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.
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