Van der Zee Erwin, Vogels Marie-Faustine, Oosterveld Paul, Van Waas Marinus
Clinic for Oral Implantology, Department of Oral Function, Academic Centre for Dentistry (ACTA), The Netherlands.
J Clin Periodontol. 2004 Apr;31(4):318-23. doi: 10.1111/j.1600-051X.2004.00448.x.
For evidence-based evaluation of guided bone regeneration (GBR), accurate registration of changes in gingiva and bone levels is needed. A new method is introduced and evaluated.
In a clinical trial with 30 patients, alginate impressions of the surgical area including the interproximal gingiva and alveolar bone at the adjacent teeth were made in duplicate prior to and during GBR surgery, fixture installation and abutment connection. Poured in hard stone, the casts were used for repeated measurements of the level of the free gingival margin and the alveolar bone with an automated probe (Florida disc-probe(R)), using the incisal edge as a fixed reference point. The reproducibility and accuracy of these measurements were evaluated by means of the Intraclass Correlation Coefficients and Generalizability Theory. The effect of treatment was evaluated by multivariate analysis of variance.
Generalizability Theory indicated a high accuracy of the gingiva- and bone-level measurements: the Intraclass Correlation Coefficients for gingiva and bone levels were 0.99 and 0.98, respectively. The intra-cast reproducibility was 0.09+/-0.07 mm (mean+/-SD) and the inter-cast reproducibility was 0.10+/-0.09 and 0.20+/-0.07 mm for gingiva and bone levels, respectively. Clinical applicability is demonstrated by the fact that manova revealed on average a small but highly significant (p=0.001) effect of the staged surgical intervention on the gingiva and bone levels at the adjacent teeth.
It is concluded that the presented method makes it possible to evaluate reproducibly and accurately changes in gingiva and bone levels for GBR studies.
为了对引导骨再生（GBR）进行循证评估，需要准确记录牙龈和骨水平的变化。本文介绍并评估了一种新方法。
在一项针对30名患者的临床试验中，在GBR手术、种植体植入和基台连接之前及过程中，对手术区域包括邻牙的邻间牙龈和牙槽骨制作藻酸盐印模，一式两份。将印模灌注成硬石膏模型，使用自动探针（Florida盘式探针（R））以切缘作为固定参考点，对游离牙龈边缘和牙槽骨水平进行重复测量。通过组内相关系数和可推广性理论评估这些测量的重复性和准确性。通过多变量方差分析评估治疗效果。
可推广性理论表明牙龈和骨水平测量具有较高的准确性：牙龈和骨水平的组内相关系数分别为0.99和0.98。模型内重复性对于牙龈和骨水平分别为0.09±0.07毫米（平均值±标准差），模型间重复性对于牙龈和骨水平分别为0.10±0.09和0.20±0.07毫米。多变量方差分析表明，分期手术干预对邻牙牙龈和骨水平平均有微小但高度显著（p = 0.001）的影响，证明了该方法的临床适用性。
得出的结论是，所提出的方法能够对GBR研究中的牙龈和骨水平变化进行可重复且准确的评估。
