Rotundo Roberto, Mori Massimiliano, Bonaccini Daniele, Baldi Carlo
Department of Periodontology, University of Florence, Florence, Italy.
Eur J Oral Implantol. 2011 Summer;4(2):127-33.
Several classification systems have been proposed in the literature, but none of them has been validated by means of an appropriate statistical analysis and, therefore, it is unknown whether these systems work in the same manner among different clinicians. The aim of the present study is to investigate the intra- and inter-rater agreement of a new system to classify gingival recession defects and to evaluate its agreement among different clinicians.
A new classification system was proposed and tested considering the following three factors: the amount of keratinised tissue ( <2 or ≥2 mm), the presence / absence of non carious cervical lesions and the presence/ absence of interproximal attachment loss. Kappa-statistics were performed to analyse the intra-rater and inter-rater agreement among three blinded examiners.
A total of 120 gingival recessions were evaluated using the new classification system. The intra-rater agreement ranged from 0.74 to 0.96 for the variable keratinised tissue, from 0.67 to 0.94 for the variable non-carious cervical lesions and from 0.70 to 0.92 for the variable interproximal attachment loss. The inter-rater agreement values ranged from 0.70 to 0.85 for keratinised tissue, from 0.54 to 0.59 for non-carious cervical lesions and from 0.54 to 0.77 for the interproximal attachment loss.
Based on the results of this study, the proposed new classification system showed moderate to substantial agreement among investigators when used in the present study population and was therefore able to diagnose the severity of gingival recession defects.
文献中已提出多种分类系统，但均未通过适当的统计分析进行验证，因此，这些系统在不同临床医生中是否以相同方式起作用尚不清楚。本研究的目的是调查一种用于分类牙龈退缩缺损的新系统在评估者内部和评估者之间的一致性，并评估其在不同临床医生之间的一致性。
提出并测试了一种新的分类系统，该系统考虑以下三个因素：角化组织的量（<2或≥2mm）、非龋性颈部病变的有无以及邻面附着丧失的有无。采用kappa统计分析三位盲法检查者之间的评估者内部和评估者之间的一致性。
使用新的分类系统共评估了120例牙龈退缩。对于角化组织变量，评估者内部一致性范围为0.74至0.96；对于非龋性颈部病变变量，范围为0.67至0.94；对于邻面附着丧失变量，范围为0.70至0.92。评估者之间的一致性值，角化组织为0.70至0.85，非龋性颈部病变为0.54至0.59，邻面附着丧失为0.54至0.77。
基于本研究结果，所提出的新分类系统在本研究人群中使用时，研究者之间显示出中度至高度一致性，因此能够诊断牙龈退缩缺损的严重程度。
