# Combining Self-Reported Information with Radiographic Bone Loss to Screen Periodontitis: A Performance Study

## TL;DR

This study shows that combining self-reported data with radiographic bone loss can effectively screen for periodontitis, especially when full exams are not possible.

## Contribution

The study introduces a combined screening method for periodontitis using self-reports and radiographic bone loss data.

## Key findings

- The R-PBL model had the highest AUC for periodontitis (0.833) and severe periodontitis (0.796).
- The Either model showed similar sensitivity to R-PBL, while SR and Both models underperformed.
- Decision curve analysis confirmed the clinical utility of R-PBL and Either models.

## Abstract

Background/Objectives: The objective of this study is to evaluate the diagnostic performance of a combined screening approach using self-reported periodontal information and radiographic periodontal bone loss (R-PBL) in identifying individuals with periodontitis. Methods: An exploratory cross-sectional study was conducted including adult participants with available panoramic radiographs and responses to a validated self-reported periodontal screening questionnaire. R-PBL was assessed on interproximal sites and classified according to established thresholds. Self-reported information followed a validated strategy based on the Center for Diseases Control tool. The performance of individual and combined indicators was analyzed against the 2018 case definition for periodontitis, calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). Results: A total of 150 participants were included, equally divided between periodontitis cases and controls, with a mean age of 46.5 years. The R-PBL model demonstrated the best predictive performance for both periodontitis (AUC: 0.833) and severe periodontitis (AUC: 0.796), with the highest precision and net benefit across thresholds. The Either model showed similar performance, particularly in sensitivity, while SR and Both models underperformed. Decision curve analysis confirmed the superior clinical utility of ‘R-PBL’ and ‘Either’ models in guiding decision-making. Conclusions: Combining self-reported information with radiographic bone loss showed adequate screening performance for periodontitis. This dual approach may provide a feasible strategy for identifying high-risk individuals in settings where full clinical examination is not possible.