Skip to main content
SpringerLink
Log in

Multilevel Modelling in Periodontal Research

  • Chapter
  • First Online:
Understanding Periodontal Research

  • 50 Accesses

Abstract

Periodontal data are usually plentiful observations made in one oral cavity. In order to describe the periodontal situation, sites (gingival units) around teeth within patients or subjects are considered by using several variables. Observations may be even repeated in a longitudinal way. This is a typical hierarchical situation with lower and upper levels.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Albandar JM, Goldstein H. Multi-level statistical models in studies of periodontal diseases. J Periodontol. 1992;63:690–5.

    Article  PubMed  Google Scholar 

  • Archie Jr JP. Mathematic coupling of data: a common source of error. Ann Surg. 1981;193:296–303.

    Article  PubMed  Google Scholar 

  • Axtelius B, Söderfeldt B, Attström R. A multilevel analysis of factors affecting pocket probing depth in patients responding differently to periodontal treatment. J Clin Periodontol. 1999;26:67–76.

    Article  PubMed  Google Scholar 

  • Bäumer A, Pretzl B, Cosgarea R, Kim TS, Reitmeir P, Eickholz P, Dannewitz B. Tooth loss in aggressive periodontitis after active periodontal therapy: patient-related and tooth-related prognostic factors. J Clin Periodontol. 2011;38:644–51. doi:10.1111/j.1600-051X.2011.01733.x.

    Article  PubMed  Google Scholar 

  • Bryk AS, Raudenbush SW. Hierarchical linear models. Applications and data analysis methods. Newbury Park: Sage Publications; 1992.

    Google Scholar 

  • Ciantar M, Gilthorpe MS, Hurel SJ, Newman HN, Wilson M, Spratt DA. Capnocytophaga spp. in periodontitis patients manifesting diabetes mellitus. J Periodontol. 2005;76:194–203.

    Article  PubMed  Google Scholar 

  • Claffey N, Egelberg J. Clinical characteristics of periodontal sites with probing attachment loss following initial periodontal treatment. J Clin Periodontol. 1994;21:670–9.

    Article  PubMed  Google Scholar 

  • Cooley W, Bond L, Mao BJ. Analysing multilevel data. In: Berk R, editor. Educational evaluation methodology. Baltimore: Johns Hopkins University Press; 1981.

    Google Scholar 

  • Cunningham SJ, Gilthorpe MS, Hunt NP. Are orthognathic patients different? Eur J Orthod. 2000;22:195–202.

    Article  PubMed  Google Scholar 

  • D’Aiuto F, Ready D, Parkar M, Tonetti MS. Relative contribution of patient-, tooth-, and site-associated variability on the clinical outcomes of subgingival debridement. I. Probing depths. J Periodontol. 2005;76:398–405.

    Article  PubMed  Google Scholar 

  • Ferreira EF, Vargas AM, Castilho LS, Velásquez LN, Fantinel LM, Abreu MH. Factors associated to endemic dental fluorosis in Brazilian rural communities. Int J Environ Res Public Health. 2010;7:3115–28.

    Article  PubMed  Google Scholar 

  • Gilthorpe MS, Cunningham SJ. The application of multilevel, multivariate modelling to orthodontic research data. Community Dent Health. 2000;17:236–42.

    PubMed  Google Scholar 

  • Gilthorpe MS, Griffiths GS, Maddick IH, Zamzuri AT. The application of multilevel modelling to periodontal research data. Community Dent Health. 2000a;17:227–35.

    PubMed  Google Scholar 

  • Gilthorpe MS, Mayhew MT, Bulman JS. Multilevel survival analysis of amalgam restorations amongst RAF personnel. Community Dent Health. 2002;19:3–11.

    Google Scholar 

  • Gilthorpe MS, Maddick IH, Petrie A. Introduction to multilevel modelling in dental research. Community Dent Health. 2000b;17:222–6.

    PubMed  Google Scholar 

  • Gilthorpe MS, Zamzuri AT, Griffiths GS, Maddick IH, Eaton KA, Johnson NW. Unification of the “burst” and “linear” theories of periodontal disease progression: a multilevel manifestation of the same phenomenon. J Dent Res. 2003;82:200–5.

    Article  PubMed  Google Scholar 

  • Goldstein H, Browne W, Rasbash J. Multilevel modelling of medical data. Stat Med. 2002;21:3291–315.

    Article  PubMed  Google Scholar 

  • Hoberman D. Periodontal sites or patients as the experimental unit. J Periodontal Res. 1992;27:417–9.

    Article  PubMed  Google Scholar 

  • Hughes FJ, Syed M, Koshy B, Marinho V, Bostanci N, McKay IJ, Curtis MA, Croucher RE, Marcenes W. Prognostic factors in the treatment of generalized aggressive periodontitis: I. Clinical features and initial outcome. J Clin Periodontol. 2006;33:663–70.

    Article  PubMed  Google Scholar 

  • Hujoel PP, Loesche WJ, DeRouen TA. Assessment of relationships between site-specific variables. J Periodontol. 1990;61:368–72.

