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Evaluating periodontal disease misclassification mechanisms under partial-mouth recording protocols
Brenda Heaton1, Praveen Sharma2, Raul I Garcia1
1Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
Journal of Clinical Periodontology
|February 1, 2018
Summary
Partial-mouth recording (PMR) protocols for diagnosing periodontal disease can lead to misclassification. Adjusting case definitions for PMR improves sensitivity but reduces specificity, potentially biasing severity measures.
Area of Science:
- Periodontology
- Dental Diagnostics
Background:
- Partial-mouth recording (PMR) protocols are widely used for periodontal disease assessment.
- The accuracy of PMR in classifying periodontal disease remains a subject of investigation.
Purpose of the Study:
- To evaluate the assumptions behind partial-mouth recording (PMR) protocols.
- To identify mechanisms of potential periodontal disease misclassification using PMR.
Main Methods:
- Utilized data from 640 participants in the VA Dental Longitudinal Study.
- Compared tooth-specific and site-specific clinical measures.
- Calculated sensitivity and specificity of various PMR protocols against a full-mouth reference standard (CDC/AAP definitions).
- Evaluated alternative case definitions for PMR protocols.
Main Results:
- Periodontitis was found to be a generalized condition, with similar severity measures across different sites, quadrants, and jaws.
- Sensitivity of periodontal disease classification via PMR depended on the number of teeth/sites and case definition.
- Modified case definitions enhanced PMR sensitivity but decreased specificity.
- Misclassification under PMR protocols was not random.
Conclusions:
- Partial-mouth recording (PMR) protocols can lead to misclassification of periodontal disease.
- While PMR protocols can be modified to increase sensitivity, this may introduce bias in mean severity measures and reduce specificity.
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