{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T07:37:11Z","timestamp":1776497831400,"version":"3.51.2"},"reference-count":30,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In this study, we explore the diagnostic accuracy of a Radiographic-based Periodontal Bone Loss (R-PBL) method as a screening tool for periodontitis, in the form of radiographic bone loss, under the 2018 case definition in comparison to the 2012 case definition. The analysis was based on 456 patients (253 females and 203 males), screened for periodontal status in the Study of Periodontal Health in Almada-Seixal (SoPHiAS) project and subjected to a panoramic dental X-ray. Patients were diagnosed for the presence of periodontitis following the 2018 and 2012 case definition. R-PBL classification was defined by alveolar bone loss and diagnosed as no periodontitis (\u226580% remaining alveolar bone), mild to moderate periodontitis (66% to 79%), or severe periodontitis (&lt;66%). We appraise the X-ray quality to look for the influence on the performance of R-PBL. Sensitivity, specificity, accuracy, and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass Receiver operating characteristic\/are under the curve (ROC\/AUC) analyses. Our results show that the tested R-PBL method under the 2018 case definition is a reliable tool in periodontitis cases screening. This method does not replace clinical periodontal evaluation, but rather, it screens patients towards a definitive periodontitis diagnosis. These results will contribute to support the development of automated prediction systems towards periodontitis surveillance.<\/jats:p>","DOI":"10.3390\/jcm9072313","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T03:23:16Z","timestamp":1595388196000},"page":"2313","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Accuracy of Panoramic Radiograph for Diagnosing Periodontitis Comparing to Clinical Examination"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-260X","authenticated-orcid":false,"given":"Vanessa","family":"Machado","sequence":"first","affiliation":[{"name":"Periodontology Department, Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Instituto Universit\u00e1rio Egas Moniz (IUEM), 2829-511 Almada, Portugal"},{"name":"Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-5936","authenticated-orcid":false,"given":"Lu\u00eds","family":"Proen\u00e7a","sequence":"additional","affiliation":[{"name":"Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2402-2277","authenticated-orcid":false,"given":"Mariana","family":"Morgado","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0167-4077","authenticated-orcid":false,"given":"Jos\u00e9 Jo\u00e3o","family":"Mendes","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-8263","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Botelho","sequence":"additional","affiliation":[{"name":"Periodontology Department, Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Instituto Universit\u00e1rio Egas Moniz (IUEM), 2829-511 Almada, Portugal"},{"name":"Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/j.1752-7325.2003.tb03492.x","article-title":"Oral Health Surveillance: Past, Present, and Future Challenges","volume":"63","author":"Malvitz","year":"2003","journal-title":"J. Public Health Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/j.1600-0757.2012.00446.x","article-title":"Recording and surveillance systems for periodontal diseases","volume":"60","author":"Eke","year":"2012","journal-title":"Periodontol. 2000"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1111\/j.1600-051X.2008.01243.x","article-title":"Effect of partial recording protocols on severity estimates of periodontal disease","volume":"35","author":"Kingman","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1111\/jcpe.12165","article-title":"Assessing periodontitis in populations: A systematic review of the validity of partial-mouth examination protocols","volume":"40","author":"Tran","year":"2013","journal-title":"J. Clin. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1111\/jcpe.12285","article-title":"Assessment of partial-mouth periodontal examination protocols for periodontitis surveillance","volume":"41","author":"Tran","year":"2014","journal-title":"J. Clin. Periodontol."},{"key":"ref_6","first-page":"1","article-title":"Partial recording protocols performance on the assessment of periodontitis severity and extent: Bias magnitudes, sensibility, and specificity","volume":"59","author":"Machado","year":"2018","journal-title":"Rev. Port. Estomatol. Med. Dent. Cir. Maxilofac."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-63700-6","article-title":"The 2018 periodontitis case definition improves accuracy performance of full-mouth partial diagnostic protocols","volume":"10","author":"Botelho","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/jcpe.12945","article-title":"Staging and grading of periodontitis: Framework and proposal of a new classification and case definition","volume":"45","author":"Tonetti","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1875-595X.2002.tb00595.x","article-title":"Periodontal Screening and Recording (PSR) Index: Precursors, utility and limitations in a clinical setting","volume":"52","author":"Landry","year":"2002","journal-title":"Int. Dent. