Periodontal inflamed surface area and periodontal case definition classification

Objective: To assess whether a higher periodontal inflamed surface area (PISA) may reflect more severe periodontitis, and if so, to calculate which cut-off point should be used to classify a patient as suffering from periodontitis. Material and methods: Eighty subjects were selected based on their periodontal status and were divided into 4 groups of 20 each; periodontally healthy, mild periodontitis, moderate periodontitis and severe periodontitis. In addition, demographic data, smoking status and socioeconomic status were also recorded. Results: The highest mean PISA value was obtained for the severe periodontitis group (2309.42 +/- 587.69 mm(2)) and the least for the periodontally healthy (34.30 +/- 16.48 mm(2)). The PISA values corresponding to the three categories of periodontitis severity were significantly higher than the periodontally healthy group. When receiver operating characteristic (ROC) analysis was performed, a PISA value >= 130.33 mm(2) predicted the presence of periodontitis with a sensitivity of 98% and a specificity of 100%. Conclusions: PISA is a periodontal parameter that may be used in conjunction with the Centers for Disease Control and Prevention - American Academy of Periodontology case definition classification in periodontal medicine research.