Güncel sınıflandırma kriterlerine göre periodontitisli hastalarda optimum tedavi kararı

Year 2025, Volume: 26 Issue: 1, 86 - 93, 20.03.2025

Ceren Kütük , Hanife Merva Parlak , Ayhan Parmaksız , Nermin Tarhan , Gencay Keçeli

https://doi.org/10.69601/meandrosmdj.1554691

Abstract

Giriş: Bu çalışmada farklı eğitim seviyelerine ve klinik deneyime sahip klinisyenlerin periodontitis tanı ve tedavi planlama sürecindeki doğruluk ve uyumlarının değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Periodontitisin evresine, derecesine ve yaygınlık bileşenlerine bağlı olarak, iki deneyimli periodontolog tarafından hazırlanan bir konsensüs tanı ve tedavi planı belgesi altın standart olarak kullanıldı. 10 periodontitis vakasından oluşan anonim bir anket 15 katılımcıya (5 periodontoloji uzmanı (PU), 5 periodontoloji uzmanlık öğrencisi ve 5 diş hekimliği lisans öğrencisi) sunuldu ve her vakayı hastalığın bileşenlerine göre sınıflandırmaları ve 11 dental tedavisi seçeneği içeren çoktan seçmeli bir anketten tedavi planlarını seçmeleri istendi. Cevapların doğruluğu altın standarda bakılarak tespit edildi ve katılımcılar arası uyum düzeyi değerlendirildi.
Bulgular: Derece hariç, periodontitis bileşenlerinde anlamlı bir grup içi fark bulunmadı ve bu fark yalnızca PU grubunda mevcuttu (p=0,012). Tedavi yanıtlarında PU grubu diğerlerine göre daha doğru yanıtlar verdi. Tüm katılımcıların evre, derece ve dağılım için anlaşma seviyeleri düşüktü (κ=0,366, 0,222 ve 0,287, sırasıyla). Tedavi planlaması, diş çekimi (κ=0,554) haricinde düşük uyum gösterdi (κ<0,31). Gruplar arasında hem tanı hem de tedavi planlamasında önemli farklılıklar görüldü.
Sonuç: Eğitim düzeyi ve deneyim, tanı ve tedavi planlaması açısından üstünlük sağlasa da doğruluk oranının düşük olması, varyasyonları azaltmak ve doğruluk düzeylerini artırmak için kalibrasyon gerekliliğini ortaya koymaktadır.

Keywords

sınıflama, klinik karar verme, tanı, periodontitis

Decision making for optimal treatment for patients with periodontitis based on recent classification criteria

Abstract

Objective: Besides clinical factors, decision-making process in daily practice is affected by non-clinical factors such as experience and educational levels that cause variations amongst clinicians. This study aimed to evaluate the accuracy and agreement in diagnosis and treatment planning process of the dental students and periodontal experts with different education levels and clinical experience.
Material and Methods: An anonymous survey of 10 periodontitis cases was given to 15 participants (5 periodontal experts (PE), 5 postgraduate periodontology students (PS), and 5 undergraduate dental students (DS)) and asked them to classify each case and mark their diagnosis and treatment planning. Consensus diagnosis and treatment plan used as a gold-standard was prepared by two experienced periodontists. The accuracy of responses was detected by referring to the gold-standard and inter-examiner agreements were assessed.
Results: Except for the diagnosis of grade in the PE group (p=0.012), no significant difference was found between groups in terms of periodontitis diagnosis. In treatment responses, PE group gave more accurate answers compared to others. The agreement levels of all examiners for stage, grade, and extent were fair (κ=0.366, 0.222, and 0.287, respectively). Treatment planning showed low agreement (κ<0.31) except for tooth extraction (κ=0.554). Both diagnosis and treatment planning had significant variations amongst groups.
Conclusion: Although education level and experience provided superiority in terms of diagnosis and treatment planning, the results with low accuracy seem to indicate the need for calibration to reduce the variations and enhance the levels of accuracy in classifying and planning the treatment of periodontitis cases.

Keywords

classification, decision making, diagnosis, periodontitis

Ethical Statement

Permission was obtained from the Ethics Committee of Hacettepe University (GO 21/427) for the study protocol.

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