{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T12:42:09Z","timestamp":1777812129823,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[1997,4,1]],"date-time":"1997-04-01T00:00:00Z","timestamp":859852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[1997,4]]},"abstract":"<jats:p>Most periodontal trials are based on the assumption that the superior treatment, as judged by short-term intangible changes in probing attachment levels (the surrogate), is also the treatment most likely to affect tooth mortality. This assumption is valid if: (1) the surrogate is informative about tooth mortality, and (2) the surrogate captures a substantial proportion of the treatment effect on tooth mortality (e.g., &gt; 50% or 75%). The goal of this study was to evaluate whether both conditions were satisfied in a randomized controlled trial (RCT) of elders at high risk for dental diseases. The results suggested that the first condition for a valid surrogate was satisfied: Both one- and two-year changes in probing attachment level were informative about tooth mortality risk. A 1-mm loss measured over a one-year period was associated with a 56% increased tooth mortality risk (relative risk= 1.56; 95% confidence interval, 1.08 to 2.26; p = 0.017); a 1-mm loss measured over a two-year period was associated with a 102% increased risk for tooth mortality (relative risk = 2.02; 95% confidence interval, 1.26 to 3.25; p = 0.004). The second condition necessary for a valid surrogate could not be confirmed in the present trial. With 95% confidence, it was concluded that one-year changes in probing attachment level measurements did not capture a significant proportion of the treatment effect (point estimate, 6%; 95% confidence interval ;- 38% to 53%). No useful statements could be made regarding the proportion of treatment effect captured by two-year changes, due to the width of the confidence interval (point estimate, 18%; 95% confidence interval; -151% to 140%). It is concluded that (1) the evidence surrounding the one-year change in probing attachment level indicates that it can be ruled out as being anything more than a weak surrogate marker for tooth mortality, and (2) further research is required to study the validity of two-year change in probing attachment level as a surrogate marker. Due to characteristics of the population and the treatments investigated, the generalizability of these findings to other RCTs is questionable.<\/jats:p>","DOI":"10.1177\/00220345970760040701","type":"journal-article","created":{"date-parts":[[2009,1,8]],"date-time":"2009-01-08T19:39:42Z","timestamp":1231443582000},"page":"858-866","source":"Crossref","is-referenced-by-count":29,"title":["Evaluating the Validity of Probing Attachment Loss as a Surrogate for Tooth Mortality in a Clinical Trial on the Elderly"],"prefix":"10.1177","volume":"76","author":[{"given":"P.P.","family":"Hujoel","sequence":"first","affiliation":[{"name":"Department of Dental Public Health Sciences, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195, Department of Epidemiology, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.G.","family":"Leroux","sequence":"additional","affiliation":[{"name":"Department of Dental Public Health Sciences, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195, Department of Biostatistics, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.A.","family":"DeRouen","sequence":"additional","affiliation":[{"name":"Department of Dental Public Health Sciences, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195, Department of Biostatistics, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.V.","family":"Powell","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.A.","family":"Kiyak","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery, School of Dentistry, Box 357475, University of Washington, Seattle, Washington 98195"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1997,4,1]]},"reference":[{"key":"atypb1","unstructured":"American Academy of Periodontology (1989a). Consensus report-Discussion section II. In: Proceedings of the World Workshop in Clinical Periodontics. Nevins M, Necker W, Kornman K, editors. New Jersey: American Academy of Periodontology, pp. 1112-1120."},{"key":"atypb2","unstructured":"American Academy of Periodontology (1989b). Consensus report-Discussion section IV. In: Proceedings of the World Workshop in Clinical Periodontics. Nevins M, Necker W, Kornman K, editors. New Jersey: American Academy of Periodontology, pp. IV22-IV27."},{"key":"atypb3","unstructured":"American Academy of Periodontology (1989c). Consensus report-Discussion section VI. In: Proceedings of the World Workshop in Clinical Periodontics. Nevins M, Necker W, Kornman K, editors. 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