    Article  PubMed  Google Scholar 

  • Kim CK, Choi SH, Kim TS, Kaltschmitt J, Eickholz P. The infrabony defect and its determinants. J Periodontal Res. 2006;41:498–502.

    Article  PubMed  Google Scholar 

  • Lewsey JD, Gilthorpe MS, Bulman JS, Bedi R. Is modelling dental caries a “normal” thing to do? Community Dent Health. 2000;17:212–7.

    PubMed  Google Scholar 

  • Lewsey JD, Gilthorpe MS, Gulabivala K. An introduction to meta-analysis within the framework of multilevel modelling using the probability of success of root canal treatment as an illustration. Community Dent Health. 2001;18:131–7.

    PubMed  Google Scholar 

  • Lie MA, Timmerman MF, van der Velden U, van der Weijden GA. Evaluation of 2 methods to assess gingival bleeding in smokers and non-smokers in natural and experimental gingivitis. J Clin Periodontol. 1998;25:695–700.

    Article  PubMed  Google Scholar 

  • Lopez R, Frydenberg M, Baelum V. Contextual effects in the occurrence of periodontal attachment loss and necrotizing gingival lesions among adolescents. Eur J Oral Sci. 2009;117:547–54.

    Article  PubMed  Google Scholar 

  • Löe H, Anerud A, Boysen H, Smith M. The natural history of periodontal disease in man. The rate of periodontal disease destruction before 40 years of age. J Periodontol 1978;49:607–620.

    Google Scholar 

  • Matuliene G, Pjetursson BE, Salvi GE, Schmidlin K, Brägger U, Zwahlen M, Lang NP. Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol. 2008;35:685–95.

    Article  PubMed  Google Scholar 

  • Müller HP. A bivariate multi-level model, which avoids mathematical coupling in the study of change and initial periodontal attachment level after therapy. Clin Oral Investig. 2007;11:307–10.

    Article  PubMed  Google Scholar 

  • Müller HP. Modeling mucosal dimensions after implantation of a bio-absorbable membrane for surgical root coverage. Clin Oral Investig. 2008;12:249–55.

    Article  PubMed  Google Scholar 

  • Müller HP. Dealing with hierarchical data in periodontal research. Clin Oral Investig. 2009a;13:273–8.

    Article  PubMed  Google Scholar 

  • Müller HP. Multilevel modeling of gingival bleeding on probing in young adult carriers of non-JP2-like strains of Aggregatibacter actinomycetemcomitans. Clin Oral Investig. 2009b;13:171–8.

    Article  PubMed  Google Scholar 

  • Müller HP, Barrieshi-Nusair KM. Site-specific gingival bleeding on probing in a steady-state plaque environment: influence of polymorphisms in the interleukin-1 gene cluster. J Periodontol. 2010;81:52–61.

    Article  PubMed  Google Scholar 

  • Müller HP, Könönen E. Variance components of gingival thickness. J Periodontal Res. 2005;40:239–44.

    Article  PubMed  Google Scholar 

  • Müller HP, Stadermann S. Multivariate multilevel models for repeated measures in the study of smoking effects on the association between plaque and gingival bleeding. Clin Oral Investig. 2006;10:311–6.

    Article  PubMed  Google Scholar 

  • Müller HP, Stadermann S, Heinecke A. Longitudinal association between plaque and gingival bleeding in non-smokers and smokers. J Clin Periodontol. 2002;29:287–94.

    Article  PubMed  Google Scholar 

  • Müller HP, Ulbrich M, Heinecke A. Alveolar bone loss in adults as assessed on panoramic radiographs. (II) multilevel models. Clin Oral Investig. 2005;9:105–10.

    Article  PubMed  Google Scholar 

  • Müller HP, Barrieshi-Nusair KM, Könönen E, Yang M. Effect of triclosan/copolymer-containing toothpaste on the association between plaque and gingival bleeding: a randomized controlled clinical trial. J Clin Periodontol. 2006;33:811–8.

    Article  PubMed  Google Scholar 

  • Mutsvari T, Lesaffre E, García-Zattera MJ, Diya L, Declerck D. Factors that influence data quality in caries experience detection: a multilevel modelling approach. Caries Res. 2010;44:438–44.

    Article  PubMed  Google Scholar 

  • Muzzi L, Nieri M, Cattabriga M, Rotundo R, Cairo F, Pini Prato GP. The potential prognostic value of some periodontal factors for tooth loss: a retrospective multilevel analysis on periodontal patients treated and maintained over 10 years. J Periodontol. 2006;77:2084–9.

    Article  PubMed  Google Scholar 

  • Nair P, Sutherland G, Palmer RM, Wilson RF, Scott DA. Gingival bleeding on probing increases after quitting smoking. J Clin Periodontol. 2003;30:435–7.

    Article  PubMed  Google Scholar 

  • Needleman I, Suvan J, Gilthorpe MS, Tucker R, St George G, Giannobile W, Tonetti M, Jarvis M. A randomized-controlled trial of low-dose doxycycline for periodontitis in smokers. J Clin Periodontol. 2007;34(4):325–33.

