Department of Oral and Maxillofacial Surgery, Kaunas University of Medicine, Kaunas, Lithuania.
J Periodontol. 2010 Jan;81(1):34-42. doi: 10.1902/jop.2009.090385.
The aim of this study is to develop and validate a complex esthetic index (CEI) designed for rating the esthetics of anterior maxillary implant-supported restorations with respect to the surrounding soft and hard tissues.
Fifty patients (31 males and 19 females; age: 18 to 50 years; mean age +/- SD: 32.4 +/- 9.1 years) previously treated with dental implants were evaluated regarding the esthetic results of their restorations using the proposed CEI. Two calibrated oral surgeons did the evaluation and recording. The evaluation was carried out twice by each of the examiners 2 weeks apart. The weighted Cohen's kappa was used to calculate the intra- and interobserver agreement.
An analysis of CEI for 50 anterior maxillary implant-supported restorations showed good intra- and interobserver agreement for the soft tissue index (S) and implant-supported restoration index (R). Only the interobserver agreement for the overall R was rated as moderate (0.54 and 0.52). The single-parameter analysis showed that the lowest (moderate) intra- and interobserver agreement was with the subjective parameters of S (soft tissue color and texture variations) and R (crown surface roughness and ridges and color and translucency). An adequate CEI of S100, P100, and R100 was scored by both examiners in 10% and 12% of cases for evaluations I and II, respectively.
This study presents evidence that this newly developed CEI, which incorporates the implant restoration and adjacent soft and hard tissue parameters, is a reproducible tool for scoring anterior implant esthetic predictably. However, prospective clinical trials involving examiners with different training backgrounds are needed to further validate the long-term stability of this index.
本研究旨在开发和验证一种复杂的美学指数（CEI），用于评估前上颌种植体支持修复体的美学效果，涉及周围软硬组织。
对 50 名患者（31 名男性和 19 名女性；年龄：18 至 50 岁；平均年龄 +/- SD：32.4 +/- 9.1 岁）进行评估，使用提出的 CEI 评估其修复体的美学效果。两名经过校准的口腔外科医生进行评估和记录。评估由每位检查者在 2 周内进行两次。使用加权 Cohen's kappa 计算观察者内和观察者间的一致性。
对 50 例前上颌种植体支持修复体的 CEI 分析显示，软组织指数（S）和种植体支持修复指数（R）的观察者内和观察者间一致性良好。只有整体 R 的观察者间一致性被评为中度（0.54 和 0.52）。单参数分析显示，S（软组织颜色和质地变化）和 R（牙冠表面粗糙度和嵴以及颜色和半透明度）的主观参数的观察者内和观察者间一致性最低（中度）。两位检查者在评估 I 和 II 时，分别有 10%和 12%的病例对 S100、P100 和 R100 进行了足够的 CEI 评分。
本研究表明，这种新开发的 CEI 结合了种植体修复体和相邻软硬组织参数，是一种可重复使用的工具，可预测性地评估前牙种植体的美学效果。然而，需要涉及不同培训背景的检查者的前瞻性临床试验来进一步验证该指数的长期稳定性。
