Validity of Periodontal Disease Using European Classification of Periodontal Disease.

Objectives:

This study's objective is to determine the validity of the European classification of assessing cases of periodontal disease (Tonetti & Claffey, 2005).  We analyzed the validity of diagnosing periodontal disease by the European classification using alveolar bone height measurement as the gold standard. European classification was compared to the Centers for Disease Control/ American Association of Periodontology (CDC/AAP) classification (Page & Eke).

Methods:

We compared the European classification of periodontal disease, against the alveolar bone score, and the CDC/AAP definitions of periodontal diseases.  A survey of 1426 subjects in the Erie County Periodontal study was our source data (Grossi et al, 1995). We validated the findings using the sensitivity, specificity analysis, positive and negative predictive values, receiver operating curve (ROC) analysis, true positive, and true negative rates.

Results:

When the Severe European classification was compared to the severe alveolar bone score, the sensitivity was 83.9% and specificity was 88.5%, with a combined score of 172.4.  The best performance was the severe European classification versus the severe alveolar bone score.  For this combination, the ROC area was 0.870 (95% CI, 0.837-0.902).

When the severe European classification was compared to the CDC/AAP classification the sensitivity was 62.8% and a specificity of 98.7%, with a combined score of 161.5 was obtained. The best performance was the severe European classification versus the severe CDC/AAP classification.  For this combination, the ROC area was 0.830 (95% CI 0.803-0.857). 

Conclusions:

The severe category of the European classification of periodontal disease works well in predicting periodontal disease, using the severe alveolar bone score as the gold standard. The European classification also works well in predicting periodontal disease, when using the CDC/AAP classification as a reference.