title: Assessment of partial-mouth periodontal examination protocols for periodontitis surveillance.
abstract: OBJECTIVE
  To evaluate bias associated with nine identified partial-mouth periodontal examination (PMPE) protocols in estimating periodontitis prevalence using the periodontitis case definition given by the Centers of Disease Control and Prevention and American Academy of Periodontology (CDC/AAP).
  
  
  METHODS
  Prevalence from full-mouth examination was determined in a sample of 3667 adults ≥30 years old from the National Health and Nutrition Examination Survey (NHANES) 2009-2010. Prevalence, absolute bias, relative bias, sensitivity and inflation factor were derived for these protocols according to the CDC/AAP definition and half-reduced CDC/AAP definition as ≤50% of sites were measured.
  
  
  RESULTS
  Bias in moderate and severe periodontitis prevalence ranged between 11.1-52.5% and 27.1-76.3% for full-mouth mesiobuccal-distolingual protocol and half-mouth mesiobuccal protocol respectively; according to the CDC/AAP definition. With half-reduced CDC/AAP definition, half-mouth four sites protocol provided small absolute bias (3.2%) and relative bias (9.3%) for the estimates of moderate periodontitis prevalence; corresponding biases for severe periodontitis were -1.2% and -10.2%.
  
  
  CONCLUSIONS
  Periodontitis prevalence can be estimated with limited bias when a half-mouth four sites protocol and a half-reduced CDC/AAP case definition are used in combination.
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: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000465:Algorithms; D015982:Bias; D002487:Centers for Disease Control and Prevention, U.S.; D003817:Dentition; D004522:Educational Status; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D010512:Periodontal Index; D010518:Periodontitis / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D012680:Sensitivity and Specificity; D012953:Societies, Dental; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: CDC/AAP case definition of periodontitis; partial-mouth periodontal examination protocols; periodontitis; surveillance