    Article  PubMed  Google Scholar 

  • Nibali L, Donos N, Farrell S, Ready D, Pratten J, Tu YK, D’Aiuto F. Association between interleukin-6-174 polymorphism and Aggregatibacter actinomycetemcomitans in chronic periodontitis. J Periodontol. 2010;81:1814–9.

    Article  PubMed  Google Scholar 

  • Nibali L, Pometti D, Tu Y-K, Donos N. Clinical and radiographic outcomes following non-surgical therapy of periodontal infrabony defects: a retrospective study. J Clin Periodontol. 2011;38:50–7.

    Article  PubMed  Google Scholar 

  • Nieri M, Muzzi L, Cattabriga M, Rotundo R, Cairo F, Pini Prato GP. The prognostic value of several periodontal factors measured as radiographic bone level variation: a 10-year retrospective multilevel analysis of treated and maintained periodontal patients. J Periodontol. 2002;73:1485–93.

    Article  PubMed  Google Scholar 

  • Pattussi MP, Hardy R, Sheiham A. The potential impact of neighbourhood empowerment on dental caries among adolescents. Community Dent Oral Epidemiol. 2006;34:344–50.

    Article  PubMed  Google Scholar 

  • Persson GR. Site-based versus subject-based periodontal diagnosis. Periodontol 2000. 2005;39:145–63.

    Google Scholar 

  • Pretzl B, Kaltschmitt J, Kim TS, Reitmeir P, Eickholz P. Tooth loss after active periodontal therapy. 2: tooth-related factors. J Clin Periodontol. 2008;35:175–82.

    Article  PubMed  Google Scholar 

  • Seibert J, Lindhe J. Esthetics and periodontal therapy. In: Lindhe J, editor. Textbook of clinical periodontology. 2nd ed. Copenhagen: Munksgaard; 1989. p. 477–514.

    Google Scholar 

  • Socransky SS, Haffajee AD, Goodson JM, Lindhe J. New concepts of destructive periodontal disease. J Clin Periodontol 1984;11:21–32.

    Google Scholar 

  • Tomasi C, Leyland AH, Wennström JL. Factors influencing the outcome of non-surgical periodontal treatment: a multilevel approach. J Clin Periodontol. 2007;34:682–90.

    Article  PubMed  Google Scholar 

  • Tomasi C, Koutouzis T, Wennström JL. Locally delivered doxycycline as an adjunct to mechanical debridement at retreatment of periodontal pockets. J Periodontol. 2008;79:431–9.

    Article  PubMed  Google Scholar 

  • Tu YK, Gilthorpe MS. Revisiting the relation between change and initial value: a review and evaluation. Stat Med. 2007;26:443–57.

    Article  PubMed  Google Scholar 

  • Tu YK, Gilthorpe MS, Griffiths GS. Is reduction of pocket probing depth correlated with the baseline value or is it “mathematical coupling”? J Dent Res. 2002;81:722–6.

    Article  PubMed  Google Scholar 

  • Tu YK, Gilthorpe MS, Griffiths GS, Maddick IH, Eaton KA, Johnson NW. The application of multilevel modeling in the analysis of longitudinal periodontal data – part I: absolute levels of disease. J Periodontol. 2004a;75:127–36.

    Article  PubMed  Google Scholar 

  • Tu YK, Gilthorpe MS, Griffiths GS, Maddick IH, Eaton KA, Johnson NW. The application of multilevel modeling in the analysis of longitudinal periodontal data – part II: changes in disease levels over time. J Periodontol. 2004b;75:137–45.

    Article  PubMed  Google Scholar 

  • Tu YK, Maddick IH, Griffiths GS, Gilthorpe MS. Mathematical coupling can undermine the statistical assessment of clinical research: illustration from the treatment of guided tissue regeneration. J Dent. 2004c;32:133–42.

    Article  PubMed  Google Scholar 

  • Tu YK, Baelum V, Gilthorpe MS. The problem of analysing the relationship between change and initial value in oral health research. Eur J Oral Sci. 2005;113:271–8.

    Article  PubMed  Google Scholar 

  • Wan CP, Leung WK, Wong MC, Wong RM, Wan P, Lo EC, Corbet EF. Effects of smoking on healing response to non-surgical periodontal therapy: a multilevel modelling analysis. J Clin Periodontol. 2009;36:229–39.

    Article  PubMed  Google Scholar 

  • Woodhouse G, Rasbash J, Goldstein H, Yang M. Introduction to multilevel modelling. In: Woodhouse G, editor. A guide to MLn for new users. London: Institution of Education, University of London; 1995. p. 9–58.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Periodontology, University of Tromsø Institute of Clinical Dentistry, Tromsø, Norway

    Alexandrina L. Dumitrescu

  2. Private practice, Bucharest, Romania

    Alexandrina L. Dumitrescu

Authors
  1. Alexandrina L. Dumitrescu
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Dumitrescu, A.L. (2012). Multilevel Modelling in Periodontal Research. In: Understanding Periodontal Research. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28923-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-28923-1_11

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-28922-4

  • Online ISBN: 978-3-642-28923-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation