Artificial Neural Networks for the Diagnosis of Aggressive Periodontitis Trained by Immunologic Parameters

There is neither a single clinical, microbiological, histopathological or genetic test, nor combinations of them, to discriminate aggressive periodontitis (AgP) from chronic periodontitis (CP) patients. We aimed to estimate probability density functions of clinical and immunologic datasets derived from periodontitis patients and construct artificial neural networks (ANNs) to correctly classify patients into AgP or CP class. The fit of probability distributions on the datasets was tested by the Akaike information criterion (AIC). ANNs were trained by cross entropy (CE) values estimated between probabilities of showing certain levels of immunologic parameters and a reference mode probability proposed by kernel density estimation (KDE). The weight decay regularization parameter of the ANNs was determined by 10-fold cross-validation. Possible evidence for 2 clusters of patients on cross-sectional and longitudinal bone loss measurements were revealed by KDE. Two to 7 clusters were shown on datasets of CD4/CD8 ratio, CD3, monocyte, eosinophil, neutrophil and lymphocyte counts, IL-1, IL-2, IL-4, INF-γ and TNF-α level from monocytes, antibody levels against A. actinomycetemcomitans (A.a.) and P.gingivalis (P.g.). ANNs gave 90%-98% accuracy in classifying patients into either AgP or CP. The best overall prediction was given by an ANN with CE of monocyte, eosinophil, neutrophil counts and CD4/CD8 ratio as inputs. ANNs can be powerful in classifying periodontitis patients into AgP or CP, when fed by CE values based on KDE. Therefore ANNs can be employed for accurate diagnosis of AgP or CP by using relatively simple and conveniently obtained parameters, like leukocyte counts in peripheral blood. This will allow clinicians to better adapt specific treatment protocols for their AgP and CP patients.