title: Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults.
abstract: BACKGROUND
  Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination.
  
  
  METHODS
  Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated.
  
  
  RESULTS
  Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors.
  
  
  CONCLUSIONS
  Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.
authors.affiliation: Research Group in Oral Epidemiology and Public Health Dentistry, Postgraduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. mperes@ccs.ufsc.br
authors.forename: Marco A
authors.initials: MA
authors.lastname: Peres
authors.forename: Karen G
authors.initials: KG
authors.lastname: Peres
authors.forename: Andreia M
authors.initials: AM
authors.lastname: Cascaes
authors.forename: Marcos B
authors.initials: MB
authors.lastname: Correa
authors.forename: Flávio F
authors.initials: FF
authors.lastname: Demarco
authors.forename: Pedro C
authors.initials: PC
authors.lastname: Hallal
authors.forename: Bernardo L
authors.initials: BL
authors.lastname: Horta
authors.forename: Denise P
authors.initials: DP
authors.lastname: Gigante
authors.forename: Ana B
authors.initials: AB
authors.lastname: Menezes
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001938:Brazil / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003728:Dental Calculus / Q000453:epidemiology; D003729:Dental Care / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D005884:Gingival Hemorrhage / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000193:education; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D016388:Tooth Loss / Q000453:epidemiology; D014099:Toothbrushing / Q000706:statistics & numerical data; D055815:Young Adult