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Kim YR, Kim SR, Son M. Interrupted time series analysis of chronic periodontitis-related procedures before and after the scaling reimbursement policy in Korea. J Clin Periodontol 2024; 51:1188-1198. [PMID: 39128864 DOI: 10.1111/jcpe.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 08/13/2024]
Abstract
AIM To study the use of a quasi-experimental design to assess the effects of scaling reimbursement policies on the incidence of chronic-periodontitis procedures. MATERIALS AND METHODS Interrupted time series analysis was used to compare the effects before and after policy implementation using data on the number of periodontitis-related procedures from the Korean National Health Insurance Service-National Sample Cohort (n = 740,467) and the Health Screening Cohort (n = 337,904). Periodontitis-related procedures with diagnosis codes were categorized into basic (scaling or root planing), intermediate (subgingival curettage) and advanced (tooth extraction, periodontal flap surgery, bone grafting for alveolar bone defects or guided tissue regeneration). Subjects' demographics and comorbidities were considered. The incidence rate of immediate changes and gradual effects before and after policy implementation was assessed. RESULTS Following the policy implementation from July 2013, an immediate increase was observed in total and basic procedures. No significant changes were noted in intermediate and advanced procedures initially. A decrease in the slope of intermediate procedures was observed in both databases. Advanced procedures showed varied trends, with no change in the National Sample Cohort but an increase in the Health Screening Cohort, particularly among subjects with comorbidities. CONCLUSIONS Following the new policy implementation, the number of intermediate procedures decreased while the number of advanced procedures increased, especially among patients with comorbidities. These findings offer valuable insights on policy evaluation.
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Affiliation(s)
- Yu-Rin Kim
- Department of Dental Hygiene, Silla University, Busan, Republic of Korea
| | - Seon-Rye Kim
- Department of Healthcare Management, Youngsan University, Yangsan, Republic of Korea
| | - Minkook Son
- Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea
- Department of Data Sciences Convergence, Dong-A University Interdisciplinary Program, Busan, Republic of Korea
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de Carvalho-Buonocore HLCC, Moreira ARO, Costa MSV, Thomaz EBAF, Souza SDFC. Accuracy of clinical and radiographic recording protocols for diagnosing periodontitis. Oral Dis 2023; 29:2854-2864. [PMID: 35785457 DOI: 10.1111/odi.14299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/21/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the accuracy of periodontal examination at 6-sites full-mouth protocol with clinical and radiographic partial-mouth recording protocols (PRPs) to diagnose periodontitis considering new 2018 case definition. METHODS Periodontitis was diagnosed by full-mouth assessment of clinical attachment level (CAL) at 6-sites (n = 8529) according to 2018 case definition (standard reference). Three clinical and radiographic PRPs were considered: (i) 4 interproximal sites of all teeth (4-sites, full-mouth); (ii) 6-sites on Community Periodontal Index of Treatment Needs (CPITN) teeth (6-sites, CPITN teeth); (iii) 4-sites on CPITN teeth (4-sites, CPITN teeth); (iv) radiographic examination on interproximal sites of all teeth (rM-D, full-mouth); and (v) radiographic examination on interproximal sites of CPITN teeth (rM-D, CPITN teeth) using Image J®. Sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV), accuracy, and Κappa (k) were estimated (α = 0.05). RESULTS The 4-sites, full-mouth protocol showed 100% sensitivity and NPV, 79.87% PPV, low specificity (38.32%), 69.30% accuracy, and poor agreement (k = 0.468). 6-sites and 4-sites CPITN teeth protocols showed 100% PPV and specificity, sensitivity and NPV of >60%, accuracy of >80%, and good agreement (k > 0.65). All clinical PRPs outperformed radiographic protocols. CONCLUSION Clinical PRPs using index teeth are highly accurate in diagnosing periodontitis considering 2018 case definition.
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Park JH, Lee H, Kim JW, Song TJ. Association between periodontal disease status and risk of atrial fibrillation: a nationwide population-based cohort study. BMC Oral Health 2023; 23:461. [PMID: 37420240 PMCID: PMC10329345 DOI: 10.1186/s12903-023-03165-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Periodontal disease can activate an immune process linked to systemic diseases, including atrial fibrillation. However, the relationship between periodontal disease and atrial fibrillation remains unclear. AIM This study aimed to investigate whether changes in periodontal disease status are associated with the risk of atrial fibrillation. METHODS Using the National Health Insurance Database Korea, participants who underwent the first oral health examination in 2003 and a second examination in 2005-2006 without a history of atrial fibrillation were included. Participants were grouped according to changes in periodontal disease status during two oral examinations: periodontal disease-free, periodontal disease-recovered, periodontal disease-developed, and periodontal disease-chronic. The outcome was the incidence of atrial fibrillation. RESULTS The study included 1,254,515 participants, with a median follow-up of 14.3 years and 25,402 (2.02%) cases of atrial fibrillation occurred. During follow-up, the risk of atrial fibrillation was highest in the periodontal disease-chronic group, followed by the periodontal disease-developed, periodontal disease-recovered, and periodontal disease-free groups (p for trend < 0.001). Moreover, recovery from periodontal disease was associated with a reduced risk of atrial fibrillation compared to a chronic periodontal disease status (Hazard ratio: 0.97, 95% Confidence interval: 0.94-0.99, p = 0.045). The development of periodontal disease was associated with an increased risk of atrial fibrillation compared to being periodontal disease-free (Hazard ratio: 1.04, 95% Confidence interval: 1.01-1.08, p = 0.035). CONCLUSION Our findings suggest that changes in periodontal disease status impact the risk of atrial fibrillation. Management of periodontal disease may help prevent atrial fibrillation.
