A prognostic model for the prediction of generalized chronic periodontitis in patients with metabolic syndrome

Abstract

The pathogenesis of periodontitis involves a complex inflammatory cascade initiated by biofilm bacteria. The susceptibility to or the risk of developing the disease is determined by the body's response to the invasion, specifically, by the strength of the inflammatory response and the differential activation of immune pathways. In this paper, we propose a model for predicting the risk of severe chronic generalized periodontitis (GCP) in patients with metabolic syndrome based on the levels of tumor necrosis factor alpha (TNF-α) in the periodontal pocket exudate. The analysis of oral cavity cytokine profiles conducted in 537 patients with GCP and comorbid metabolic syndrome showed that increased TNF-a correlated with the severity of GCP: higher levels of TNF-a were observed in patients whose condition was more severe. The prognostic model built in Statistica. 10 allowed us to use TNF-a as a prognostic criterium for GCP severity. We determined the cut-off point above which a high risk of severe GCP can be concluded with 91.2% sensitivity and 70.8% specificity. The spreadsheet in Microsoft Excel 2010 automatically computed the risk of severe GCP from a patient's TNF-a concentrations in the PP, which makes the model convenient for routine clinical use in dentistry.