Predicting reliably which of our patients will develop periodontitis remains an elusive goal for periodontists. As clinicians, we would greatly desire to be able to perform a simple diagnostic test that would indicate, with adequate sensitivity and specificity, which of our patients are at greatest risk for developing disease. In order to develop and validate such a system, large scale longitudinal clinical trials would be required. This concept was explored at a break-out session of the recent Philips Oral Healthcare Emerging Trends Symposium in Cologne. The discussion, while not scientifically rigorous, was lively and imaginative and led to the development of an idea for the 'perfect clinical trial' which was interpreted by the participants as the clinical trial that they would best like to undertake. Such a trial would aim to develop a method for identifying patients at risk for periodontitis before they actually demonstrated clinical signs of the disease. The discussion focussed on ideas rather than detail about process, and the participants realised that this study, while very desirable in concept, would need a great deal of thought, planning and preliminary experimentation before it could become reality. All of these issues would impact on the practicality of undertaking such a study, which would require significant funding.
Keywords: periodontal disease, disease susceptibility, prevention, diagnosis, clinical trials