Gold Standards in Periodontics: A Review
PDF

Keywords

Clinical attachment loss
gold standard
periodontal debridement
periodontics

Abstract

The field of dentistry has evolved where people expect the best oral health care from specialists. Periodontics is that specialty of dentistry which deals with prevention, diagnosis, and treatment of diseases of the supporting tissues of the teeth. Almost half of the world's population is suffering from periodontal diseases. Periodontitis is the sixth most common chronic diseases in the world and along with dental caries, the most common cause of tooth loss. Through the effort of various professional organisations and research, various reliable products and treatment modalities have been developed. A gold standard is a benchmark which has been thoroughly tested and has reputation as a reliable modality. Some of established gold standards in periodontics include: periodontal probing, measurement of clinical attachment loss, bone loss, cone beam computed tomography, quantitative polymerase chain reaction tests, biopsies as investigative techniques; periodontal debridement, subepithelial connective tissue graft for recession coverage, lasers, autogenous bone in alveolar ridge augmentation prior to oral implantation, dental implant as reconstruction of missing dentition, and chlorhexidine mouth wash as treatment options. The objective of the review is to provide critical evaluation of the data available from existing studies in Periodontics which can help identify potential research areas to explore.

PDF

References

American Academy of Periodontology (AAP). Glossary of periodontal terms [internet]. 4th ed. Chicago: AAP; 2001. Available from: https://www.perio.org/sites/default/files/files/PDFs/Clinical%20Resources/GlossaryOfPeriodontalTerms2001Edition.pdf

Socransky SS, Haffajee AD. The bacterial aetiology of destructive periodontal disease: Current concepts. J Periodontol. 1992;63(4 Suppl):322-31.

Albandar JM, Rams TE. Global epidemiology, of periodontal diseases: an overview, Periodontol 2000. 2002;29:7-10.

Versi E. "Gold standard" is an appropriate term. Br Med J. 1992;305(6846):187.

Saah AJ, Hoover DR. "Sensitivity" and "specificity" reconsidered: the meaning of these terms in analytical and diagnostic settings. Ann Intern Med. 1997 Jan 1;126(1):91-4.

Soviero V, Leal S, Silva R, Azevedo R. Validity of microct for in vitro detection of proximal carious lesions in primary molars. J Dent. 2012;40(1):35-40.

Moore C, Bai Y, Hariri A, Sanchez JB, Lin CY, Koka S, et al. Photoacoustic imaging for monitoring periodontal health: A first human study. Photoacoustics. 2018 Nov 1;12:67-74.

Dowsett SA, Eckert GJ, Kowolik MJ. The applicability of half-mouth examination to periodontal disease assessment in untreated adult populations. J Periodontol. 2002;73(9):975-81.

Wang CJ, McCauley LK. Osteoporosis and periodontitis. Curr Osteoporos Rep. 2016 Dec;14(6):284-91.

Gupta N, Rath S, Lohra P. Comparative evaluation of accuracy of periodontal probing depth and attachment levels using a Florida probe versus traditional probes. Med J Armed Forces India. 2015 Oct;71(4):352-8.

Moore C, Bai Y, Hariri A, Sanchez JB, Lin C-Y, Koka S, et al. Photoacoustic imaging for monitoring periodontal health: A first human study. Photoacoustics. 2018;12:67-74.

Molander B, Ahlqwist M, Gröndahl HG. Panoramic and restrictive intraoral radiography in comprehensive oral radiographic diagnosis. Eur J Oral Sci. 1995;103(4):191-8.

Banodkar AB, Gaikwad RP, Gunjikar TU, Lobo TA. Evaluation of accuracy of cone beam computed tomography for measurement of periodontal defects: A clinical study. J Indian Soc Periodontol. 2015;19(3):285-9.

D'Ercole S, Catamo G, Piccolomini R. Diagnosis in periodontology: A further aid through microbiological tests. Crit Rev Microbiol. 2008;34(1):33-41.

Devanoorkar A, Guttiganur N, Dwarakanath C, Savitha A. Biopsy the gold standard in the final diagnosis of solitary gingival enlargements: Case reports and an overview. Int J Oral Health Sci. 2013;3(1):65-9.

Berezow AB, Darveau RP. Microbial shift and periodontitis. Periodontol 2000. 2011;55(1):36-47.

Drisko CL. Periodontal debridement: Still the treatment of choice. J Evid Based Dent Pract. 2014;14:33-41.

Ghezzi C, Ferrantino L, Donghi C, Vaghi S, Viganò V, Costa D, et al. Clinical audit of minimally invasive nonsurgical techniques in active periodontal therapy. J Contemp Dent Pract. 2020;21(4):431-7.

Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent. 2017; 3(1):23-39.

Ripamonti U, Heliotis M, Ferretti C. Bone morphogenetic proteins and the induction of bone formation: From laboratory to patients. Oral Maxillofac Surg Clin North Am. 2007 Nov 1;19(4):575-89.

Caffesse RG, Echeverría JJ. Treatment trends in periodontics. Periodontol 2000. 2019;79(1):7-14.

Chambrone L, de Castro Pinto RCN, Chambrone LA. The concepts of evidence-based periodontal plastic surgery: Application of the principles of evidence-based dentistry for the treatment of recession-type defects. Periodontol 2000. 2019;79(1):81-106.

Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes–systematic review. J Clin Periodontol. 2013;40:S181-S94.

Zangrando MS, Valle LA, Stuani V, Costa MR, Shibuy SK, Damante CA. Clinical outcomes of root coverage with subepithelial connective tissue graft according to site specific factors - Longitudinal retrospective clinical study. J Int Acad Periodontol. 2019;21(4):159-67.

Pini Prato GP, Chambrone L. Orthodontic treatment in periodontal patients: The use of periodontal gold standards to overcome the "grey zone". J Periodontol. 2020 Apr;91(4):437-41.

Grzech-Leśniak K. Making use of lasers in periodontal treatment: A new gold standard? Photomed Laser Surg. 2017 Oct;35(10):513-4.

Suárez-López Del Amo F, Yu SH, Wang HL. Non-surgical therapy for peri-implant diseases: A systematic review. J Oral Maxillofac Res. 2016 Sep 9;7(3):e13.

Jones CG. Chlorhexidine: is it still the gold standard? Periodontol 2000. 1997;15:55-62.

Cardoso JR, Pereira LM, Iversen MD, Ramos AL. What is gold standard and what is ground truth? Dental Press J Orthod. 2014;19(5):27-30.

Russell A. A system of classification and scoring for prevalence surveys of periodontal disease. J Dent Res. 1956;35(3):350-9.

Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-51.

Ramfjord SP. The periodontal disease index (PDI). J Periodontol. 1967 Nov-Dec;38(6):Suppl:602-10.

Miller PD, Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985;5(2):8-13.

Miller SC. Textbook of periodontia. Philadelphia: Blakiston Co,1950:91.

Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza's clinical periodontology 11th ed: Elsevier health sciences; 2011.

Löe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol. 1965;36(3):177-87.

Theilade E, Wright W, Jensen SB, Löe H. Experimental gingivitis in man: II. A longitudinal clinical and bacteriological investigation. J Periodontol Res. 1966;1(1):1-13.

Löe H, Anerud A, Boysen H, Morrison E. Natural history of periodontal disease in man: rapid, moderate and no loss of attachment in sri lankan laborers 14 to 46 years of age. J Clin Periodontol. 1986;13(5):431-40.

Socransky SS, Haffajee AD. The bacterial aetiology of destructive periodontal disease: current concepts. J Periodontol. 1992;63:322-31.

Socransky S, Haffajee A, Cugini M, Smith C, Kent Jr R. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25(2):134-44.

Donlan RM, Costerton JW. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002;15(2):167-93.

Page RC, Offenbacher S, Schroeder HE, Seymour GJ, Kornman KS. Advances in the pathogenesis of periodontitis: summary of developments, clinical implications, and future directions. Periodontol 2000. 1997;14(1):216-48.

Seo BM, Miura M, Gronthos S, Bartold PM, Batouli S, Brahim J, et al. Investigation of multipotent postnatal stem cells from human periodontal ligament. Lancet. 2004;364(9429):149-55.

Klein BA, Tenorio EL, Lazinski DW, Camilli A, Duncan MJ, Hu LT. Identification of essential genes of the periodontal pathogen porphyromonas gingivalis. BMC Genomics. 2012;13(1):578-94.

Branemark PI. Tissue-integrated prostheses. Quint. 1985:99-115.

Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4(1):1-6.

Caton JG, Armitage G, Berglundh T, Chapple IL, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Periodontol. 2018;89:S1-S8.

Demmer RT, Behle JH, Wolf DL, Handfield M, Kebschull M, Celenti R, et al. Transcriptomes in healthy and diseased gingival tissues. J Periodontol. 2008;79(11):2112-24.

Shah EB, MoDi BB, Shah MA, Dave DH. Patient centered outcomes in periodontal treatment - An evidenced based approach. J Clin Diag Res: JCDR. 2017;11(4):ZE05-ze7.

Jones DS, Podolsky SH. The history and fate of the gold standard. The Lancet. 2015;385(9977):1502-3.