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PerioTwin-DeltaCRED: a validation-aware physiological digital twin for longitudinal periodontal treatment response prediction.

Created on 26 Sep 2026

Authors

Pradeep Kumar Yadalam

Published in

Frontiers in physiology. Volume 17. Pages 1958029. Epub Sep 11, 2026.

Abstract

Predicting individual periodontal treatment response remains clinically unresolved. Existing machine-learning models are predominantly cross-sectional, lack a longitudinal response-vector design, and are rarely evaluated within validation-aware digital-twin frameworks that capture multidimensional credibility rather than single-endpoint discrimination alone. This study aimed to develop and evaluate PerioTwin-DeltaCRED, a validation-aware periodontal digital twin that models treatment response as a longitudinal PPD and CAL response vector, and to benchmark classical and quantum machine-learning engines against that framework.
Five hundred patients with Stage II-IV periodontitis were retrospectively assembled from the Saveetha DIAS system; treatment was observational, involving either scaling and root planing alone or with low-level laser therapy. A stratified 60:20:20 split (training n=300, validation n=100, test n=100) was used for all models, using only baseline predictors-follow-up measurements and outcome variables were excluded to prevent leakage. Classical learners (logistic regression, random forest, gradient boosting) were benchmarked for poor-response classification, PPD reduction, CAL gain, and residual deep-pocket risk. Three quantum architectures-VQC-Pauli, Data Re-Uploading VQC (DRU-VQC), and QSVC-along with a hybrid quantum-classical stack, were evaluated as exploratory engines; six principal components (83.6% of variance) were angle-encoded into six-qubit circuits. Hyperparameters were optimized by Optuna on the validation set, with the test set withheld until final assessment. Uncertainty was estimated by bootstrap resampling, and the Delta-PTFI summarized credibility.
Classical logistic regression was the strongest poor-response model (test AUROC 0.69, 95% CI 0.59-0.80; sensitivity 0.54, specificity 0.75), with random forest comparable (AUROC 0.68) and providing the best residual deep-pocket discrimination (AUROC 0.76). Continuous responses were predicted with modest error (PPD-reduction mean absolute error 0.37 mm; CAL-gain 0.31 mm); against observed changes of 1.20 ± 0.46 mm and 0.78 ± 0.36 mm, these errors were equivalent to an intercept-only baseline. Baseline CAL and periodontal stage were the dominant and most stable predictors (mean top-5 stability 0.75), and a two-variable model using stage and baseline CAL alone matched the full model (AUROC 0.71 versus 0.69). An exploratory composite credibility index (Delta-PTFI) was 0.62, falling to 0.25 when its continuous-outcome components were anchored to an intercept-only reference. No quantum architecture surpassed classical learning: the data re-uploading classifier (DRU-VQC) was the best quantum model (test AUROC 0.63), followed by the hybrid stack (0.60), VQC-Pauli (0.46), and QSVC (0.40). Classical learners restricted to the same six principal components reached AUROC 0.58-0.66, and the best of them (random forest, 0.66) still exceeded every quantum model.
PerioTwin-DeltaCRED provides a validation-aware digital twin for periodontal treatment response, assessing calibration, fidelity, response stability, and credibility index instead of just discrimination. Classical models outperformed, and quantum architectures like DRU-VQC showed no advantage in noiseless six-qubit tests. This is among the first studies embedding and benchmarking quantum machine learning in a periodontal digital twin; more validation and noise testing is needed before clinical use.

PMID:
42798377
Bibliographic data and abstract were imported from PubMed on 26 Sep 2026.

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