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Affiliation(s)
- Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Anyangcheon-Ro 1071, Yangcheon-Gu, Seoul, 07985 Republic of Korea
| | - Hyungwoo Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804 Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Anyangcheon-Ro 1071, Yangcheon-Gu, Seoul, 07985 Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804 Republic of Korea
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Yuan Y, Liu Q, Yang S, He W. Four-Dimensional Superimposition Techniques to Compose Dental Dynamic Virtual Patients: A Systematic Review. J Funct Biomater 2023; 14:jfb14010033. [PMID: 36662080 PMCID: PMC9861356 DOI: 10.3390/jfb14010033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Four-dimensional virtual patient is a simulation model integrating multiple dynamic data. This study aimed to review the techniques in virtual four-dimensional dental patients. Searches up to November 2022 were performed using the PubMed, Web of Science, and Cochrane Library databases. The studies included were based on the superimposition of two or more digital information types involving at least one dynamic technique. Methodological assessment of the risk of bias was performed according to the Joanna Briggs Institute Critical Appraisal Checklist. Methods, programs, information, registration techniques, applications, outcomes, and limitations of the virtual patients were analyzed. Twenty-seven full texts were reviewed, including 17 case reports, 10 non-randomized controlled experimental studies, 75 patients, and 3 phantoms. Few studies showed a low risk of bias. Dynamic data included real-time jaw motion, simulated jaw position, and dynamic facial information. Three to five types of information were integrated to create virtual patients based on diverse superimposition methods. Thirteen studies showed acceptable dynamic techniques/models/registration accuracy, whereas 14 studies only introduced the feasibility. The superimposition of stomatognathic data from different information collection devices is feasible for creating dynamic virtual patients. Further studies should focus on analyzing the accuracy of four-dimensional virtual patients and developing a comprehensive system.
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Affiliation(s)
- Ying Yuan
- Department of Orthodontics, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - Qian Liu
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - Shuo Yang
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
- Correspondence: (S.Y.); (W.H.); Tel.: +86-15-92033-2690 (S.Y.); +86-15-52109-6103 (W.H.)
| | - Wulin He
- Department of Orthodontics, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
- Correspondence: (S.Y.); (W.H.); Tel.: +86-15-92033-2690 (S.Y.); +86-15-52109-6103 (W.H.)
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Alnomay N, Alolayan L, Aljohani R, Almashouf R, Alharbi G. Association between periodontitis and COVID-19 severity in a tertiary hospital: A retrospective cohort study. Saudi Dent J 2022; 34:623-628. [PMID: 35915835 PMCID: PMC9327183 DOI: 10.1016/j.sdentj.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/22/2022] [Accepted: 07/24/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Periodontitis is a chronic inflammatory disease caused by biofilm accumulation resulting in loss of periodontal attachment which could be linked to systemic implications. Coronavirus disease of 2019 (COVID-19) is a disease caused by SARS-CoV-2 that triggers damage to the lungs and other organs. COVID-19 and periodontitis share similar risk factors such as smoking, obesity, old age, and diabetes mellitus. Studies noted that periodontitis along with some systemic diseases has increased mortality. Thus, this study aims to examine the association of periodontitis with COVID-19 outcomes. Methods This observational study included periodontitis group and non-periodontitis group for COVID-19 outcome assessment. Inclusion criteria were applied to select adults (≥18 years old) who showed at least one dental visit, and were isolated or admitted due to a COVID-19 complication (i.e. in-ward, ICU, or death). Exclusion criteria were patients with no active dental records. The periodontal status was examined from posterior bitewings and panoramic radiographs. The primary outcome assessed was COVID-19 complications versus no admission. Results and discussion This study was the first of its kind as a retrospective cohort study to assess the association between periodontitis and COVID-19 severity in Riyadh, Saudi Arabia. Our findings revealed that periodontitis is statistically associated with COVID-19 severity. Periodontitis patients were three times more likely to have COVID-19 complications (p = 0.025). Diabetes (p = 0.004) and hypertension (p = 0.016) patients were 3.5 times more likely to have COVID-19 complications. Conclusion Understanding the potential association between periodontitis and COVID-19 through systemic inflammation might be a pathway to achieve high quality medical care.
