Comparative estimation of periodontal conditions by means of different index systems

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Abstract
The aim of the present study was to compare epidemiological data of periodontal disease obtained from a sample of adults by means of different, commonly employed, partial and full‐mouth index systems, in order to explore the amount of discrepancy attributed to the methodology per se. 169 dentate subjects, aged 25–64 years, were subjected to a clinical examination, including circumferential probing assessments of pocket depth (PPD) and attachment level (PAL) at all teeth present. The individual mean % of tooth sites with PPD of 6 mm and the % of subjects exhibiting at least one such deep pocket were calculated based on (i) full‐mouth data, (ii) data derived from the buccal and mesial surfaces from 1 randomly selected upper and 1 lower quadrant, (iii) probing assessments at the 6 “Ramfjord teeth”, (iv) the full‐mouth community pehodontal index for treatment needs (CPITN), and (v) the partial CPITN based on 10 index teeth. The PAL data were analyzed by means of 3 versions of the extent and severity index, 1 generated by full‐moutn assessments and 2 by partial assessments based on 28 and 10 tooth sites, respectively. In the entire sample, the individual mean % of sites with PPD of 6 mm generated by the different systems ranged between 5.0 and 4.2 sites/subject. By full‐mouth CPITN scorings, an average of 1.0 score‐4 sextants/subject was recorded, while the partial CPITN generated a corresponding value of 0.8 score‐4 sextants/subject. The prevalence of subjects with at least one deep pocket was found to be (i) 47% by the full‐mouth examination, (ii) 24% by the half‐mouth examination, (iii) 26% by the use of the “Ramfjord teeth”, and (iv) 44% by the partial CPITN. Variations in the accuracy of the partial recordings were observed in different age groups. Analysis of the PAL data generated extent values ranging between 93 and 96% and severity values between 3.6 and 3.9 mm. It was concluded that partial recording systems (i) provide reasonably valid estimates of the individual mean number of “affected” tooth sites; however, (ii) they grossly underestimate the prevalence of subjects exhibiting deep periodontal pockets.

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