Gopalakrishnan Dharmarajan, Miller Preston Dallas, Levine Robert A, Sidharthan Sangamithra, Mahuli Amit Vasant, Saleh Muhammad H A, Miller Whitney, Buranawat Borvornwut
Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India.
Division of Periodontics, Medical University of South Carolina, Charleston, South Carolina.
J Indian Soc Periodontol. 2024 Jan-Feb;28(1):75-78. doi: 10.4103/jisp.jisp_542_23. Epub 2024 Jun 4.
A 10-year survival analysis was performed to assess the predictive validity of the periodontal risk score (formerly known as Miller-McEntire Periodontal Prognostic Index [MMPPI]) to predict long-term survival of periodontally diseased molars in a longitudinally assessed cohort.
The MMPPI scores were computed at baseline by summarizing scores allocated for individual factors. The cohort was treated, followed up, and placed under regular periodontal maintenance. Molar survival data collected up to 10 years of follow-up were analyzed. Cox proportional regression was performed, and hazards ratio (HR) were computed for each prognostic factor and the MMPPI score. To estimate the predictive value of MMPPI, a receiver operating curve (ROC) curve analysis was performed.
From 1032 molars, 155 molars were extracted over the 10-year follow-up duration. Cox proportional hazard analysis showed significant hazard ratios for tooth loss for the component variables significant HR was noted for age: 4.92 (3.34:7.27), smoking: 1.74 (1.38-2.22), diabetes: 1.66 (1.49-1.86), molar type: 1.39 (1.15-1.67), probing depth: 2.00 (1.63-2.46), furcation: 2.64 (2.30-3.03), mobility: 3.45 (2.98-4.01), and total MMPPI score: 1.98 (1.85-2.12). ROC curve analysis showed an area under the curve value of 0.94 for the MMPPI index as a predictor of molar loss at 8 years, and the Youden index was maximized at the optimal cutoff point score of 7.
All component scores of MMPPI showed significant hazard ratios at 10 years. These findings support the previous results from the 5-year analysis of this university-based cohort and warrant validation in independent cohorts.
进行了一项10年生存分析，以评估牙周风险评分（以前称为米勒 - 麦肯蒂尔牙周预后指数[MMPPI]）在纵向评估队列中预测牙周病磨牙长期生存的预测有效性。
在基线时通过汇总为各个因素分配的分数来计算MMPPI分数。对该队列进行治疗、随访，并进行定期牙周维护。分析了长达10年随访期收集的磨牙生存数据。进行了Cox比例回归分析，并计算了每个预后因素和MMPPI分数的风险比（HR）。为了评估MMPPI的预测价值，进行了受试者工作特征曲线（ROC）分析。
在10年的随访期内，从1032颗磨牙中拔除了155颗。Cox比例风险分析显示，各组成变量的牙齿脱落风险比均有统计学意义，年龄的风险比显著：4.92（3.34：7.27），吸烟：1.74（1.38 - 2.22），糖尿病：1.66（1.49 - 1.86），磨牙类型：1.39（1.15 - 1.67），探诊深度：2.00（1.63 - 2.46），根分叉病变：2.64（2.30 - 3.03），牙齿松动度：3.45（2.98 - 4.01），以及MMPPI总分：1.98（1.85 - 2.12）。ROC曲线分析显示，MMPPI指数作为8年磨牙丧失预测指标的曲线下面积值为0.94，约登指数在最佳截断点分数为7时达到最大值。
MMPPI的所有组成分数在10年时均显示出显著的风险比。这些发现支持了此前对该大学队列进行的5年分析结果，值得在独立队列中进行验证。
