Natural progression of periodontal diseases in Chinese villagers based on the 2018 classification

Abstract

Background Based on the 2018 classification, we aimed to determine the prevalence, distribution, and progression of periodontitis in the rural Chinese population without access to dental care. Methods In all, 404 subjects (28.7 ± 8.9 years, M:F = 182:222) were randomly enrolled in 1992 and re‐called in 1996. With the new classification, the prevalence and distribution of stage, grade, and extent were characterized. Stage progression was compared with the progression of clinical attachment loss (CAL) and radiographic bone loss (RBL). Results At baseline, 94.1% villagers suffered from periodontitis, of whom 53.7% were in Stage III/IV. The prevalence of Stage III/IV increased from 18.2% in the age group of 15 to 24 years to 60.9% in 25 to 34‐year‐old group and 88.7% in the 35 to 44‐year‐old group. Significantly more Stage III/IV, generalized, and Grade C periodontitis were found in male villagers than female villagers. In 1996, the prevalence rate of periodontitis increased to 98.5%, with 80.0% in Stage III/IV. Further, 84.2% villagers presented with Grade C periodontitis based on longitudinal ΔCAL. The rate of progression (≥1 site with ΔCAL ≥3 mm) was 63.7%. Stage progression correlated significantly with CAL and RBL progression in Stage I/II, but this association was not found in Stage III/IV. Among subjects with disease progression in Stage III/IV, 90.4% shifted from localized to generalized cases. Furthermore, ceiling effects were observed in Stage III/IV. Conclusions In villagers without access to dental care, 94.1% suffered from periodontitis, with more than half having Stage III/IV disease based on the 2018 classification. The majority cases presented with rapid periodontal progression. Although stage progression correlated significantly with CAL and RBL progression in Stage I/II, ceiling effects existed in Stage III/IV.

Oral Health Status in Patients with Head and Neck Cancer before Radiotherapy: Baseline Description of an Observational Prospective Study

“…Studies adopting the criteria proposed by the 2017 classification are very few [36][37][38], and our present work is the first to use them in a cohort of patients with HNC. Studies that have attempted to investigate a possible correlation between periodontitis and HNC are extremely diverse and often methodologically weak, as highlighted by a recent review [39].…”

Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification

“…When the maximum PD value was added when determining complexity, the distribution of periodontitis stages changed dramatically (Table 3). Only a few epidemiological studies have used the new classification [12,[24][25][26][27][28]. However, the epidemiological surveys did not clearly explain how complexity was used to determine periodontitis staging.…”

Periodontitis in Ischemic Stroke Patients: Case Definition Challenges of the New Classification Scheme (2018)

“…Both the 2012 CDC/AAP and the 2018 EFP/AAP case definition systems use a combination of parameters-clinical attachment loss (CAL) and probing depth (PD)-to define periodontitis, but the threshold values and their combinations are different. This can result in significant differences in periodontitis identification and prevalence values, creating confusion surrounding the associative relationships with risk factors or general diseases, thus hindering the direct comparison between studies [42].…”