Department of Prosthodontics, Friedrich-Alexander University Erlagen-Nuremberg, Germany.
Int J Prosthodont. 2011 Nov-Dec;24(6):576-81.
This study tested the applicability of a multistage rating scale based on modified California Dental Association (CDA) criteria and the original criteria of the CDA for surface evaluation of all-ceramic restorations with the use of dental stone replicas, photographs, and scanning electron microscopy (SEM).
Two examiners clinically evaluated 105 all-ceramic restoration units in the posterior region after a mean observation period of 42.2 months; the examiners employed the CDA criteria and a detailed six-stage rating scale. In addition, standardized photographs and gypsum stone and epoxy replicas based on impressions were analyzed blindly using the same rating scales and examiners. SEM images of gold-coated epoxy replicas enabled indirect ceramic surface evaluation, serving as the gold standard to control indirect evaluation and clinical findings. The Cohen kappa was applied to test for concordance; intraclass correlations and Spearman rank correlations were calculated.
Statistically significant rating correlations of the clinical situation, photographs, and stone replicas with the SEM photographs were generated from both evaluation systems. With the use of the multistage rating scale, the highest rating correlation was found for stone replica-SEM (r = 0.61, P < .001), and the lowest for clinical photography-SEM (r = 0.5, P < .001).
A multistage rating scale based on modified CDA criteria is reliable for precise assessment of in vivo ceramic surface alterations. Stone replicas were found to be better-suited than photographs for the assessment of all-ceramic surface alterations and confirmation of clinical ratings.
本研究测试了一种基于改良加利福尼亚牙科协会（CDA）标准和 CDA 原始标准的多阶段评分量表，用于通过牙科石膏模型、照片和扫描电子显微镜（SEM）评估所有陶瓷修复体的表面。
两名检查者在平均观察期 42.2 个月后，临床评估了 105 个后牙区的全瓷修复体单元；检查者使用 CDA 标准和详细的六阶段评分量表。此外，使用相同的评分量表和检查者，对标准化照片和基于印模的石膏和环氧模型进行了盲法分析。涂金环氧模型的 SEM 图像可实现间接陶瓷表面评估，作为控制间接评估和临床发现的金标准。应用 Cohen kappa 检验一致性；计算了组内相关系数和 Spearman 秩相关系数。
两种评估系统均产生了临床情况、照片和石膏模型与 SEM 照片之间具有统计学意义的评分相关性。使用多阶段评分量表，石膏模型-SEM 的评分相关性最高（r = 0.61，P <.001），临床摄影-SEM 的评分相关性最低（r = 0.5，P <.001）。
基于改良 CDA 标准的多阶段评分量表可用于精确评估体内陶瓷表面变化。与照片相比，石膏模型更适合评估全瓷表面变化并确认临床评分。
