EFFICACY OF CPITN SEXTANT SCORES FOR DETECTION OF PERIODONTITIS DISEASE-ACTIVITY

The relationship between CPITN sextant scores and periodontitis recurr ence at individual tooth sites was evaluated in a longitudinal study i n 83 treated adult periodontitis patients receiving systematic 3-month maintenance care. At baseline and semi-annual examinations over 36 mo nths, CPITN scores were assigned to each dentition sextant using probi ng depths and gingival index scores, and relative periodontal attachme nt level was assessed at individual tooth sites using an occlusal refe rence stent. Periodontitis recurrence was defined as any periodontal s ite exhibiting either a probing depth increase of greater than or equa l to 3 mm from baseline, or a probing depth increase of greater than o r equal to 1 mm from baseline together with a loss of relative periodo ntal attachment of greater than or equal to 2 mm from baseline. 49 (59 .0%) subjects developed periodontitis recurrence in 147 (29.8%) sextan ts at 181 (2.2%) individual periodontal sites during the 36-month stud y period. Baseline CPITN scores of 4 were more common in disease-activ e subjects than clinically-stable subjects (p = 0.003, t-test), and we re associated with a statistically significant 1.66 relative risk of p eriodontitis recurrence within 36 months. CPITN sextant scores of 3 or 4 showed low specificity and low positive predictive values as indica tors of periodontitis recurrence at greater than or equal to 1 individ ual sites within the affected sextant. In comparison, low CPITN sextan t scores (0-2) provided high specificity (96.2-100%), high positive pr edictive values (99.5-100%), and a summary odds ratio of 24.2 as an in dicator of clinical stability at all periodontal sites within a given dentition sextant. Changes in sextant scores for CPITN over 6-month pe riods showed no relationship with periodontitis recurrence at individu al periodontal sites. This study suggests that while CPITN is inadequa te for detection of periodontitis recurrence, low CPITN scores provide rapid presumptive identification of clinically-stable sextants in adu lt periodontitis patients on maintenance care.