Optimal Examination Sites for Periodontal Disease Evaluation: Applying the Item Response Theory Graded Response Model

Abstract

Periodontal examination data have a complex structure. For epidemiological studies, mass screenings, and public health use, a simple index that represents the periodontal condition is necessary. Periodontal indices for partial examination of selected teeth have been developed. However, the selected teeth vary between indices, and a justification for the selection of examination teeth has not been presented. We applied a graded response model based on the item response theory to select optimal examination teeth and sites that represent periodontal conditions. Data were obtained from 254 patients who participated in a multicenter follow-up study. Baseline data were obtained from initial follow-up. Optimal examination sites were selected using item information calculated by graded response modeling. Twelve sites—maxillary 2nd premolar (palatal-medial), 1st premolar (palatal-distal), canine (palatal-medial), lateral incisor (palatal-central), central incisor (palatal-distal) and mandibular 1st premolar (lingual, medial)—were selected. Mean values for clinical attachment level, probing pocket depth, and bleeding on probing by full mouth examinations were used for objective variables. Measuring the clinical parameters of these sites can predict the results of full mouth examination. For calculating the periodontal index by partial oral examination, a justification for the selection of examination sites is essential. This study presents an evidence-based partial examination methodology and its modeling.

Accuracy of Estimating Periodontitis and Its Risk Association Using Partial-Mouth Recordings for Surveillance Studies: A Systematic Review and Meta-Analysis

“…Future Directions. Some of the recent studies [42,43], despite the fact that they were excluded due to the deficiency of their clinical data, have used promising approaches for the assessment of optimal PRP selection and the optimal case definitions. e optimal selection of PRPs was tested using the item response theory model, where they aimed to select a PRP that examines the least number of sites while retaining the highest accuracy compared to an FRP [43].…”

“…Some of the recent studies [42,43], despite the fact that they were excluded due to the deficiency of their clinical data, have used promising approaches for the assessment of optimal PRP selection and the optimal case definitions. e optimal selection of PRPs was tested using the item response theory model, where they aimed to select a PRP that examines the least number of sites while retaining the highest accuracy compared to an FRP [43]. is study suggests using a PRP with only 12 sites, which is one of the PRPs with the least number of sites while still providing high accuracy; however, further testing of this approach and its feasibility is recommended.…”

Comparative oral health outcomes before and after periodontitis treatment: Scaling and root planning alone versus Nd: YAG Laser Assisted New Attachment Procedure.

“…The described benefits of LANAP include better access to the root surfaces, predictable hemostasis, and widened patient acceptance (without conventional surgical flaps and sutures) [17,18]. The objectively determinable variables for a correct diagnosis and evaluation of periodontal conditions are represented by plaque index (VPI), bleeding on probing (BOP), periodontal probing depth (PPD), and clinical attachment level (CAL), or bone level (BL) [19].…”