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Affiliation(s)
- Nora Alnomay
- Dental Center, Central Region, King Abdulaziz Medical City, Saudi Arabia.,College Of Dentistry, King Saud Bin Abdulaziz University for Health Sciences/King Abdullah International Medical Research Center, Ministry Of National Guard, Riyadh, Saudi Arabia
| | - Layan Alolayan
- College Of Dentistry, King Saud Bin Abdulaziz University For Health Sciences/King Abdullah International Medical Research Center, Ministry Of National Guard, Riyadh, Saudi Arabia
| | - Raghad Aljohani
- College Of Dentistry, King Saud Bin Abdulaziz University For Health Sciences/King Abdullah International Medical Research Center, Ministry Of National Guard, Riyadh, Saudi Arabia
| | - Razan Almashouf
- College Of Dentistry, King Saud Bin Abdulaziz University For Health Sciences/King Abdullah International Medical Research Center, Ministry Of National Guard, Riyadh, Saudi Arabia
| | - Gharam Alharbi
- College Of Dentistry, Qassim University, Qassim, Saudi Arabia
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Li A, Vermaire JH, Chen Y, van der Sluis LWM, Thomas RZ, Tjakkes GHE, Schuller AA. Trends in socioeconomic inequality of periodontal health status among Dutch adults: a repeated cross-sectional analysis over two decades. BMC Oral Health 2021; 21:346. [PMID: 34266415 PMCID: PMC8284001 DOI: 10.1186/s12903-021-01713-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 07/03/2021] [Indexed: 01/25/2023] Open
Abstract
Background Studies exclusively focusing on trends in socioeconomic inequality of oral health status in industrialized countries are relatively sparse. This study aimed to assess possible differences in oral hygiene and periodontal status among people of different socioeconomic status (SES) in the Netherlands over two decades.
Methods A repeated cross-sectional analysis of 3083 participants aged 25–54 years was conducted on the Dutch National Oral Health Surveys of 1995, 2002, 2007, and 2013. Plaque-free was defined according to the Simplified Oral Hygiene Index (OHI-S = 0). Periodontal status was classified in two different ways, either periodontal health/disease (probing pocket depth index [PDI] = 0/ ≥ 1) or with/without deep pockets (PDI = 2). We used the regression-based absolute and relative effect index to measure the absolute and relative socioeconomic inequalities. Multivariable logistic regressions were used to explore temporal trends in oral hygiene and periodontal status by low- and high-SES groups. Results Age-standardized percentages of individuals with plaque-free increased in the whole population from 1995 to 2013 (12.7% [95% CI 10.5–14.9] to 28.1% [24.8–31.5]). Plaque-free showed significant socioeconomic differences in absolute and relative inequalities in 2007 and 2013. Between 1995 and 2013, age-standardized percentage of periodontal health increased (from 51.4% [48.1–54.7] to 60.6% [57.0–64.1]). The significant absolute inequalities for periodontal health were seen in 2002 and 2013. The relative scale presented a similar pattern. Regarding deep pockets, there was little difference in the age-standardized overall prevalence in 1995 versus 2013 (from 6.5% [4.9–8.2] to 5.4% [3.7–7.0]). The significant absolute and relative inequalities in deep pockets prevalence were found in 1995. Yet, all interaction terms between survey year and SES did not reach significance (plaque-free: P = .198; periodontal health: P = .490; deep pockets: P = .678). Conclusions Socioeconomic inequalities in oral hygiene and periodontal status were present in the Netherlands in the last two decades.
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Affiliation(s)
- An Li
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
| | - Jan Hendrik Vermaire
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.,Department of Child Health, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Yuntao Chen
- Medical Statistics and Decision Making, Department of Epidemiology, UMCG, University of Groningen, Groningen, The Netherlands
| | - Luc W M van der Sluis
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Renske Z Thomas
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.,Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Geerten-Has E Tjakkes
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Annemarie A Schuller
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.,Department of Child Health, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
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Li A, Thomas RZ, van der Sluis L, Tjakkes G, Slot DE. Definitions used for a healthy periodontium-A systematic review. Int J Dent Hyg 2020; 18:327-343. [PMID: 32330350 PMCID: PMC7687205 DOI: 10.1111/idh.12438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/07/2020] [Accepted: 04/20/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the explicitness and variability of the definition of periodontal health in the current scientific literature. MATERIAL AND METHODS The authors conducted a systematic literature review using PubMed and CENTRAL (2013-01/2019-05) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the guidelines of the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. RESULTS A total of 51 papers met the predefined inclusion criteria. Of these, 13 papers did not report any explicit definitions of periodontal health. Out of the 38 remaining articles, half of them used a reference to support their definition and half of them not. The studies published in periodontics-related journals or those that scored a low risk of bias for the methodical quality presented more explicit and valid definitions. Probing pocket depth was the most frequently used individual parameter for defining periodontal health. However, there were substantial variations in the methods of measurement and cut-off values. CONCLUSIONS Given the diversity of periodontal health definitions, a cross-study comparison is difficult. The results of this review may be useful in making others aware of the significance of standardizing the definition of a healthy periodontium.
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Affiliation(s)
- An Li
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
| | - Renske Z. Thomas
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
- Department of DentistryRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Luc van der Sluis
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
| | - Geerten‐Has Tjakkes
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
| | - Dagmar Else Slot
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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