Review Article

Chronic Periodontitis Case Definitions and Confounders in Periodontal Research: A Systematic Assessment

Table 2

Frequency and percentage of criteria and threshold used in chronic periodontitis case definitions.

DefinitionStudies # (%)
N=351
Criteria Studies
# (%)
N=224

CAL
CAL≥115(4.3)at least 2 sites6(2.7)
CAL≥22(0.6)at least 3 sites4(1.8)
CAL≥321(6.0)at least 4 sites3(1.3)
CAL≥411(3.1)at least 1 site3(1.3)
CAL≥54(1.1)at least ≥ 50 % sites1(0.4)
CAL≥61(0.3)CAL ≥3 in at least 2 sites and CAL≥5 in 30%5(2.2)
Radiograph
Bitewing + periapical2(0.6)≥2mm4(1.8)
Panorama6(1.7)≥3mm2(0.9)
Bitewing11(3.1)≥6mm (2 studies at least one side)2(0.9)
Periapical1(0.3)≥20% (one study at least 7 sites)3(1.3)
≥50%1(0.4)
PD
PD≥446(13.1)at least 6 sites1(0.4)
PD≥3.547(13.4)at least 10 sites2(0.9)
PD≥32(0.6)at least 1 sites56(25.0)
PD≥512(3.4)at least 3 sites (one study per quadrant)3(1.3)
PD≥62(0.6)at least 1 tooth3(1.3)
PD≥71(0.3)at least 4 sites2(0.9)
PD + CAL
PD ≥5 CAL≥53(0.9)at least 10% sites (PD+CAL)1(0.4)
PD ≥5 CAL≥426(7.4)6 teeth with at least 1 site each1(0.4)
PD ≥5 CAL≥36(1.7)at least 4 sites2(0.9)
PD ≥3 CAL≥61(0.3)at least 2 sites CAL and 1 site PD36(16.1)
PD ≥3 CAL≥11(0.3)at least 2 sites17(7.6)
PD ≥3 CAL≥21(0.3)at least 2 teeth (one study with 3 sites PD and 3 studies with one site)7(3.1)
PD ≥3 CAL≥31(0.3)at least 3 sites PD and 2 sites CAL2(0.9)
PD ≥3 CAL≥46(1.7)at least 4 teeth and at least one site each9(4.0)
PD ≥4 CAL≥334(9.7)at least 6 sites1(0.4)
PD ≥4 CAL≥25(1.4)at least 6 teeth and at least one site each1(0.4)
PD ≥4 CAL≥414(4.0)at least 8 teeth1(0.4)
PD ≥4 CAL≥54(1.1)at least 4 sites (one study 4 sites CAL and one site PD2(0.9)
PD ≥5 CAL≥612(3.4)at least one posterior tooth1(0.4)
PD ≥5 CAL≥11(0.3)at least one site10(4.4)
PD ≥5 CAL≥21(0.3)at least one tooth with at least one site1(0.4)
PD ≥6 CAL≥41(0.3)at least two molars1(0.4)
PD ≥6 CAL≥53(0.9)CAL at more than one tooth site and with more than three sites of probing depth1(0.4)
PD ≥6 CAL≥61(0.3)CAL in at least two sites of different teeth and in at least one proximal site1(0.4)
PD in one or more bleeding-positive sites and CAL in two or more sites. 1(0.4)
PD + Radiograph
PD ≥4 Radiograph bitewing1(0.3)at least 10 pockets in 10 teeth1(0.4)
PD ≥5 Radiograph panorama2(0.6)
PD ≥5 Radiograph panorama2(0.6)
CAL + furcation
CAL ≥1 & furcation1(0.3)
CAL + radiograph
CAL ≥1 &Radiograph bitewing1(0.3)CAL 30% or more of the sites, and 20>% bone loss as estimated from the radiographs1(0.4)
CAL ≥2 &Radiograph bitewing1(0.3)
CAL ≥4 &Radiograph bitewing2(0.6)
PD+CAL+BOP
PD ≥5 CAL≥5 BOP5(1.4)10% of teeth with PD or CAL ≥5mmm or 15% of teeth with PD or CAL ≥4mm and 10% of sites with BOP1(0.4)
PD ≥4 CAL≥3 BOP8(2.3)at least 2 teeth and one tooth BOP1(0.4)
PD ≥4 CAL≥2 BOP2(0.6)at least 4 teeth with one or more site11(4.9)
PD ≥4 CAL≥4 BOP1(0.3)at least 5 sites2(0.9)
PD ≥5 CAL≥3 BOP4(1.1)at least 8 sites1(0.4)
PD ≥6 CAL≥3 BOP1(0.3)at least one site1(0.4)
PD+BOP
PD ≥3 BOP4(1.1)at least four teeth 2(0.9)
PD ≥4 BOP2(0.6)
PD ≥5 BOP1(0.3)
PD +CAL +Radiograph
PD ≥5 CAL≥6 & Radiograph1(0.3)at least 2 sites1(0.4)
PD ≥4 CAL≥4 & Radiograph2(0.6)at least 3 sites in at least 3 quadrant2(0.9)
PD ≥5 CAL≥5 & Radiograph1(0.3)
Edema +BOP +PD+ recession +mobility
edema +BOP +PD+ recession +mobility1(0.3)If two or more parameters 1(0.4)
PD+ furcation
PD & furcation1(0.3)at least 8 teeth1(0.4)
PD+Radiograph +BOP
PD ≥4 & Radiograph1(0.3)10% of teeth with radiograph at least one tooth PD 15% BOP1(0.4)
PD ≥5 & Radiograph1(0.3)

CAL: clinical attachment level, PD: probing depth, and BOP: bleeding on probing.