title: New attempts to modify periodontal risk assessment for generalized aggressive periodontitis: a retrospective study.
abstract: BACKGROUND
  Periodontal risk assessment (PRA) model was designed for risk evaluation of treated patients with periodontal disease. However, its use on generalized aggressive periodontitis (GAgP) had been scarcely reported. This study aims to investigate the association of original PRA/modified PRA (MPRA) and compliance of periodontal maintenance with long-term treatment outcomes of Chinese patients with GAgP.
  
  
  METHODS
  Eighty-eight patients from a GAgP cohort, who completed active periodontal treatment (APT) and accepted reevaluation 3 to 11 years (mean of 5.5 years) afterward, were enrolled. PRA was modified (three strategies involving replacement of bleeding on probing with bleeding index >2, counting sites with probing depth ≥6 mm and changing method of bone loss [BL] calculation) to classify patients into different risk groups based on data at the first recall after APT. PRA and three MPRA models were investigated regarding long-term association with tooth loss (TL) and alteration of bone level (∆BL).
  
  
  RESULTS
  Based on original PRA, 87 patients (98.8%) had a high-risk profile. According to three MPRA models, annual TL per patient values were greater in high-risk groups than in low-to-moderate risk groups (MPRA-1, 0.20 ± 0.33 versus 0.04 ± 0.14; MPRA-2, 0.18 ± 0.32 versus 0.05 ± 0.14; MPRA-3, 0.17 ± 0.32 versus 0.05 ± 0.15; P <0.05). By MPRA-1, irregular compliers with low-to-moderate risk profile had greater ∆BL (0.027 ± 0.031, indicating bone increment) than those with high risk (-0.012 ± 0.064, tendency for BL). For regular compliers, no significant differences of annual TL or ∆BL were found between risk groups.
  
  
  CONCLUSIONS
  MPRA models could be used for evaluating the long-term outcomes of Chinese patients with severe GAgP, especially irregular compliers. High-risk patients of MPRAs exhibited more TL and less bone fill than low-to-moderate risk ones.
authors.affiliation: Department of Periodontology, School and Hospital of Stomatology, Peking University, Beijing, China.
authors.forename: Da
authors.initials: D
authors.lastname: Lü
authors.forename: Huanxin
authors.initials: H
authors.lastname: Meng
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Ruifang
authors.initials: R
authors.lastname: Lu
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Chen
authors.forename: Xianghui
authors.initials: X
authors.lastname: Feng
authors.forename: Dong
authors.initials: D
authors.lastname: Shi
authors.forename: Yu
authors.initials: Y
authors.lastname: Tian
authors.forename: Xian'e
authors.initials: X
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D010520:Aggressive Periodontitis / Q000517:prevention & control*; D016301:Alveolar Bone Loss / Q000145:classification / Q000517:prevention & control; D002681:China; D015331:Cohort Studies; D003773:Dental Plaque / Q000517:prevention & control; D012534:Dental Scaling / Q000379:methods; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000517:prevention & control; D016300:Radiography, Bitewing / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016745:Root Planing / Q000379:methods; D016388:Tooth Loss / Q000145:classification / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult