Chu Yi, Ouyang Xiangying
Department of Periodontology, School and Hospital of Stomatology, Peking University, Beijing, China.
J Periodontol. 2015 Mar;86(3):406-17. doi: 10.1902/jop.2014.140422. Epub 2014 Oct 16.
Partial-mouth periodontal examination (PMPE) has been widely used in periodontal epidemiologic studies. In this study, the authors evaluate the accuracy of extent and severity estimates from PMPE protocols in a Chinese population.
The study enrolled 200 individuals with periodontitis, ages 22 to 64 years. Full-mouth examination was performed to determine probing depth (PD), attachment loss (AL), and bleeding on probing (BOP) at mesio-buccal (MB), mid-buccal (B), disto-buccal (DB), mesio-lingual (ML), mid-lingual (L), and disto-lingual (DL) sites per tooth. Extent and severity estimates from 15 PMPE protocols were derived from and compared to full-mouth data. Relative bias (RB) and intraclass correlation coefficients (ICCs) were calculated. Bland-Altman plots were used to evaluate the agreement patterns across disease levels.
Of the 15 PMPE protocols, the random half-mouth six-sites per tooth (r6sites) protocol performed best in both extent (AL ≥ 2, ≥ 4, or ≥ 6 mm; PD ≥ 4 or ≥ 6 mm; and BOP) and severity (AL and PD) estimates, with RB within 5.0% and ICCs ≥ 0.950 in most cases. MB-B-DB and MB-B-DL protocols generally resulted in RB within 20.0% for extent and within 5.0% for severity. Protocols involving only interproximal sites (MB-DB, MB-DL, and MB-DB-ML-DL) showed good accuracy in AL (RB within 20.0% for extent and within 3.0% for severity), but overestimated PD (RB 12.5% to 54.2% for extent and >10.0% for severity). The community periodontal index teeth protocol caused severe overestimation of up to 110.4% for extent and 14.6% for severity.
The r6sites protocol is best for assessing extent and severity for AL, PD, and BOP under the study conditions.
部分牙列牙周检查（PMPE）已广泛应用于牙周病流行病学研究。在本研究中，作者评估了在中国人群中PMPE方案对范围和严重程度估计的准确性。
该研究纳入了200名年龄在22至64岁之间的牙周炎患者。进行全口检查以确定每颗牙齿的近中颊侧（MB）、颊侧中部（B）、远中颊侧（DB）、近中舌侧（ML）、舌侧中部（L）和远中舌侧（DL）位点的探诊深度（PD）、附着丧失（AL）和探诊出血（BOP）情况。从15种PMPE方案得出范围和严重程度估计值，并与全口数据进行比较。计算相对偏差（RB）和组内相关系数（ICC）。采用Bland-Altman图评估不同疾病水平的一致性模式。
在15种PMPE方案中，随机半口每颗牙齿六个位点（r6sites）方案在范围（AL≥2、≥4或≥6mm；PD≥4或≥6mm；以及BOP）和严重程度（AL和PD）估计方面表现最佳，大多数情况下RB在5.0%以内，ICC≥0.950。MB-B-DB和MB-B-DL方案在范围方面的RB一般在20.0%以内，在严重程度方面在5.0%以内。仅涉及邻面位点的方案（MB-DB、MB-DL和MB-DB-ML-DL）在AL方面显示出良好的准确性（范围方面RB在20.0%以内，严重程度方面在3.0%以内），但高估了PD（范围方面RB为12.5%至54.2%，严重程度方面>10.0%）。社区牙周指数牙齿方案在范围方面导致高达110.4%的严重高估，在严重程度方面为14.6%。
在研究条件下，r6sites方案最适合评估AL、PD和BOP的范围和严重程度。
