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 1946–2012, which compared PMPE vs. full mouth periodontal examination (FMPE) protocols for CAL or PD ≥ 4mm or REC ≥ 3mm 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: 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.
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 3,667 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% to 52.5% and 27.1% to 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.
The capacity to locate, access, and appraise information is an important skill required for success in dental school and beyond. An interdisciplinary course was implemented to teach first-year dental students at the University of Texas Health Science Center at Houston Dental Branch about evidence-based dentistry, search strategies, critical appraisal of the literature, and dental informatics. Students learned to develop a clinical question, conduct a search to find answers to that question, and critically appraise one of the retrieved resources. Over a period of four years, a total of 259 dental students completed a questionnaire that requested their assessment of this course. Seventy-five percent of the respondents agreed or strongly agreed that they learned to effectively search databases such as the Cochrane Collaboration and PubMed and to critically appraise websites and journal articles and that the information on evidence-based dentistry and critical thinking skills was valuable.In response to open-ended questions, approximately 35 percent of the respondents mentioned the importance of learning to search PubMed and Cochrane databases. Approximately 20 percent of the respondents felt the course did not contain new information. These results indicated the effectiveness of the course in familiarizing the students with the capacity of online resources to help them locate, access, and appraise information pertinent to oral health issues and the practice of dentistry. A future goal is to integrate information and skills associated with evidence-based practice into other courses in the dental curriculum.Dr. Levine is Associate Professor,
Single-bottle bonding agents provide similar in vitro bond strengths for use with packable composites as do the same manufacturers' multiple-bottle bonding agents.
We have previously demonstrated that half-mouth four-site periodontal examination protocol performed well in estimating periodontitis prevalence. This study aimed to assess biases associated with this same protocol in estimating periodontitis extent and severity in a United States population. Periodontitis extent as determined by percentage of sites with clinical attachment loss (CAL) ≥3, and ≥5 mm and severity as determined by mean CAL were calculated for full-mouth examination and half-mouth four-site protocol based on 3734 adults sampled from the National Health and Nutrition Examination Survey 2009-2010. Probing depth was excluded because of low data reliability. The comparison between full-mouth and half-mouth assessments was based on bias, relative bias, Wilcoxon signed-rank test, and intra-class correlation coefficient (ICC). For full-mouth examination, periodontitis extent was 21.2% for CAL ≥3 mm and 6.9% for CAL ≥5 mm; periodontitis severity (mean CAL) was 1.73 mm. Half-mouth four-site protocol provided bias À1.2% and relative bias À5.7% for extent (CAL ≥3 mm). Corresponding numbers were À0.3% and 4.3% for extent (CAL ≥5 mm), À0.05 mm and À2.9% for severity. Although the difference between full-mouth and half-mouth assessments was statistically significant, ICCs between them were ≥0.96 for extent (CAL ≥3, 5 mm), and severity (mean CAL). Half-mouth four-site protocol performed well in estimating periodontitis extent and severity based on CAL. Therefore, this protocol should be considered for periodontitis surveillance.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.