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1111\/jcpe.12946","article-title":"Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"45","author":"Papapanou","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/jcpe.12936","article-title":"Periodontal health","volume":"45","author":"Lang","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_12","unstructured":"Horner, K., Rushton, V., Walker, A., Tsiklakis, K., Hirschmann, P.N., van der Stelt, P.F., Glenny, A.-M., Velders, X.L., and Pavitt, S. (2004). European Guidelines on Radiation Protection in Dental Radiology\u2014The Safe Use of Radiographs in Dental Practice."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8495","DOI":"10.1038\/s41598-019-44839-3","article-title":"Deep Learning for the Radiographic Detection of Periodontal Bone Loss","volume":"9","author":"Krois","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1034\/j.1600-051X.2003.00379.x","article-title":"Comparison between panoramic and intra-oral radiographs for the assessment of alveolar bone levels in a periodontal maintenance population","volume":"30","author":"Persson","year":"2003","journal-title":"J. Clin. Periodontol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1600-051X.2008.01225.x","article-title":"Trends over 30 years, 1973\u20132003, in the prevalence and severity of periodontal disease","volume":"35","author":"Hugoson","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1161\/CIRCULATIONAHA.115.020324","article-title":"Periodontitis Increases the Risk of a First Myocardial Infarction: A Report From the PAROKRANK Study","volume":"133","author":"Buhlin","year":"2016","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1177\/0022034518765735","article-title":"Severe Periodontitis Is Associated with Myocardial Infarction in Females","volume":"97","author":"Nordendahl","year":"2018","journal-title":"J. Dent. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"15538","DOI":"10.1038\/s41598-019-52116-6","article-title":"Study of Periodontal Health in Almada-Seixal (SoPHiAS): A cross-sectional study in the Lisbon Metropolitan Area","volume":"9","author":"Botelho","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_19","first-page":"1","article-title":"STARD 2015: An updated list of essential items for reporting diagnostic accuracy studies","volume":"351","author":"Bossuyt","year":"2015","journal-title":"BMJ"},{"key":"ref_20","first-page":"43","article-title":"Image quality assessment in panoramic dental radiography: A comparative study between conventional and digital systems","volume":"3","author":"Sabarudin","year":"2013","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1902\/jop.2012.110664","article-title":"Update of the case definitions for population-based surveillance of periodontitis","volume":"83","author":"Eke","year":"2012","journal-title":"J. Periodontol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/S0895-4356(03)00177-X","article-title":"The diagnostic odds ratio: A single indicator of test performance","volume":"56","author":"Glas","year":"2003","journal-title":"J. Clin. Epidemiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v079.c02","article-title":"plotROC: A Tool for Plotting ROC Curves","volume":"79","author":"Sachs","year":"2017","journal-title":"J. Stat. Softw."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: A global public health challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0300-5712(99)00062-7","article-title":"The usefulness of radiographs in diagnosis and management of periodontal diseases: A review","volume":"28","author":"Tugnait","year":"2000","journal-title":"J. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/j.1600-051X.1997.tb00484.x","article-title":"The relationship of bone loss observed on panoramic radiographs with clinical periodontal screening","volume":"24","author":"Walsh","year":"1997","journal-title":"J. Clin. Periodontol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1600-051X.1992.tb00654.x","article-title":"Comparison of panoramic and intraoral radiography and pocket probing for the measurement of the marginal bone level","volume":"19","author":"Rohlin","year":"1992","journal-title":"J. Clin. Periodontol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/jcpe.12935","article-title":"A new classification scheme for periodontal and peri-implant diseases and conditions\u2014Introduction and key changes from the 1999 classification","volume":"45","author":"Caton","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/jcpe.13157","article-title":"Comparison of periodontitis patients\u2019 classification in the 2018 versus 1999 classification","volume":"46","author":"Graetz","year":"2019","journal-title":"J. Clin. Periodontol."},{"key":"ref_30","unstructured":"WHO (2020, July 13). Public Health Surveillance. Available online: https:\/\/www.who.int\/immunization\/monitoring_surveillance\/burden\/vpd\/en\/."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/7\/2313\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:50:22Z","timestamp":1760176222000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/7\/2313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,21]]},"references-count":30,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["jcm9072313"],"URL":"https:\/\/doi.org\/10.3390\/jcm9072313","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,21]]}}}