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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)., Material and 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%., Conclusion: 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., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

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)., Material and 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., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)