J Periodontal Implant Sci.  2017 Oct;47(5):328-338. 10.5051/jpis.2017.47.5.328.

Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions

• Park SY
• Ahn S
• Lee JT
• Yun PY
• Lee YJ
• Lee JY
• Song YW
• Chang YS
• Lee HJ

• KMID: 2392719
• DOI: http://doi.org/10.5051/jpis.2017.47.5.328

Abstract

PURPOSE
A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes.
METHODS
This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study.
RESULTS
PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P<0.01) and with periodontal indexes, such as BOP and the plaque index (PI) (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test). Porphyromonas gingivalis (P. gingivalis) expression and the presence of serum P. gingivalis antibodies were significant factors affecting PISA values in a simple linear regression analysis, together with periodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease.
CONCLUSIONS
PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.

Keyword

Dental plaque; Inflammation; Periodontal diseases; Periodontal index; Porphyromonas gingivalis

MeSH Terms

Antibodies
Chronic Periodontitis
Classification
Cohort Studies
Dental Plaque
Hemorrhage
Humans
Inflammation
Linear Models
Multivariate Analysis
Periodontal Diseases
Periodontal Index
Periodontal Pocket
Porphyromonas gingivalis
Prospective Studies
Smoke
Smoking
Spondylitis, Ankylosing
Antibodies
Smoke

Figure

• 

  Figure 1 Periodontal conditions according to the severity of periodontal disease (A-D). Box-plot diagrams showing BOP (%) and PI (%) according to the severity of periodontal disease; BOP and PI increased with disease severity (P=0.04 and P=0.10, respectively; 1-way ANOVA with the Bonferroni post hoc test; A and B). A histogram showing P. gingivalis DNA detection in periodontal patients; P. gingivalis DNA detection was more frequently observed in subjects with severe periodontal disease (P<0.01; χ2 test; C). A box-plot diagram showing that serum P. gingivalis antibody levels were also higher in patients with severe periodontal disease (P<0.01 and P<0.01, respectively; 1-way ANOVA with the Bonferroni post hoc test; D). BOP: bleeding on probing, PI: plaque index, ANOVA: analysis of variance, P. gingivalis: Porphyromonas gingivalis.

• 

  Figure 2 Correlation of PISA values with periodontal conditions (A-D). A box-plot diagram showing PISA levels in periodontal patients according to the severity of the diseases; PISA values significantly increased with increasing periodontal disease severity (Spearman correlation coefficient=0.52; P<0.01; A). Scatter plots showing correlations of PISA and BOP and of PISA and PI (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test; B and C). A box-plot diagram showing PISA values in subjects in P. gingivalis (+) or P. gingivalis (−) groups; the P. gingivalis (+) group showed significantly higher PISA values than the P. gingivalis (−) group (P<0.01, Student t-test; D). PISA: periodontal inflamed surface area, BOP: bleeding on probing, PI: plaque index, P. gingivalis: Porphyromonas gingivalis.

• 

  Figure 3 Graphs predicting PISA values according to the multivariate linear regression analysis. PISA values increased with PI and the quantity of current smoking (A). When the severity of periodontal disease was incorporated into the analysis, the PISA value also increased with increasing PI, but there was no difference between moderate and severe disease, although PISA values showed distinct values between mild disease and moderate or severe periodontitis (B). PISA: periodontal inflamed surface area, PI: plaque index.

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