(38) The Modified Miller-McEntire Periodontal Prognostic Index: Initiation and Validation of 6762 teeth over up to 47 years.

Co-Author(s)

PM

Preston Dallas Miller, DDS

Clinical Professor
Medical University of South Carolin
Germantown, Tennessee, United States

Lead Author(s)

Muhammad H. Saleh, BDS, MDS

Clinical assisstant Professor
University of Michigan
Ann Arbor, Michigan, United States

Co-Author(s)

Hom-Lay Wang, DDS, MSD, PhD

Professor and Director of Graduate Periodontics
University of Michigan
Ann Arbor, Michigan, United States

Introduction: Tooth-level prognostic systems are valuable tools for treatment planning and risk assessment of periodontally involved teeth. Recently the Miller-McEntire prognosis index was found to significantly outperform comparable systems. However, it had some limitations. The present study aimed to develop and evaluate the prognostic performance of a modified version of the Miller-McEntire prognosis system.

Methods: Data were retrieved retrospectively from patients who received surgical and non-surgical periodontal treatment at the University of Michigan, School of Dentistry. Data on medical history and smoking status at baseline and the last maintenance visit were collected. Using both univariate and multivariate Cox proportional hazard regression models to analyze the prognostic capability for predicting tooth loss due to periodontitis (TLP) risk. In addition, a post-hoc comparison was conducted using the Bonferroni test to evaluate intraclass stratification in both systems. Ratios of Restricted Mean Survival Time (RMST) in the univariate analysis, for the comparison with the reference class was also assessed.

Results: A total of 6762 teeth (281 patients) were followed up for a mean period of 22.6 ± 6.34 (10-47.6y) years and individually evaluated. The Modified Miller-McEntire index was successfully able to stratify the risk of TLP at baseline when different classes of association were compared for anterior and/or posterior tooth loss. After controlling for maintenance, age, and gender, the index showed an excellent predictive capacity for TLP with a Harrell's C-index of 0.947. The survival analysis of this University-based cohort showed remarkably similar survival rates to those established in a private practice setting.

Conclusions: The Modified-Miller-McEntire prognosis system displayed excellent predictive capability for anterior as well as posterior tooth loss due to periodontitis. This system has also been validated to work for both anterior and posterior teeth.

Lead Author’s Contributions to the Research Project: The Lead Author was responsible for the inception, study design, data collection, and the composition of the abstract.