Partial recording protocols performance on the assessment of periodontitis severity and extent: Bias magnitudes, sensibility, and specificity

Objectives: This study aimed to assess bias magnitudes, sensibility, and specifiicity of particular partial-mouth recording protocols (PRPs) to estimate periodontal clinical measurements and periodontal status. Methods: Estimates of mean clinical attachment loss (MCAL) and mean probing depth (MPD) were calculated for 15 different PRPs and were compared to full-mouth recording protocol (FRP) data from 402 Portuguese. Biases, relative biases and intra-class correlations for all PRPs were evaluated. Bland-Altman plots and Receiver Operating Characteristic / Area Under the Curve (ROC/AUC) analysis were used to assess the sensitivity and specificity for each PRP periodontal diagnosis. Results: Regarding MPD, Half RD6 UR/LL and RD6 UL/LR had the lowest bias observed with 0.00 mm (-0.22% and 0.22%, respectively) and all full-mouth PRPs significantly produce an underestimation. Concerning MCAL, the Half MB-B-DL UR/LR had the lowest bias observed with 0.01 mm (0.16%). Excluding CPITN, Full-Mouth PRPs outperforms in average Half Mouth PRPs correlations. The Half RD6 UR/LL had the highest AUC (0.96) with 95.5 and 97.1% of sensitivity and specificity, respectively. Conclusions: Three half-mouth PRPs (Half MB-B-DL UR/LR, Half RD6 UR/LL and Half RD6 UL/LR) protocols can be used to estimate periodontal clinical measurements with limited bias, and high sensitivity, specificity, and concordance. All full-mouth PRPs failed to estimate pocket depth means, and for clinical attachment loss, they present less ability then half-mouth partial protocols, despite presenting high sensitivity levels.