title: Case Presentations Demonstrating Periodontal Treatment Variation: PEARL Network.
abstract: BACKGROUND
  Variation in periodontal terminology can affect the diagnosis and treatment plan as assessed by practicing general dentists in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. General dentists participating in the PEARL Network are highly screened, credentialed, and qualified and may not be representative of the general population of dentists.
  
  
  METHODS
  Ten randomized case presentations ranging from periodontal health to gingivitis, to mild, moderate, and severe periodontitis were randomly presented to respondents. Descriptive comparisons were made between these diagnosis groups in terms of the treatment recommendations following diagnosis.
  
  
  RESULTS
  PEARL practitioners assessing periodontal clinical scenarios were found to either over- or under-diagnose the case presentations, which affected treatment planning, while the remaining responses concurred with respect to the diagnosis. The predominant diagnosis was compared with that assigned by two practicing periodontists. There was variation in treatment based on the diagnosis for gingivitis and the lesser forms of periodontitis.
  
  
  CONCLUSIONS
  Data suggests that a lack of clarity of periodontal terminology affects both diagnosis and treatment planning, and terminology may be improved by having diagnosis codes, which could be used to assess treatment outcomes.
  
  
  CONCLUSIONS
  This article provides data to support best practice for the use of diagnosis coding and integration of dentistry with medicine using ICD-10 terminology.
authors.affiliation: Director, Practitioners Engaged in Applied Research and Learning (PEARL) Network, New York, New York.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Curro
authors.affiliation: Coordinator, PEARL Network, New York, New York; Clinical Assistant Professor, Dental Hygiene Programs, New York University College of Dentistry, New York, New York.
authors.forename: Ashley C
authors.initials: AC
authors.lastname: Grill
authors.affiliation: Senior Biostatistician, EMMES Corporation, Rockville, Maryland.
authors.forename: Abigail G
authors.initials: AG
authors.lastname: Matthews
authors.affiliation: Private Practitioner in Periodontics and PEARL Practitioner-Investigator, State College, Pennsylvania; Chief Science Officer, PreViser Corporation, Mount Vernon, Washington.
authors.forename: John
authors.initials: J
authors.lastname: Martin
authors.affiliation: Chair, Oral Health Policy and Epidemiology, Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine, Boston, Massachusetts.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kalenderian
authors.affiliation: Private Practitioner in Periodontics and Professor, Department of Basic Sciences and Craniofacial Biology, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, New York.
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Craig
authors.affiliation: Professor of Obstetrics and Gynecology, Environmental Medicine Director, Reproductive Biology Research Co-Director, New York University Interdisciplinary Program in Menopause Medicine, Medical Director, PEARL Network, New York, New York.
authors.forename: Frederick
authors.initials: F
authors.lastname: Naftolin
authors.affiliation: Professor, Tissue Engineering and Biophotonics, King's College London Dental Institute, Guy Hospital, London, England.
authors.forename: Van P
authors.initials: VP
authors.lastname: Thompson
mesh_terms: D003937:Diagnosis, Differential; D005792:General Practice, Dental; D006801:Humans; D038801:International Classification of Diseases; D010347:Patient Care Planning; D010510:Periodontal Diseases / Q000175:diagnosis* / Q000628:therapy*; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D009626:Terminology as Topic