal screening examination: the Community Periodontal Index of Treatment Needs (WHO) in general practice. Int Dent J. 1984, 34: 28-34.PubMed
28.
Ainamo J, Tervonen T, Nordblad A, Kallio P: Use of CPITN cross-tabulations--a research perspective. Int Dent J. 1987, 37: 173-178.PubMed
29.
Cutress TW, Ainamo J, Sardo-Infirri J: The community periodontal index of treatment needs (CPITN) procedure for population groups and individuals. Int Dent J. 1987, 37: 222-233.PubMed
30.
Benigeri M, Brodeur JM, Payette M, Charbonneau A, Ismail AI: Community periodontal index of treatment needs and prevalence of periodontal conditions. J Clin Periodontol. 2000, 27: 308-312. 10.1034/j.1600-051x.2000.027005308.x.CrossRefPubMed
31.
Lewis JM, Morgan MV, Wright FA: The validity of the CPITN scoring and presentation method for measuring periodontal conditions. J Clin Periodontol. 1994, 21: 1-6. 10.1111/j.1600-051X.1994.tb00268.x.CrossRefPubMed
32.
Grytten J, Holst D, Gjermo P: Validity of CPITN's hierarchical scoring method for describing the prevalence of periodontal conditions. Community Dent Oral Epidemiol. 1989, 17: 300-303. 10.1111/j.1600-0528.1989.tb00641.x.CrossRefPubMed
33.
Takahashi Y, Kamijyo H, Kawanishi S, Takaesu Y: Presence and absence of bleeding in association with calculus in segments given Code 2 in the Community Periodontal Index of Treatment Needs (CPITN). Community Dent Oral Epidemiol. 1988, 16: 109-111. 10.1111/j.1600-0528.1988.tb01854.x.CrossRefPubMed
34.
Holmgren CJ, Corbet EF: Relationship between periodontal parameters and CPITN scores. Community Dent Oral Epidemiol. 1990, 18: 322-323. 10.1111/j.1600-0528.1990.tb00090.x.CrossRefPubMed
35.
Baelum V, Fejerskov O, Manji F: Periodontal diseases in adult Kenyans. J Clin Periodontol. 1988, 15: 445-452. 10.1111/j.1600-051X.1988.tb01599.x.CrossRefPubMed
36.
Gera I: Periodontal treatment needs in Central and Eastern Europe. J Int Acad Periodontol. 2000, 2: 120-128.PubMed
37.
Schurch E, Minder CE, Lang NP, Geering AH: Comparison of clinical periodontal parameters with the Community Periodontal Index for Treatment Needs (CPITN) data. Schweiz Monatsschr Zahnmed. 1990, 100: 408-411.PubMed
38.
Baelum V, Manji F, Wanzala P, Fejerskov O: Relationship between CPITN and periodontal attachment loss findings in an adult population. J Clin Periodontol. 1995, 22: 146-152.CrossRefPubMed
39.
Croxson LJ, Purdell-Lewis D: Periodontal health: CPITN as a promotional strategy. Int Dent J. 1994, 44: 571-576.PubMed
40.
Salkin LM, Cuder R, Rush R: A look at the PSR impact on one dental practice. J Am Dent Assoc. 1993, 124: 230-231.PubMed
41.
Charles CJ, Charles AH: Periodontal screening and recording. J Calif Dent Assoc. 1994, 22: 43-46.PubMed
42.
Eaton KA, Woodman AJ: Evaluation of simple periodontal screening technique currently used in the UK armed forces. Community Dent Oral Epidemiol. 1989, 17: 190-195. 10.1111/j.1600-0528.1989.tb00609.x.CrossRefPubMed
43.
Albandar JM, Brunelle JA, Kingman A: Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. J Periodontol. 1999, 70: 13-29. 10.1902/jop.1999.70.1.13.CrossRefPubMed
44.
Kingman A, Albandar JM: Methodological aspects of epidemiological studies of periodontal diseases. Periodontol 2000. 2002, 29: 11-30. 10.1034/j.1600-0757.2002.290102.x.CrossRefPubMed
45.
Caton J: Periodontal diagnosis and diagnostic aids. Proceedings of the World Workshop in Clinical Periodontics. 1989, 1.1-1.22.
46.
Keagle JG, Garnick JJ, Searle JR, King GE, Morse PK: Gingival resistance to probing forces. I. Determination of optimal probe diameter. J Periodontol. 1989, 60: 167-171.CrossRefPubMed
47.
Atassi F, Newman HN, Bulman JS: Probe tine diameter and probing depth. J Clin Periodontol. 1992, 19: 301-304. 10.1111/j.1600-051X.1992.tb00648.x.CrossRefPubMed
48.
Mombelli A, Muhle T, Frigg R: Depth-force patterns of periodontal probing. Attachment-gain in relation to probing force. J Clin Periodontol. 1992, 19: 295-300. 10.1111/j.1600-051X.1992.tb00647.x.CrossRefPubMed
49.
Larsen C, Barendregt DS, Slot DE, Van d V, Van der WF: Probing pressure, a highly undervalued unit of measure in periodontal probing: a systematic review on its effect on probing pocket depth. J Clin Periodontol. 2009, 36: 315-322. 10.1111/j.1600-051X.2009.01383.x.CrossRefPubMed
50.
Watts TL: Probing site configuration in patients with untreated periodontitis. A study of horizontal positional error. J Clin Periodontol. 1989, 16: 529-533. 10.1111/j.1600-051X.1989.tb02331.x.CrossRefPubMed
51.
Van der ZE, Davies EH, Newman HN: Marking width, calibration from tip and tine diameter of periodontal probes. J Clin Periodontol. 1991, 18: 516-520. 10.1111/j.1600-051X.1991.tb00083.x.CrossRef
52.
Pihlstrom BL: Measurement of attachment level in clinical trials: probing methods. J Periodontol. 1992, 63: 1072-1077.CrossRefPubMed
53.
Breen HJ, Rogers PA, Lawless HC, Austin JS, Johnson NW: Important differences in clinical data from third, second, and first generation periodontal probes. J Periodontol. 1997, 68: 335-345.CrossRefPubMed
54.
Lindhe J, Okamoto H, Yoneyama T, Haffajee A, Socransky SS: Periodontal loser sites in untreated adult subjects. J Clin Periodontol. 1989, 16: 671-678. 10.1111/j.1600-051X.1989.tb01038.x.CrossRefPubMed
55.
Ismail AI, Morrison EC, Burt BA, Caffesse RG, Kavanagh MT: Natural history of periodontal disease in adults: findings from the Tecumseh Periodontal Disease Study, 1959-87. J Dent Res. 1990, 69: 430-435.CrossRefPubMed
56.
Perry DA, Taggart EJ, Leung A, Newburn E: Comparison of a conventional probe with electronic and manual pressure-regulated probes. J Periodontol. 1994, 65: 908-913.CrossRefPubMed
57.
Tupta-Veselicky L, Famili P, Ceravolo FJ, Zullo T: A clinical study of an electronic constant force periodontal probe. J Periodontol. 1994, 65: 616-622.CrossRefPubMed
58.
Silva-Boghossian CM, Amaral CS, Maia LC, Luiz RR, Colombo AP: Manual and electronic probing of the periodontal attachment level in untreated periodontitis: a systematic review. J Dent. 2008, 36: 651-657. 10.1016/j.jdent.2008.04.015.CrossRefPubMed
59.
Magnusson I, Fuller WW, Heins PJ, Rau CF, Gibbs CH, Marks RG: Correlation between electronic and visual readings of pocket depths with a newly developed constant force probe. J Clin Periodontol. 1988, 15: 180-184. 10.1111/j.1600-051X.1988.tb01566.x.CrossRefPubMed
60.
Osborn J, Stoltenberg J, Huso B, Aeppli D, Pihlstrom B: Comparison of measurement variability using a standard and constant force periodontal probe. J Periodontol. 1990, 61: 497-503.CrossRefPubMed
61.
Cohen J: A coefficient of agreement for nominal scales. Education and Psychological Measurement. 1960, 20: 37-46. 10.1177/001316446002000104.CrossRef
62.
Allen F, Steele J: Data Validity and Quality. Statistical and Methodological Aspects of Oral Health Research. Edited by: Lesaffre E, Feine J, Leroux BG, Declerck D. 2009, 1
63.
Lesaffre E, Mwalili SM, Declerck D: Analysis of caries experience taking inter-observer bias and variability into account. J Dent Res. 2004, 83: 951-955. 10.1177/154405910408301212.CrossRefPubMed
Metadata
Title
Methodological issues in epidemiological studies of periodontitis - how can it be improved?
Authors
Roos Leroy
Kenneth A Eaton
Amir Savage
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2010
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/1472-6831-10-8

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