模拟临床附着丧失的变化以分类牙周疾病进展。
Modelling changes in clinical attachment loss to classify periodontal disease progression.
作者信息
Teles Ricardo, Benecha Habtamu K, Preisser John S, Moss Kevin, Starr Jacqueline R, Corby Patricia, Genco Robert, Garcia Nathalia, Giannobile William V, Jared Heather, Torresyap Gay, Salazar Elida, Moya Julie, Howard Cynthia, Schifferle Robert, Falkner Karen L, Gillespie Jane, Dixon Debra, Cugini MaryAnn
机构信息
Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA.
出版信息
J Clin Periodontol. 2016 May;43(5):426-34. doi: 10.1111/jcpe.12539. Epub 2016 Apr 6.
AIM
The goal of this study was to identify progressing periodontal sites by applying linear mixed models (LMM) to longitudinal measurements of clinical attachment loss (CAL).
METHODS
Ninety-three periodontally healthy and 236 periodontitis subjects had their CAL measured bi-monthly for 12 months. The proportions of sites demonstrating increases in CAL from baseline above specified thresholds were calculated for each visit. The proportions of sites reversing from the progressing state were also computed. LMM were fitted for each tooth site and the predicted CAL levels used to categorize sites regarding progression or regression. The threshold for progression was established based on the model-estimated error in predictions.
RESULTS
Over 12 months, 21.2%, 2.8% and 0.3% of sites progressed, according to thresholds of 1, 2 and 3 mm of CAL increase. However, on average, 42.0%, 64.4% and 77.7% of progressing sites for the different thresholds reversed in subsequent visits. Conversely, 97.1%, 76.9% and 23.1% of sites classified as progressing using LMM had observed CAL increases above 1, 2 and 3 mm after 12 months, whereas mean rates of reversal were 10.6%, 30.2% and 53.0% respectively.
CONCLUSION
LMM accounted for several sources of error in longitudinal CAL measurement, providing an improved method for classifying progressing sites.
目的
本研究的目的是通过将线性混合模型（LMM）应用于临床附着丧失（CAL）的纵向测量来识别进展性牙周部位。
方法
93名牙周健康受试者和236名牙周炎受试者每两个月测量一次CAL，共测量12个月。计算每次访视时CAL从基线增加超过指定阈值的部位比例。还计算了从进展状态逆转的部位比例。对每个牙位拟合LMM，并使用预测的CAL水平对部位的进展或消退进行分类。根据模型估计的预测误差确定进展阈值。
结果
在12个月内，根据CAL增加1、2和3mm的阈值，分别有21.2%、2.8%和0.3%的部位出现进展。然而，平均而言，不同阈值下进展部位在后续访视中分别有42.0%、64.4%和77.7%发生逆转。相反，使用LMM分类为进展的部位在12个月后观察到CAL增加超过1、2和3mm的比例分别为97.1%、76.9%和23.1%，而平均逆转率分别为10.6%、30.2%和53.0%。
结论
LMM考虑了纵向CAL测量中的多种误差来源，为进展部位的分类提供了一种改进方法。
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