Clinical assessment of periodontitis in young adults--evaluation of probing depth and partial recording methods.
The present study was carried out to compare the ability of different methods of periodontal assessment to identify those subjects in a population who had suffered the worst periodontal breakdown. Comparisons were made between full mouth approximal attachment loss (CAL) assessment and methods relying on pocket probing depth (PPD) evaluation or on partial recording of CAL or PPD. Both of the latter types of assessment are commonly used in epidemiological surveys. 202 workers at an electronics factory aged between 20 and 40 yr were examined for approximal PPD and CAL, excluding third molars. The data were used to determine which individuals had the worst periodontitis based on CAL at several thresholds. Further analysis was carried out to determine which of these subjects would have been identified on the basis of the presence of deep (> or = 6 mm) pocketing, or by using one of a battery of partial recording subsets. CAL was frequently present in the absence of deep pocketing. A subset made up of four approximal sites around each of the 10 index teeth recommended by the WHO for partial recording (two molars in each quadrant and maxillary right and mandibular left central incisors) and a subset comprising maxillary buccal and mandibular lingual sites ("Pritchard" sites) performed best of the subsets considered in identifying the subjects who had been found by full mouth assessment to have at least one or at least two approximal sites with CAL at thresholds of 2, 3 or 4 mm. It was concluded that measurements of CAL using either of these subsets should reduce problems of under-recording of the prevalence of periodontitis associated with the use of PPDs alone or on CAL assessment at other partial recording subsets.