title: Validation of an algorithm for chronic periodontitis risk assessment and prognostication: analysis of an inflammatory reactivity test and selected risk predictors.
abstract: BACKGROUND
  Patients with severe forms of chronic periodontitis present with varying degrees of decreased inflammatory reactivity. A previously reported algorithm for chronic periodontitis risk assessment and prognostication is based on the analysis of some 20 risk predictors. One of these predictors is a skin provocation test that assesses the individual patient's reactivity to a lipid A challenge. The aim of this report was to analyze results from validation data for the algorithm with respect to the contribution of results of the skin provocation test as a risk predictor for the progression of chronic periodontitis and to compare these results with the contribution from other predictors, namely smoking, angular bony destruction, furcation involvement, abutment teeth, and endodontic pathology.
  
  
  METHODS
  Data from a previously reported clinical validation sample were used for the analysis, including the calculation of quality measures and explanatory values using different types of regression analysis and non-parametric testing.
  
  
  RESULTS
  Smoking, endodontic pathology, abutment teeth, angular bony destruction, and furcation involvement presented with individual explanatory values for periodontitis progression between 4% and 13% and highly significant parameter estimates. Explanatory values for the results of the skin provocation test ranged between 2.6% and 5.1% depending on the disease severity group, with a positive predictive value of 82% for the identification of high-risk patients.
  
  
  CONCLUSIONS
  The skin provocation test provided a clinically significant contribution to the quality of analysis with the periodontitis risk and prognostication algorithm, in particular in the selection of high-risk patients for in-depth individual tooth analysis.
authors.affiliation: DentoSystem Scandinavia AB, S-114 40 Stockholm, Sweden. sven.lindskog@dentosystem.se
authors.forename: Sven
authors.initials: S
authors.lastname: Lindskog
authors.forename: Johan
authors.initials: J
authors.lastname: Blomlöf
authors.forename: Inger
authors.initials: I
authors.lastname: Persson
authors.forename: Anders
authors.initials: A
authors.lastname: Niklason
authors.forename: Anders
authors.initials: A
authors.lastname: Hedin
authors.forename: Leif
authors.initials: L
authors.lastname: Ericsson
authors.forename: Mats
authors.initials: M
authors.lastname: Ericsson
authors.forename: Bo
authors.initials: B
authors.lastname: Järncrantz
authors.forename: Ulf
authors.initials: U
authors.lastname: Palo
authors.forename: Georg
authors.initials: G
authors.lastname: Tellefsen
authors.forename: Olle
authors.initials: O
authors.lastname: Zetterström
authors.forename: Leif
authors.initials: L
authors.lastname: Blomlöf
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D055113:Chronic Periodontitis / Q000276:immunology*; D000044:Dental Abutments; D003788:Dental Pulp Diseases / Q000473:pathology; D003793:Dental Restoration, Permanent; D018450:Disease Progression; D005260:Female; D017823:Furcation Defects / Q000000981:diagnostic imaging; D006801:Humans; D008050:Lipid A / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011859:Radiography; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods; D012882:Skin Tests; D012907:Smoking; D018709:Statistics, Nonparametric
chemical_list: D008050:Lipid A