Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, National Center of Stomatology, National Clinical Research Center of Oral Diseases, Shanghai key Laboratory of Stomatology, Shanghai, China.
J Clin Periodontol. 2021 Aug;48(8):1037-1050. doi: 10.1111/jcpe.13484. Epub 2021 Jun 1.
To clinically validate a self-reported questionnaire for periodontal disease and assess its accuracy for differentiating periodontal health and different stages of periodontitis.
A Chinese (Cantonese) version of a self-reported questionnaire was prepared by translating and validating the original English questions proposed by the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). The utility of the CDC/AAP questionnaire and its individual questions was assessed against a full-mouth periodontal examination. Periodontal case definition was based on the 2017 World Workshop classification of periodontal diseases. Multivariable logistic regression and the area under the receiver operating characteristic curve (AUROC) analysis were performed to assess the accuracy of the questionnaire.
408 subjects enrolled in this study, including those with periodontal health (16.2%), gingivitis (15.2%), Stages I/II periodontitis (31.8%) and Stages III/IV periodontitis (36.8%). Overall, the questionnaire had poor accuracy in detecting the presence of Stages I/II periodontitis with an AUROC 0.608. While it showed moderate to high accuracy for identifying periodontal disease (gingivitis and periodontitis), periodontitis and Stages III/IV periodontitis with an AUROC of 0.837, 0.803 and 0.870, respectively. Self-reported measures in combination with age and tobacco smoking showed excellent performance for identifying Stages III/IV periodontitis with a high AUROC of 0.953, a sensitivity of 95.7%, and a specificity of 89.0%. Specific questions and combinations provided greater utility to discriminate the various periodontal case definitions.
The self-reported CDC/AAP questionnaire may be a feasible tool for detecting periodontitis, and its combination with demographic and lifestyle factors is useful for the identification of individuals with Stages III/IV periodontitis. This questionnaire seems less helpful in screening of Stages I/II periodontitis. Further studies are needed to test the validity in larger community-based populations.
临床验证一种自我报告的牙周病问卷，并评估其区分牙周健康和不同阶段牙周炎的准确性。
通过翻译和验证疾病控制与预防中心/美国牙周病学会（CDC/AAP）提出的原始英文问题，准备了一份中文（粤语）版本的自我报告问卷。根据 2017 年牙周病世界工作会议分类，使用全口牙周检查评估 CDC/AAP 问卷及其各项问题的效用。牙周病的病例定义基于 2017 年牙周病世界工作会议的分类。采用多变量逻辑回归和受试者工作特征曲线（ROC）下面积（AUROC）分析评估问卷的准确性。
本研究共纳入 408 例受试者，包括牙周健康（16.2%）、牙龈炎（15.2%）、牙周炎 I/II 期（31.8%）和牙周炎 III/IV 期（36.8%）。总体而言，问卷在检测牙周炎 I/II 期的准确性较差，AUROC 为 0.608。而对于识别牙周病（牙龈炎和牙周炎）、牙周炎和牙周炎 III/IV 期，问卷具有中等至高的准确性，AUROC 分别为 0.837、0.803 和 0.870。自我报告的测量值结合年龄和吸烟状况，对识别牙周炎 III/IV 期具有极好的性能，AUROC 为 0.953，灵敏度为 95.7%，特异性为 89.0%。特定的问题和组合提供了更好的辨别各种牙周病病例定义的能力。
自我报告的 CDC/AAP 问卷可能是一种检测牙周炎的可行工具，与人口统计学和生活方式因素相结合，有助于识别牙周炎 III/IV 期患者。该问卷在筛查牙周炎 I/II 期时效果较差。需要进一步的研究来测试其在更大的基于社区的人群中的有效性。
