Methods of predicting treatment outcome in chronic periodontitis patients
The invention is a new method for predicting when subjects having chronic periodontitis will fail or succeed conventional standard therapy. The method uses measures of the plaque cadaverine fraction with additional measurements including age, fraction of gingival margins that bleed on probing (BOP), and clinical attachment level (CAL in mm) to calculate discriminant function equations for calculating individual score sets. When CF is above 0.45 in periodontitis patients, it is predicted that most available therapies with which the periodontitis patient can be treated will fail, including a conventional standard treatment or an aggressive combined antibiotic/oral hygiene therapy.
1 . A method of predicting an outcome of a treatment regimen for a patient having chronic periodontitis, comprising:
obtaining from the patient measurements of age, bleeding on probing, clinical attachment level, and plaque cadaverine fraction;
combining the measurements of age, bleeding on probing, clinical attachment level, and plaque cadaverine fraction using a mathematical algorithm comprising a set of discriminant function equations based on variables of age, bleeding on probing, clinical attachment level, and plaque cadaverine fraction thereby determining a score set for the set of discriminant function equations; and
using the score set to predict whether the outcome of the treatment regimen will be success or failure.
2 . The method of claim 1 wherein the treatment regimen is a standard treatment regimen comprising deep scaling and root planing and home care.
3 . The method of claim 2 wherein an outcome of success is based on a decreased mean clinical attachment level measurement at each of four clinical assessments taken at approximately three month intervals after the deep scaling and root planing of the standard treatment regimen.
4 . The method of claim 2 wherein an outcome of failure is based on an increased mean clinical attachment level measurement at least one of four clinical assessments taken at approximately three month intervals after the deep scaling and root planing of the standard treatment regimen.
5 . The method of claim 1 wherein the patient measurements are taken from the patient having chronic periodontitis prior to undergoing the treatment regimen.
6 . The method of claim 1 wherein the set of discriminant function equations is based on a pretherapy data set obtained from a plurality of healthy individuals and chronic periodontitis patients who were subsequently treated successfully and chronic periodontis patients who subsequently failed treatment.
7 . The method of claim 1 wherein in the step of using the score set to predict success or failure, the score set is compared to a centroid point corresponding to treatment success and to a centroid point corresponding to treatment failure, and wherein a prediction of treatment success is made when the score set is closest to the centroid point corresponding to treatment success, and wherein a prediction of treatment failure is made when the score set is closest to the centroid point corresponding to treatment failure.
8 . The method of claim 1 wherein, when the outcome of the treatment regimen is predicted to be failure, and also when the plaque cadaverine fraction of the patient exceeds 0.45, the patient is further predicted to have an outcome of failure to an aggressive combined antibiotic/oral hygiene therapy.
9 . The method of claim 1 wherein the plaque cadaverine fraction is [nmol/cadaverine/(nmol lysine+nmol cadaverine)] as measured from a plaque sample taken from the patient before or after deep scaling.
10 . A method of predicting an outcome of an aggressive combined antibiotic/oral hygiene therapy regimen for a chronic periodontitis patient who already has a failed outcome to a conventional standard treatment regimen, comprising:
obtaining from the patient a measurement of plaque cadaverine fraction; and
predicting that the patient will have a failed outcome to an aggressive combined antibiotic/oral hygiene therapy regimen when the measurement of plaque cadaverine fraction exceeds 0.45.
11 . The method of claim 10 wherein the plaque cadaverine fraction is [nmol/cadaverine/(nmol lysine+nmol cadaverine)] as measured from a plaque sample taken from the patient.