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

Abstract

The identification of the associative relationships between ischemic stroke (IS) and risk factors such as advanced age and periodontitis is essential to design real screening protocols and to address them using primary and secondary preventive policies. This study primarily aimed to evaluate the diagnostic performance of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) case definition in detecting periodontitis against the 2012 Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) case definition in a group of IS patients. Secondarily, we report the periodontal status of IS patients and the associative relationship with respect to some risk factors. Patients with their first IS were assessed based on demographic data, medical, oral risk factors and periodontal parameters. The two case definitions were applied to identify the periodontitis burden. The agreement between the two case definition systems, as well as the misclassification ratio, were calculated. A total of 141 patients were included. According to the 2012 CDC/AAP and the 2018 EFP/AAP case definitions, a frequency of periodontitis of 98.5% and 97.8% based on two modalities of inclusion of cases in the severity groups, sensitivity values of 98.54% or 100%, and specificity values of 25% or 14.7% were calculated. Thus, the new case definition system has a higher capacity to detect periodontitis, especially the well-established forms.

Insights into the Relationship between Periodontitis and Systemic Sclerosis Based on the New Periodontitis Classification (2018): A Cross-Sectional Study

“…This trend of reclassifying patients has already been reported by our team, with a misclassification rate of 23.41% ( n = 33) found among a group of stroke patients [ 7 ]. In the present study, higher rates of misclassification of periodontal conditions were identified, namely, 39.6% ( n = 21) for the SSc group and 31.1% ( n = 33) for the controls.…”

“…Periodontitis is a chronic infectious inflammatory disease of the tooth-supporting apparatus frequently reported in the general population [ 4 ], as well as in some systemically affected groups [ 5 , 6 , 7 , 8 ]. Periodontitis has been epidemiologically associated with various chronic diseases, such as cardiovascular diseases, type 2 diabetes mellitus, certain cancers, inflammatory bowel disease, and rheumatoid arthritis.…”

The Treatment of Severe Periodontitis Using a Local Antiseptic Desiccant and Subgingival Mechanical Instrumentation: A Pilot Study

“…The investigators were previously calibrated at the initiation of another study [ 31 ]. At the initiation of the present study, the investigators received written instructions on the study protocol and participated in two training meetings coordinated by a senior periodontist (D.R.).…”

Association between skull bone mineral density and periodontitis: Using the National Health and Nutrition Examination Survey (2011–2014)

“…However, the cause of CAL is not specifically described in the NHANES periodontitis database. Therefore, analysis of NHANES data using the 2018 EFP/AAP classification of periodontal diseases may increase the prevalence of periodontitis [50,51]. CAL and periodontal PD were used in the 2012 AAP/ CDC periodontitis case definition, minimizing the potential erroneous effect of periodontal recession on the accuracy of probing depth measurements [47].…”