Clinical Decision Making in Periodontal Diagnosis (According to 2017 Classification) and Treatment Planning by Specialists and General Dentists

Muhammad Haseeb                     BDS, MDS, M.Perio RCS Ed, MCPS
Arsala Khalid                                BDS
Myra Ahmed                                  BDS, FCPS
Muhammad Faran                         PhD
Muhammad Hassan                      PhD
Zubair Ahmed Khan                      BDS, MSc, MCPS

OBJECTIVE: The aim of this study is to evaluate variation of the periodontal diagnosis (according to 2017 classification)
and treatment planning of two periodontal cases among specialists and residents of Periodontics and other restorative dental
specialists (Prosthodontics and Operative & Endodontics) and General Dental Practitioners.
METHODOLOGY: A cross-sectional study included 3 cohorts (general dental practitioners, periodontists and other restorative
specialists). Stratified sampling technique by using proportional allocation was used to collect data. Electronic questionnaire
was filled by the dentists in face-to-face meeting. The questionnaire contained two clinical cases of periodontitis, followed by
a question regarding diagnosis using 2017 periodontal classification, treatment options and radiographic judgment about bone
loss. There responses were compared among groups using descriptive statistics, Chi-square test, binary and multinomial logistic
regression model.
RESULTS: 290 questionnaires were obtained in total. Multivariate regression analysis disclosed that highest number of correct
diagnosis in case 1 and 2 were made by periodontists; Large proportion of general dentists diagnosed case 1 correctly but failed
to correctly diagnose case 2. Restorative specialists fail to diagnose both cases (p>0.05) according to 2017 classification when
compared to periodontists. Regarding questions about treatment planning, there was an agreement related to quadrant wise
scaling over the other options but significant differences (p<0.01) was found among periodontists when compared to restorative
specialists and general dentists in prescribing systemic antibiotics and local antimicrobials in the initial phase.
CONCLUSION: Periodontists had significantly more correct responses than general dentists in diagnosis and treatment plan.
The study also showed that the overall agreement of practitioners towards diagnosis and clinical judgment about the bone loss
was suboptimal but agreed to suggest appropriate initial non-surgical periodontal therapy for both cases irrespective of their
KEYWORDS: Periodontology, Evidence Based Practice, Diagnosis, Treatment planning, Periodontal classification 2017
HOW TO CITE: Haseeb M, Khalid A, Ahmed M, Faran M, Hassan M, Khan ZA. Clinical decision making in periodontal diagnosis
(according to 2017 classification) and treatment planning by specialists and general dentists. J Pak Dent Assoc 2024;33(1):1-6.
Received: 10 January 2024, Accepted: 14 March 2024

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