Diagnostic performance of the AAP/EFP classification and the CDC/AAP case definition among pregnant women and a practical screening tool for maternal periodontal diseases

• Published in: Journal of periodontal research Vol. 57; no. 5; pp. 960 - 968
• Main Authors: Li, Hui‐Jun, Zhao, Dan, Xu, Xiaoyi, Yu, Rong, Zhang, Feng, Cheng, Tianfan, Zheng, Zheng, Yang, Hong, Yang, Chuanzhong, Yao, Jilong, Wen, Ping, Jin, Lijian
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.10.2022
• Subjects: assessment; case definitions; Centers for Disease Control and Prevention, U.S; Classification; Diabetes mellitus; Diagnosis, Oral; Female; Gum disease; Humans; Periodontal diseases; Periodontal Diseases - diagnosis; periodontal status; Periodontitis; Periodontitis - diagnosis; Pregnancy; Pregnant Women; screening; Statistical analysis; United States; Womens health; United States; assessment; case definitions; screening; pregnant women; periodontal status
• ISSN: 0022-3484; 1600-0765; 1600-0765
• DOI: 10.1111/jre.13032

Background and Objective There is a limited number of studies on the performance assessment of the 2017 AAP/EFP classification and the CDC/AAP case definition among pregnant females. This study evaluated the agreement between these two systems and explored a practical tool for screening maternal periodontal diseases by general dentists. Materials and Methods Totally, 204 systemically healthy females at different phases of pregnancy underwent a full‐mouth periodontal examination. Demographic characteristics, lifestyles, and systemic conditions were recorded. Referring to the CDC/AAP definition, the diagnostic performance of the AAP/EFP classification was evaluated by the area under the ROC curve (AUC) and statistical tests (e.g., Youden's index and kappa coefficient). Additionally, a modified scoring system of the FDI Periodontal Diseases Chairside Guide (FDI‐CG) was formulated with the addition of pregnancy for testing accordingly. Results Overall, there were 22.1% of the participants in early phase of pregnancy (7–13 weeks) and 77.9% in late phase (34–36 weeks). The majority of them were below 35 years and non‐smokers without gestational diabetes. Notably, 30.9% of subjects presented with Moderate/Severe periodontitis (CDC/AAP), and 35.8% with Stages II‐IV periodontitis (AAP/EFP). Referring to the CDC/AAP definition, the AUC, Youden's index, and κ of the AAP/EFP classification were 0.979, 0.890, and 92.9%, respectively. The modified FDI‐CG system improved the AUC (0.815), Youden's index (63.0%), and κ (0.544) with reference to the original one. Conclusions This study shows that the AAP/EFP classification is in high agreement with the CDC/AAP definition among the pregnant women. The phases of pregnancy‐integrated FDI scoring system may serve as a convenient screening tool for maternal periodontal diseases in general dental practice.