title: Assessing periodontitis in populations: a systematic review of the validity of partial-mouth examination protocols.
abstract: OBJECTIVE
  To estimate bias associated with partial-mouth periodontal examination (PMPE) protocols regarding estimates of prevalence, severity and extent of clinical attachment loss (CAL), pocket depth (PD) and gingival recession (REC).
  
  
  METHODS
  A search was made for articles published in English, from 1946 to 2012, which compared PMPE versus full-mouth periodontal examination protocols for CAL or PD ≥ 4 mm or REC ≥3 mm thresholds. PMPE protocols were evaluated for sensitivity of estimates of periodontitis prevalence, relative biases for severity and extent estimates.
  
  
  RESULTS
  A review of the literature identified 12 studies which reported 32 PMPE protocols. Three PMPE protocols which had sensitivities ≥85% and relative biases ≤0.05 in absolute values for severity and extent estimates were as follows: (1) half-mouth six-sites, (2) diagonal quadrants six-sites and (3) full-mouth mesiobuccal-midbuccal-distobuccal (MB-B-DB). Two other PMPE protocols (full-mouth and half-mouth mesiobuccal-midbuccal-distolingual) performed well for prevalence and severity of periodontitis; however, their performance in estimates of extent was unknown.
  
  
  CONCLUSIONS
  Among the 32 PMPE protocols listed, the half-mouth six-sites and full-mouth MB-B-DB protocols had the highest sensitivities for prevalence estimates and lowest relative biases for severity and extent estimates.
authors.affiliation: School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Duong T
authors.initials: DT
authors.lastname: Tran
authors.forename: Isabel
authors.initials: I
authors.lastname: Gay
authors.forename: Xianglin L
authors.initials: XL
authors.lastname: Du
authors.forename: Yunxin
authors.initials: Y
authors.lastname: Fu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Bebermeyer
authors.forename: Ana S
authors.initials: AS
authors.lastname: Neumann
authors.forename: Charles
authors.initials: C
authors.lastname: Streckfus
authors.forename: Wenyaw
authors.initials: W
authors.lastname: Chan
authors.forename: Muhammad F
authors.initials: MF
authors.lastname: Walji
mesh_terms: D015982:Bias; D005889:Gingival Recession / Q000453:epidemiology; D006801:Humans; D017622:Periodontal Attachment Loss / Q000453:epidemiology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000453:epidemiology; D010518:Periodontitis / Q000453:epidemiology*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: partial-mouth examination protocols; periodontal indices; periodontitis; periodontitis prevalence