Publication:
The Impact Of A Clinical Pathway On Treatment Outcomes Of Patients With Periodontitis In Public University Settings: A Quasi-experimental Study

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Abstract

This study tested a newly-developed clinical pathway (CP) to manage periodontitis patients against patients managed using usual care. This study was a multi-center quasi-experimental involving newly-diagnosed chronic periodontitis patients. Five dental schools at Malaysian public universities participated in the study. A total of 36 patients participated as a test group and received non-surgical periodontal treatment based on the CP and reviewed at 6, 12 and 24 weeks. Treatment outcomes at each review were compared with data of 36 patients who had been treated without CP and matched as historical controls. Outcome variables were clinical parameters namely probing pocket depth (PPD), clinical attachment level (CAL), gingival bleeding index and visible plaque index. Improvements in these parameters for both groups were compared using independent t-test for normally distributed data and Mann–Whitney U test for non-normally distributed data. Both groups showed statistically significant post-treatment improvements for all clinical parameters. The CP group had significantly reduced number of sites for PPD ≥ 7mm and CAL gain compared to control group at 12th week (p=0.040) and 24th week (p=0.041), as well as between baseline to 24 weeks (p=0.039) with Cohen’s effect size 0.87, respectively. The use of a CP could lead to significant clinical improvement for patients with chronic periodontitis. Its use could be recommended in dental settings involving multiple operators to ensure best outcomes based on standardized optimal care and shared guidelines for clinical decision-making.

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Volume 44, Issue 05 (pp.: 2005-2014)

Keywords

Care pathway, Periodontics, Dental scaling, Treatment outcome, Patient-reported outcome

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