Methodological challenges and strengths
obesity, PD
OBESITY, DISEASE, OBESE, PLAQUE
The unbalanced distribution of subjects within the two groups, with a lower number of subjects included in the non-MetS group, might undermine the statistical power of the study. In the present study, staging and grading were primarily based on clinical measures such as CAL, PD, furcation involvement, and bitewing radiographs. Registration of plaque would give a more nuanced understanding of all clinical parameters and particularly BoP. The rather high mean BMI of our study sample may undermine the likelihood of detecting intergroup differences. Only about 15% of the obese population will not develop obesity related co-morbidities [The strength of this study is the full-mouth periodontal evaluation, and the periodontal examination performed by only one examiner with high ICC values, improving the disease detection accuracy. The sociodemographic, oral hygiene habits, laboratory and clinical data were rather comprehensive and relevant.