OBJECTIVE: Self-reported questionnaire is an efficient method for early detection of periodontal disease and epidemiological surveys. The objective of this study was to develop a self-reported questionnaire for periodontal disease risk assessment.

MATERIALS AND METHODS: We conducted a cross-sectional study of 50 patients with and 51 patients without periodontal disease. Both patient groups completed the same questionnaire that contained items pertaining to the symptoms of periodontal disease. Multiple logistic regression analysis was performed to identify factors associated with periodontal disease risk and to develop a risk score based on the identified items. Receiver-operating-characteristic curve analysis was conducted to determine the predictive accuracy of the score.

RESULTS: A total of 50 patients with and 50 patients without periodontal disease (one of the 51 registered patients without periodontal disease dropped out of the study) were included in this analysis. The results of multiple logistic regression analysis, considered together with the clinical perspectives in periodontology, identified the age, presence/absence of swelling, tooth mobility, plaque and dental calculus, halitosis, and itchy gums as useful barometers for the prediction of periodontal disease. In the receiver operating characteristic curve analysis, the cutoff score was determined to be 7 and the area under the curve was 0.90 for determining the periodontal disease risk.

CONCLUSION: A novel self-reported questionnaire for estimation of the periodontal disease risk in the Japanese population was developed, and its reliability, internal consistency and the predictive accuracy were examined among 40- to 83-year-old Japanese subjects with or without periodontal disease visiting auniversity dental clinic.

Careless incorporation of orthodontic treatment into periodontal therapy may accelerate the progression of periodontal tissue destruction; however, it has been reported that orthodontic therapy is not a contraindication if inflammation is sufficiently controlled. Herein, we report the 17-year treatment course of a patient with generalized severe chronic periodontitis who has received initial periodontal therapy, periodontal-orthodontic treatment, and supportive periodontal therapy (SPT). Nonsurgical therapy was performed in addition to conventional periodontal tissue examination, bacterial testing with polymerase chain reaction (PCR) and serum antibody titer testing, in order to assist in the diagnosis and maintain motivation, since the patient had dental treatment phobia and refused to undergo periodontal surgical treatment. Dramatic improvement of the gingival inflammation was observed as a result of appropriate self-care, as well as scaling and root planing by the dental practitioner. Amelioration of the interdental separation and malalignment noted prior to the treatment was observed following the periodontal-orthodontic treatment, and treatment was provided for stabilization of the periodontal tissue and proper occlusion. At present, 17 years have elapsed since the initial visit, and the patient has received SPT for 13 years without any problems. Based on our experience with this patient, we believe that by performing periodontal-orthodontic treatment in addition to controlling inflammation in patients with pathologic tooth position abnormality, it is possible to preserve the teeth with progressive destruction of periodontal tissue, so that they function optimally and are also aesthetically pleasing.

Several methods for the evaluation of periodontitis have been reported and used clinically. Nevertheless, there is no established method to precisely assess the degree of inflammation in the periodontal tissue. We conducted ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET)/computed tomography (CT), which is widely used in the medical field, and is capable of visualizing, localizing, and quantifying the degree of periodontal inflammation. In this case report, we compared the existing diagnostic methods with ¹⁸F-FDG PET/CT, based on the efficiency of assessment of periodontal inflammation during the treatment of a chronic periodontitis patient with breast cancer. During the periodontal treatment, the bleeding on probing (BOP) and periodontal inflamed surface area (PISA) improved from 56% to 3% and 1143 mm² to 27 mm², respectively. Additionally, the accumulation of ¹⁸F-FDG, observed using ¹⁸F-FDG PET/CT, disappeared. These results indicate that ¹⁸F-FDG PET/CT would be useful as a new diagnostic tool for oral inflammatory disease. This case report suggests that ¹⁸F-FDG PET/CT should be included in "common clinical examination" in medical and dental fields, which may enhance the cooperation between these fields, and be useful for effective periodontal treatment of patients affected by several systemic diseases.