Buduneli Eralp, Aksoy Okay, Köse Timur, Atilla Gül
Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
J Clin Periodontol. 2004 Oct;31(10):815-9. doi: 10.1111/j.1600-051x.2004.00560.x.
Periodontal probe is the standard instrument for assessment of probing pocket depth and clinical attachment level. However, probing measurements have inherent measurement errors from a wide range of sources, such as instrument, patient, examiner and disease status.
The purpose of the present study was to create an in vitro model simulating gingival sulcus/pocket and investigate the accuracy and reproducibility of two different manual probes.
Thirty-three aluminium blocks with dimensions of 2 x 2 cm and thickness ranging from 2.00 to 10.00 mm were constructed. Holes with a diameter of 1.00 mm were made in the blocks through the whole thickness. These 33 aluminium blocks were then carefully stuck together so that the probing faces would be on the same level. A plastic material, which shows deformation with forces >45 g was placed at the base of the blocks. Two conventional manual probes (Williams and WHO probes) were used in the present study. Seventeen periodontists were selected to perform duplicate measurements on the blocks over two visits using both of the probes. The intra- and inter-examiner percentage accuracy (with regard to 0.25 mm) and reproducibility for each of the duplicate measurements was calculated and analysed using repeated measure analysis of variance (ANOVA) (three factor experiments with repeated measure on two factors; probe and probing session).
ANOVA showed statistically significant differences between the examiners (p=0.000) and between the two readings of each probe (p=0.002), while the differences between the two probes were not statistically significant (p=0.098). The overall percentage of accuracy was higher with WHO probe compared with Williams probe. Kappa analysis revealed better reproducibility percentages for WHO probe in comparison with Williams probe.
This in vitro study, using a metal construction and a plastic material with a deformation coefficient similar to that of gingival pocket, may be suggested as a good model to test intra- and inter-examiner differences in periodontal probing. Our findings emphasise the importance of inter-examiner calibration for probing, particularly in longitudinal studies.
牙周探针是评估探诊袋深度和临床附着水平的标准器械。然而，探诊测量存在来自多种来源的固有测量误差，如器械、患者、检查者和疾病状态。
本研究的目的是创建一个模拟牙龈沟/牙周袋的体外模型，并研究两种不同手动探针的准确性和可重复性。
制作了33个尺寸为2×2 cm、厚度在2.00至10.00 mm之间的铝块。在铝块上沿整个厚度钻直径为1.00 mm的孔。然后将这33个铝块小心地粘在一起，使探诊面处于同一水平。在铝块底部放置一种在力>45 g时会变形的塑料材料。本研究使用了两种传统手动探针（威廉姆斯探针和世界卫生组织探针）。选择17名牙周病医生，使用两种探针在两次就诊时对铝块进行重复测量。使用重复测量方差分析（ANOVA）（两因素重复测量的三因素实验；探针和探诊环节）计算并分析每次重复测量的检查者内和检查者间百分比准确性（相对于0.25 mm）及可重复性。
ANOVA显示检查者之间（p = 0.000）以及每种探针的两次读数之间（p = 0.002）存在统计学显著差异，而两种探针之间的差异无统计学意义（p = 0.098）。与威廉姆斯探针相比，世界卫生组织探针的总体准确性百分比更高。Kappa分析显示，与威廉姆斯探针相比，世界卫生组织探针的可重复性百分比更高。
这项体外研究使用金属结构和变形系数与牙龈袋相似的塑料材料，可被认为是测试牙周探诊中检查者内和检查者间差异的良好模型。我们的研究结果强调了探诊时检查者间校准的重要性，特别是在纵向研究中。
